The vast majority of adults who live in homes with guns say they have never discussed firearm safety with a clinician, a new study finds.

Analysis of data from more than 4,000 adults who responded to a nationally representative survey revealed that that fewer than 10 percent of those living in homes with firearms have ever discussed safety with a clinician, according to the report published in the Annals of Internal Medicine.

“This shows that as clinicians and physicians we could do better at counseling patients on the risks of household firearms, given that many medical organizations, including the American Medical Association, the American College of Emergency Physicians and the American College of Physicians all advocate for clinicians and physicians to counsel patients on the risks,” said the study’s lead author, Andrew Conner, a medical student at the Frank H. Netter MD School of Medicine at Quinnipiac University in North Haven Connecticut.

Conner says he and his colleagues weren’t surprised by the findings.

“They’re pretty much in line with previous studies,” he said. “But ours is the first to look at the issue on a national level. Others have looked at specific subgroups, such as parents of children.”

In the last decade, more than a dozen states have introduced legislation aiming to prohibit physicians from asking their patients about gun ownership or gun safety precautions. Florida’s “gag law,” the most restrictive, was eventually found to violate physicians’ 1st Amendment rights.

“I think there are a lot of physicians who may not feel comfortable counseling patients on sensitive topics, especially given the political nature of the firearms debate” Conner said. “Lack of training is another commonly cited reason why physicians and clinicians don’t counsel their patients on this subject.”

To take a closer look at how often clinicians and physicians are talking to patients about gun safety, Conner and his colleagues turned to data from the second National Firearms Survey, conducted online from July 30 to August 11, 2019, by the survey firm Ipsos. All of those participating in the survey were adults living in homes with firearms, both owners and people who lived with them.

The participants were sampled from the Ipsos Knowledge Panel, a probability based web panel of approximately 55,000 noninstitutionalized, English-speaking adults designed to represent the U.S. population, with the exception of active military personnel.

Respondents were asked: “Has a physician or other health care provider ever spoken to you about firearm safety?” Those who answered yes were asked a series of other questions: where did the discussions occur (outpatient medical visit, outpatient mental health visit, emergency department or other setting); who the patient was (the respondent, another adult or a child); and what was discussed in the most recent encounter. The survey data included information on socio-demographics and whether there were children in the home.