Michael Siegel, MD/MPH — Why Are Physicians Supporting The NRA?

This blog is written wholly by Michael Siegel, who earned an MD from Yale and an MPH from University of California, Berkeley. He has published extensively on gun violence and is currently Professor of Community Health Sciences at School of Public Health, Boston University.

There is no question that preventing gun violence is in physicians’ lane and it is heartening to see so many of my fellow physicians speak out in response to the NRA’s suggestion that physicians “stay in their lane.” However, while individual physicians are speaking out, a number of physician organizations are — behind the scenes — undermining gun violence prevention efforts by financially supporting members of Congress who are the main obstacle to meaningful gun violence prevention policies in this country.

In fact, these physician organizations are supporting members of Congress who are not only blocking sensible policies like universal background checks, but promoting a concealed carry reciprocity bill that would intrude upon states’ ability to protect the safety and security of their own residents.

Alex Yablon at The Trace has written a nice article which summarizes the campaign I and a number of other physicians have initiated to bring to light the hypocrisy of organizations like the American College of Emergency Physicians (ACEP), American College of Physicians (ACP), and American Medical Association (AMA), which are giving hundreds of thousands of dollars to members of Congress who take NRA money and oppose all public health policies related to gun violence prevention (and even CDC research on gun violence).

As I said in the article, these organizations are making public statements and taking public positions in support of gun policies. Which is great. But it doesn’t make sense to support candidates who work against these policies. For example, while the ACP issued a position statement supporting a number of important gun violence prevention policies: “the words rang hollow in the context of the medical group’s political giving. In the election cycle then drawing to a close, Siegel noted, the ACP gave $46,000 to national politicians supported by the NRA. Beneficiaries included members of House Republican leadership like Kevin Brady and Paul Ryan. The ACP also contributed money to Andy Barr and Greg Walden, strong proponents of the NRA’s top policy objective, national concealed-carry reciprocity.”

In response to this criticism, the American College of Emergency Physicians defended its contributions to Congressmen who are promoting national concealed carry reciprocity by stating: “ACEP is not a single-issue organization and our political giving through NEMPAC reflects the diversity of our membership.”

The diversity of its membership? What percentage of emergency physicians believe that the federal government should usurp states’ rights to protect the safety and security of their own residents by forcing them to allow residents of other states who have a criminal history of violence to carry guns in their states as long as they have a concealed carry permit in their own state? What percentage of emergency physicians oppose the idea that you should need a background check before being able to purchase a gun?

I’d also like to know what percentage of the ACEP membership believes that the Holocaust wouldn’t have happened if the small number of German Jews had possessed personal firearms, which is what NEMPAC-supported candidate Don Young of Alaska told an audience last year (prior to NEMPAC’s decision to support this candidate for re-election).

Let’s face it. The real reason why the American College of Emergency Physicians and other physician groups are contributing to members of Congress with A+ ratings has nothing to do with its members views’ on gun violence prevention. The reason for these donations is that these particular members of Congress support policies that are in the economic interests of physicians, such as malpractice reform, physician reimbursement, and paperwork reduction. And do you know what? I think it’s fine for these organizations to decide that their economic interests should take a higher priority than preventing gun violence. I don’t begrudge any organization the right to protect the financial welfare of their members.

However, if that is your decision, then there’s one thing you cannot do: claim to be a leader in the movement to prevent gun violence. You just can’t have it both ways. You cannot contribute to members of Congress who you know are going to block any gun violence prevention legislation and then pretend that you are fighting gun violence because your organization publishes a “position paper” supporting the very policies that you are helping to block. Tweeting that preventing gun violence is in your lane does little good if your organization is helping to prevent effective policies by contributing to A+ NRA-rated Congress members.

The Rest of the Story

The rest of the story is that the American College of Emergency Physicians, American College of Physicians, the AMA, and other physician organizations have a choice to make. Is it a higher priority to protect their financial interests or is it a higher priority to prevent gun violence in our nation?

Right now, they are choosing to make it a higher priority to protect their financial interests. And they certainly have that right. But don’t make that decision and then stand up in front of me and tell me that you are a leader in gun violence prevention.

If we as physicians want to enter the realm of public health, rather than just medicine, then there is a sacrifice that needs to be made. We need to change our priorities and definitively place the health of the public above our own financial and institutional interests as physicians.

If we are supporting candidates who want to dismantle the Affordable Care Act and take health insurance away from millions of Americans because there are other issues that we view as more important, then we’re not practicing public health.

If we are supporting lawmakers who want to undermine the rights of states to protect the safety and security of their citizens by forcing them to accept out-of-state concealed carry permits, even for violent offenders, because we are not “a single-issue organization,” then we’re not practicing public health.

If we are supporting lawmakers who will do everything in their power to block meaningful gun violence prevention policy reform because they are all in on malpractice reform, then we may be legitimately protecting our financial interests, but we are not practicing public health.

This is the decision that physician organizations face: What lane do they want to drive in?

Is their lane supporting politicians who are with them on issues of financial and institutional interest to them despite their opposition to gun violence prevention and other critical public health policies? If so, then that’s their right. I don’t begrudge them for that decision. But they can’t make that decision and then tell the public that gun violence prevention is their lane.

If physician organizations truly want to join us in gun violence prevention and public health, then how they spend their money has to reflect a different set of priorities.

The decision they need to make is what is their highest priority. And that decision, more than any position paper or tweet, will define whether they are national leaders in gun violence prevention.