Medical Screening forms asking about guns in the home

[cbusht]

I recently completed a Medical screening questionnaire. Under the section named "Social Health" It directed the following:
Mark any of the following that currently apply to you.
1. I am single.
2. I live alone.
3. I feel very lonely much of the time.
4 i am a single parent with children at home.
5. I am having serious relationship problems.
6. I've recently experienced a personal crisis(lost a loved one, divorce, lost job).
7. I live or work in a high crime neighborhood.
8. My living situation is very crowded.
9. I am caring for an elderly parent.
10 I am exposed to domestic violence or abuse.
11.There is a handgun in my home.

I was required to identify myself on this questionnaire but was not required to sign something as to the veracity of the answers given.
A few years back I notified the NRA of such question and was told they were working to have that kind of question eliminated.

It hasn't been.

c

[bubbadavis]

Just make sure you have more than one handgun in the house... Then you don't have 'a' handgun in the home.

[SomeGuy]

The NRA hasn't got direct control over this, they push legislation. A slow way to do the job, and not even a promise of victory.

Better solution: Tell your primary provider this bothers you, and you didn't come to the office to be given anti-gun lectures/have your time wasted in such a manner. Depending upon your providers response, you may find it best to let your wallet talk for you.

In the end, wouldn't we be better off supporting pro-gun providers, so our money goes to our friends?

[2ndtonone]

Depending upon your providers response, you may find it best to let your wallet talk for you.
Very well put "someguy" I to agree with this statement, also you can always put the pressure back on you medical staff and doctor by answering questions with (N/A) not applicable! This should put a red flag up with the staff/Doctor for you to see if it is time to find another physician period. And oh payment of Co-pay not due untill services renderd, No service for medical attention No pay after all you went for health issues not " Obama care" Enough Said.....

[Fred762]

Yeah I sometimes see these types of 'surveys'..when I do all it makes me do is think.."gee, I wonder how the real criminals answer these same questions"
Then I remind myself that it seems WE honest, hard-working TAXPAYERS are somehow becomming the 'real criminals' ....to these questioners.
Personally I'd go find another doc or ins company.

[Mousegun]

I would simply say, "When the NRA starts asking the Medical Association about medical procedures, then the Association's doctors can start asking me about guns, till then, no comment".

[johnharris]

Tennessee Medical Association has told Rep. Faison (who has a bill pending to ban this practice in Tennessee) that they are required by law to ask these questions. I would like to know from those who are in the medical field if any such law or regulation actually exists.

[fl0at]

Best I can guess, and I'm still in school, so SomeGuy would be better here than I, is that certain in house policies require certain questions to be asked, and BME requires that all policies must be adhered (http://health.state.tn.us/Downloads/BME_Pol110606.pdf). Beyond that, specific law? Couldn't say.

The only other thing I could envision, is that either BME or billing requires certain documentation in order to bill, as in, if you bill for a higher level visit than you actually take part in, you are committing fraud. So if a Level-4 E/M requires that X documentation be completed, and you don't complete X documentation, you can't bill at Level-4 and thus have to bill at Level-3. If, and I do mean if, because I don't really know, that documentation requires that firearms must be screened/counselled, and the provider isn't allowed, then they'll never be allowed to bill at that level.

The nuances of billing and documentation is really insurance provider specific, so... you might have to contact a few insurance companies and see if they have any requirements. I'd probably start with a well-child visit, say 12 month old well-child, and ask if they have a requirement to ask about firearms. If they say yes, and it is required to bill for a certain level, then that is the problem TMA is raising.

I would assume that is what they mean, but the complexity of billing and documentation requirements is beyond my limited knowledge.

As another possible nuance, in order to maintain Board Certification, each Board might have specific guidelines and requirements.

[fl0at]

John, after further digging, I think TMA is talking about the Federal ruling on the Florida attempt at this law. The overview is here (http://www.ama-assn.org/amednews/2011/0 ... sc0926.htm).

It effectively argued that barring questioning is a "gag law" and is in violation of 1st Amendment rights. I'm not sure if it has progressed further than the current ruling.

Hope this helps.

[SomeGuy]

As an RN working in an acute care facility, we never ask this. No such law requires it of us.

As a FNP student, nothing has indicated we MUST ask this.

As a person who has read the entirety of the Nurse Practice Acts, and the regulations from the BON, I have seen no such requirement.

Lastly, as a person who has worked with quite a few docs, and gone to multiple practices, and only once seen this question (and several years ago at that), I am inclinced to say that either a majority of practicing physicians are violating a law nobody aside from the TMA knows, about or the TMA rep is full of it.

As float mentioned, it may be a billing issue, however, there are plenty of other things documentable to code for a higher rate. I don't buy for a second that without the ability to assess for guns in the home docs will lose money.

[fl0at]

The AAP has no requirement, and only advises that it should be done, but makes no stipulation. I looked through a quick level-4 billing template, and for a level-4 for a new patient, you have to do a full PFSH, but no requirement to screen for a firearm.

No requirement to screen exists, as near as I can tell.

[Tim Nunan]

Could use the form in the third post here: viewtopic.php?f=12&t=2516&hilit=+FIREARMS+SAFETY+COUNSELING