Shoot to Bill? by Pat Conrad MD


While most of the trade journals, political hat passing, and anything marked “AMA” go immediately to the trash or the birdcage, I keep browsing through “Family Practice News.” Not only does it allow me to keep up with the continued ruination of western medicine, but also it allows me to exercise an admittedly morbid fascination with how someone could get hooked up with a discipline that moves in such utter contempt of that person’s values.

The August issue on-the-fold: “Expect dementia patients to have a gun at home”. The dateline is – sigh – Copenhagen. At the July 2014 Alzheimer’s Association International Conference in Denmark, a busybody fourth-year medical student investigator named Jason Hsieh presented his findings with this keystone plea: “This combination of a growing elderly population and guns presents some concerning health issues.” He notes that the elderly have “the highest suicide rate of any population segment, and a firearm is the most common method of carrying out that act.”

Mr. Hsieh then catalogues all the badness of dementia, including aggression, hallucinations, and paranoia (how this makes them different form the average AARP member I’m not sure).

And here Family Practice News swoops in, informing that “National statistics already identify gun ownership as fairly high among U.S. elders”: as high as 27 % who own one and those that do are likely to own more than one – “up to six, in fact.” Such were the conclusions on a chart review of 495 patients at the Cleveland Clinic. “Of these, 89 (18%) lived in a home with a gun.” FPN furnishes a nice inset pic of the author, and a QR code where we can watch him being interviewed. He ends with the cautionary “Doctors have no legal right to remove weapons from the home.” FPN adds, “All they can do is encourage carers (sic) to remove or unload and lock it away.”


  • that FPN would add such an admonition editorializes that they wish FP’s could do more. That is NOT our job.
  • a fourth year med student presenting this topic in a European Union state more than indicates his ideology, and his inflated sense of self-worth. (Author’s note: Denmark certainly has socialist creepings, but I spent a week there in 1987 and have never been around a more fun race. Cin cin!)
  • If old Uncle Herschel ain’t right, then by all means, take away his car keys, his gun(s), and while we’re at it, his ability to vote and dial 911 for constipation. If we’re going for common sense, then lets spread it around. But…
  • …and here’s the kicker: mealy-mouthed, busy-body One Worlders who present papers in foreign countries that encourage getting into other peoples’ business tend to gain an audience in arrogant academia, and amongst bureaucrats and politicians who are already well disposed toward such reflexes. The truly insidious feature of Mr. Hsieh’s study and FPN’s editorializing is that it takes something good and mutates it.

Authentic medicine should mean looking out for your patient, and inquiring about whether or not Aunt Pearly is buying bulk ammunition right after she takes her Aricept. A lot of us already learned that in residency, Mr. Hsieh. It should not include stupid, anti-freedom studies that will, I guaran-damn-tee it, find their way into government hearings, policy proposals, and probably core measures.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “Shoot to Bill? by Pat Conrad MD

  1. Doug Given MD
    September 17, 2014 at 11:02 pm

    Great rant about this article and the author of such high level research (a 4th yr med student). Love it and couldn’t agree more. Where I practice, not having a gun indicates a level of dysfunction.

  2. Madelyn Sieraski
    September 13, 2014 at 12:51 pm

    My patients took a perverse pleasure in telling me about the lies they told me they were teens . Sexual activity, drug use but no guns. There are a lot of people who hunt in this area. I wonder how many secrets they still have.

  3. R Watkins
    September 12, 2014 at 10:50 am

    Based on intensive personal research, I’ve determined that each issue of FPN contains a minimum of 8 new tasks family physicians should/must do at every office visit.

  4. Sir Lance-a-lot
    September 12, 2014 at 6:51 am

    Excellent, Pat.

    Essentially, these bureaucratic busybodies who insist that we ask specific questions and check boxes, are doing nothing more than undermining the trust between physician and patient, and the practice of medicine itself.

    I read the charts of patients who have seen our pediatricians all the time. They all have a series of boilerplate questions inserted into the history section asking about guns, seatbelts, bicycle helmets, and all that crap. You wanna guess how many kids I see who have guns in their houses (or who don’t wear bicycle helmets)? Essentially none. Zero. In a conservative state with minimal gun laws and a huge proportion of gun owners. How can that be? The parents do exactly what I would do in their position: They lie. Makes the visit go more smoothly, avoids an annoying lecture from a busybody doctor who may not even know which end the bullet comes out of (though we do have a few real sportsmen at the hospital as well), and keeps their private information out of databases that may go God-knows-where.

    In the long run, all this does is normalizes lying to your primary doctor (as if there isn’t enough of that, anyway – if patients ate as much fiber as they claimed, there would be no bran flakes left at the supermarket), and makes it so routine as to be second nature. Your doctor needs to be someone you can trust, someone whom you can level with (sooner or later), so he can help you to help yourself. This BS is turning the physician / patient relationship into a bureaucrat / patient relationship, in which patients will learn to be just as forthcoming as they are with the clerk at the Motor Vehicle office.

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