‘This Is Our Lane’ must become a movement, not a moment

Monday, Nov. 20, 2018: An enraged gunman—evidently using a gun legally granted to him under a concealed-carry permit—guns down his ex-fiancée, a physician; a pharmacy resident; and a police officer at Mercy Hospital in Chicago, killing all three.

Four people are found shot dead “execution-style” in a house in Philadelphia.

A woman is sexually assaulted, shot, and killed at a Catholic Supply Store in Saint Louis.

Someone fires into a crowd of homeless people in Denver, killing one and wounding five others.

A girl in Baltimore, just turned 5, is caught in a crossfire and seriously wounded on her way to the corner store; her 7-year-old sister was shot and killed in July while sitting in the backseat of a car.

These are just a subset of the scores of Americans who were killed or injured by guns in the same 24-hour period, and of the estimated 99,000 people killed or injured by firearms in this country each year.

Yet numbers alone don't do justice to the unbearable grief of loved ones, friends, and colleagues who've lost someone to gun violence; the dedication and frustration of physicians and nurses who do their best to save the lives of shooting victims, yet often can't; the horrific and often lifelong suffering and disabilities of the gunshot survivors doctors are able to save; the ongoing trauma and associated mental and physical health problems of their family members; and the overwhelming sense of despair that none of us are safe, anywhere, any time, from gun violence.

If any issue is a public health one, gun violence certainly is.

It should be no surprise then that for over 20 years, the American College of Physicians has advocated for commonsense policies to reduce gun violence. On Oct. 20, 2018, Annals of Internal Medicine published an update of ACP's 2014 policy paper, “Reducing Firearm Injuries and Deaths in the United States.” The paper reaffirms many of ACP's 2014 recommendations, such as banning sales of assault weapons and requiring universal background checks, and proposes new policies found to be effective in reducing gun-related injuries and deaths:

• Close loopholes in the background check system that allow some domestic violence offenders to buy and possess guns;
• Enact laws to require that guns and ammunition be stored safely and securely; and
• Pass extreme risk protection order laws, which enable family members to ask a judge to temporarily order the removal of guns from another family member who is at imminent and extreme risk of harming him- or herself and others, with due process for the gun owner.

The National Rifle Association evidently did not like it that ACP spoke out again for commonsense policies to reduce injuries and deaths from guns. On Nov. 7, 2018, the NRA tweeted, “Someone should tell self-important anti-gun doctors to stay in their lane,” in reference to ACP's paper and related editorial content from Annals' editors.

The reaction to the NRA's tweet, from ACP, from Annals, and from the tens of thousands of physicians who replied to the NRA, was extraordinary, organic, and viral. Many physicians replied by tweeting graphic photos of bloodied floors, boots, and clothing, recounting specific examples (with patient privacy protected) of gunshot victims they've treated, using the #ThisIsOurLane and #ThisISMyLane hashtags.

Mainstream news outlets picked up on the story, including the New York Times, the Washington Post, and NPR. It led to op-eds and editorials, and pledges by physicians to talk to at-risk patients about gun violence, including making a commitment on Annals of Internal Medicine's website. The firm Altmetric, which tracks published research by the amount of attention received by conventional and social media, reported that out of more than 12 million research outlets tracked across all sources, ACP's position paper on firearm violence was in the top five percent of all research outlets that Altmetric had ever tracked.

Shortly after ACP released its updated policy, the American College of Surgeons and the American Medical Association separately and coincidentally released new gun violence policy recommendations that are consistent in nearly every respect with ACP's, amplifying physicians' voices at this critical juncture.

The attention that ACP's policy and advocacy bring to firearm violence prevention is good, in that it means we have begun to change the national conversation on gun violence. Yet it's not a cause for celebration, because behind it are stories of every person who has suffered grievously.

For physician advocacy on firearm violence to have a lasting impact, it has to be sustained. In the song “My Shot” from the hit musical “Hamilton,” the title character sings, “We have to make this moment last, that's plenty/ Scratch that. This is not a moment, it's the movement/ Where all the hungriest brothers with something to prove went?/ Foes oppose us, we take an honest stand/ We roll like Moses, claimin’ our promised land.”

Like this Hamilton's ode to the fight for American independence, #ThisIsOurLane must become a movement that lasts, not merely a moment. To this end, ACP will be reaching out to our sister physician organizations to collaborate on advocacy, policy, and communications, amplifying and sustaining our shared commitment to reducing gun violence. We'll create opportunities for ACP chapters to advocate for initiatives in their own states consistent with ACP's policies, and for ACP members to participate in the movement. Stay tuned for details.

Anyone who doubts ACP's influence, commitment, and effectiveness on this and other public policy issues should just ask the NRA. They unsuccessfully tried to silence us because they were worried we'd be effective, because we are. We didn't look for a fight with them, but when foes oppose us, we will take an honest stand, to claim the promised land of public policies that advance the health of patients.

Robert B. Doherty is ACP's Senior Vice President for Governmental Affairs and Public Policy.