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Space Coast Medicine August 2011 : Page 102

BREVARD PHYSICIANS NETWORK TECH SPOTLIGHT Physician Opinion BY LISA A. COSGROVE, MD FLORIDA GOVERNOR Rick Scott Legislators Dictate Patient-Physician Relationship CS/CS/HB 155 -PRIVACY OF FIREARM OWNERS GENERAL BILL by Health & Human Services Committee and Criminal Justice Subcommittee and Brodeur (Co-Spon-sors) Ahern; Artiles; Baxley; Caldwell; Corcoran; McKeel; Nuñez; Pilon; Smith; Stargel; Trujillo; and Van Zant. PRIVACY OF FIREARM OWNERS: Provides that licensed practitioner or facility may not record fi rearm ownership information in patient’s medical record; provides exception; provides that unless information is relevant to patient’s medical care or safety or safety of others, inquiries regarding fi rearm ownership or possession should not be made; provides exception for EMTS & paramedics; provides that patient may decline to provide information regarding ownership or possession of fi rearms; clarifi es that physician’s authority to choose patients is not altered; prohib-its discrimination by licensed practitioners or facilities based solely on patient’s fi rearm ownership or possession; prohibits harassment of patient regarding fi rearm ownership during examination; prohibits denial of insurance cover-age, increased premiums, or other discrimination by insurance companies issuing policies on basis of insured’s or applicant’s ownership, possession, or storage of fi rearms or ammunition; clarifi es that insurer is not prohibited from considering value of fi rearms or ammunition in setting personal property premiums; provides for disciplinary action. EFFECTIVE DATE: June 2, 2011 D espite valiant eff orts to defeat Privacy of Firearm Owners (HB 155/SB 432), the bill passed in both Florida House and Senate sessions and is awaiting Gov. Rick Scott (R-Fla.) to sign it into Florida law. Th e Florida Pediatric Society (the Florida chapter of the American Academy of Pediatrics [AAP]) maintains its opposition to this irrational and ir-responsible bill, which will restrict physicians’ ability to discuss gun safety. Ultimately, the bill will infringe on the patient-physician relation-ship, increase government intru-sion in the practice of medicine, and decrease the safety and health care of Florida’s children. Th e bill is an unnecessary intrusion into the physician-patient relationship as privacy regarding patient visits is currently covered under national law under the Health Insurance Portability and Accountability Act. Because of the existence of HIPAA, no law is needed. A substantial amount of research has shown fi rearms in the home pose signifi cant risks. Most notably the 2008 annual summary of vital statistics found that fi rearms contribute to otherwise avoidable suicide, homicide, and accidental death, which are among the lead-ing causes of death in children and teens. In the American Acad-emy of Pediatrics Bright Future 102 CENTRALFLORIDAMEDICINE.COM • AUG / SEP 2011

Physician Opinion

Lisa A. Cosgrove, MD

Legislators Dictate Patient-Physician Relationship

CS/CS/HB 155 - PRIVACY OF FIREARM OWNERS

GENERAL BILL by Health & Human Services Committee and Criminal Justice Subcommittee and Brodeur (Co-Sponsors) Ahern; Artiles; Baxley; Caldwell; Corcoran; McKeel; Nuñez; Pilon; Smith; Stargel; Trujillo; and Van Zant.

PRIVACY OF FIREARM OWNERS: Provides that licensed practitioner or facility may not record firearm ownership information in patient’s medical record; provides exception; provides that unless information is relevant to patient’s medical care or safety or safety of others, inquiries regarding firearm ownership or possession should not be made; provides exception for EMTS & paramedics; provides that patient may decline to provide information regarding ownership or possession of firearms; clarifies that physician’s authority to choose patients is not altered; prohibits discrimination by licensed practitioners or facilities based solely on patient’s firearm ownership or possession; prohibits harassment of patient regarding firearm ownership during examination; prohibits denial of insurance coverage, increased premiums, or other discrimination by insurance companies issuing policies on basis of insured’s or applicant’s ownership, possession, or storage of firearms or ammunition; clarifies that insurer is not prohibited from considering value of firearms or ammunition in setting personal property premiums; provides for disciplinary action.

EFFECTIVE DATE: June 2, 2011

Despite valiant eff orts to defeat Privacy of Firearm Owners (HB 155/SB 432), the bill passed in both Florida House and Senate sessions and is awaiting Gov. Rick Scott (R-Fla.) To sign it into Florida law. Th e Florida Pediatric Society (the Florida chapter of the American Academy of Pediatrics [AAP]) maintains its opposition to this irrational and irresponsible bill, which will restrict physicians’ ability to discuss gun safety.

Ultimately, the bill will infringe on the patient-physician relationship, increase government intrusion in the practice of medicine, and decrease the safety and health care of Florida’s children. Th e bill is an unnecessary intrusion into the physician-patient relationship as privacy regarding patient visits is currently covered under national law under the Health Insurance Portability and Accountability Act. Because of the existence of HIPAA, no law is needed.

A substantial amount of research has shown firearms in the home pose significant risks. Most notably the 2008 annual summary of vital statistics found that firearms contribute to otherwise avoidable suicide, homicide, and accidental death, which are among the leading causes of death in children and teens. In the American Academy of Pediatrics Bright Future Guidelines, pediatricians are given explicit recommendations to ask about firearms and safe storage as standard routine for child health counseling.

It is important to understand that, during an exam, several aspects of the home are discussed, including swimming pools, hazardous chemicals, smoke detectors, medications and firearms. Answers to these questions help parents protect their child from multiple forms of harm.

First Admendment Infringement

The Florida Pediatric Society remained strong in its opposition of the bill amidst a compromise between the National Rifle Association and the Florida Medical Association. Th e agreement between these two major organizations removed civil and criminal penalties from the original bill, yet introduced referral to the Florida Board of Medicine for possible sanctions if a physician harasses a patient or enters unnecessary information in a medical record regarding firearms in the home.

However, the compromise language does allow physicians to ask patients about gun ownership and enter it into the medical record, if it is found medically necessary. Th e physician can also choose which patients to see for reasons other than firearm ownership.

Th e AAP joined with the Florida Pediatric Society in opposition. Th eir involvement was extremely beneficial to the Florida chapter, as they provided governmental and communications staff support, press releases, leadership advocacy, and major media coverage. Th e AAP received further support from the American College of Surgeons and the American Academy of Child and Adolescent Psychiatry, who also vigorously objected to this bill.

Surprisingly, these bills are not new to the profession. Similar legislation has already been proposed in Alabama and North Carolina this year. In 2006, similar bills were introduced, yet subsequently defeated, in Virginia and West Virginia. Since Florida’s version of the bill has been pacified, these states and more receive bills that are expected to be worse.

Aside from the obvious infringement of the First Amendment, this potential Florida law raises medical malpractice concerns by limiting the appropriate standards of care a physician is obligated to perform. Referencing the Virginia and West Virginia bills, an article in the 2006 issue of Pediatrics noted that a pediatrician who failed to inquire about firearms and counsel appropriately might have been subject to a malpractice claim if a child were injured or killed as a result (Pediatrics 2006; 18:2168-72).

What’s next? Will physicians not be allowed to ask about sexuality issues in teens or whether the patient takes care of their teeth? We cannot help prevent health risks if we do not ask about them.

Read the full article at http://trendmag2.trendoffset.com/article/Physician+Opinion/800822/77404/article.html.

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