ACS Firearm Injury Prevention Efforts Continue to Make a Difference

At Tuesday’s Special Session, Surgeons as Leaders: An Update on Firearm Injury Prevention, ACS leaders discussed the College’s multidisciplinary efforts to address firearm violence.

Since 2018, when firearm deaths—including both suicides and homicides—exceeded motor vehicle deaths as the leading cause of injury-related death in the US, the ACS and its Committee on Trauma (COT) have expanded efforts to address the problem, according to Deborah A. Kuhls, MD, FACS, the ACS Second Vice-President and member of the COT.

The ACS surveyed members to gauge their overall perspective on firearms and the College’s work. While there were split opinions on firearms in general, members were largely in favor of the organization having a voice.

Dr. Kuhls said that 75% of those who responded to the survey felt it was extremely or very important for the ACS to support policy initiatives that would lower the incidence of firearm injuries.

The broad areas of agreement, without significant polarization, represent an opportunity to find the common approaches to firearms violence and firearm ownership in general, explained Ronald M. Stewart, MD, FACS, a Past-Chair of the COT and Past-Medical Director of ACS Trauma Programs. 

The COT has made a conscious choice to frame the firearm violence epidemic as a medical and public health problem, not a political problem, Dr. Stewart said, which makes it easier to bridge the gap between conflicting narratives regarding firearms.

“I believe that we’ve objectively proven that our group of 500 opinionated surgeons, who have well-formed positions on these issues, have worked together with a common goal while recognizing differences,” noted Dr. Stewart.

From there, a common narrative emerged, and the goal of advocating for federal research funding to match the burden of the surgical disease became an attainable goal.

The COT’s aim to include surgeons who are firearm owners in its initiatives has been a notable part of their success, said Brendan T. Campbell, MD, MPH, FACS, Chair of the COT Injury Prevention and Control Committee, in discussing the COT Firearm Strategy Team (FAST).

Firearm owners often are approached as part of the problem, and less often as part of the solution to violence, according to Dr. Campbell, and the public health model shows that it is critical to get stakeholder and community engagement to address issues with any meaningful, lasting results.

“Firearm owners are trusted messengers in this model,” Dr. Campbell said. “If we’re going to address this in a scientific way that adheres to the public health model, we need trusted messengers, and we need to talk about the issues in a culturally competent way.”

The initial FAST workgroup, comprising nearly 20 firearm-owning surgeons and several COT leaders, worked to create the FAST recommendations.

Addressing this societally pervasive problem will require building multidisciplinary partnerships, according to Eileen M. Bulger, MD, FACS, Medical Director of ACS Trauma Program and Past-Chair of the COT.

In 2019, the ACS convened the first Medical Summit on Firearm Injury Prevention, which hosted major medical organizations including physicians, nurses, and paramedics, among others. 

The group found a high level of consensus on firearm injury as a public health issue and discussed how to address the root causes of firearm violence.

“There are societal problems that put people in communities where they are at increased risk,” Dr. Bulger said. “We know that we have strategies we need to employ that look at these social determinants of health, or social determinants of violence, in our society.”

After the first Summit, the COT created the ISAVE (Improving Social Determinants to Attenuate Violence) task force, a multidisciplinary group comprising surgeons and community advocates. 

The COVID-19 pandemic and its associated increase in firearm violence led the ACS to convene the Second Medical Summit on Firearm Injury Prevention in 2022, which focused on public policy initiatives, addressing community violence, and effectiveness health sector community. Afterward, the ACS and other groups launched the formal Healthcare Coalition for Firearm Injury Prevention, which more than 40 organizations have joined to date.

The developing efforts in this space are proving critical in moving the needle in local, state, and federal policymakers, according to Joseph V. Sakran, MD, MPH, MPA, FACS, an ACS Governor in the Health Policy and Advocacy Workgroup and COT member.

The College has been leveraging its effective advocacy apparatus in efforts to increase firearm injury research funding and to support proposed legislation, Dr. Sakran said.

The Bipartisan Safer Communities Act, which was signed by President Biden in 2022, included several ACS-supported elements, and the White House recently launched the first Office of Gun Violence Prevention to lend more power to the joint efforts of the multidisciplinary firearm violence prevention advocates in communities and states. 

Dr. Sakran encouraged surgeons to get out of their comfort zones when it comes to advocacy.

“As clinicians, we’re not necessarily trained to do this work beyond the bedside,” Dr. Sakran said, “but I think we can do this in a way that allows us to be collegial and respect the other side and, most importantly, figure out the data-driven solutions that will actually save lives.”

Watch the full session on-demand through the virtual conference platform.