Many Surgeons Work In War Zone

William Schwab hasn’t ever gone to war, but the 51-year-old surgeon says he sometimes thinks he’s in one.

“We average about 500 gunshot wounds a year,” said Schwab, chief of critical care and trauma for the Hospital of the University of Pennsylvania.

“I trained in the U.S. Navy during Vietnam, and it’s similar,” he said. “Think of the phrase ‘incoming wounded.’ That’s what it’s like.”

A survey published in Sunday’s issue of the Annals of Internal Medicine finds that 87 percent of surgeons and 94 percent of internists across the country believe it’s time to consider gunshot wounds a public health epidemic - akin to AIDS, alcoholism and tobacco use.

Doctors should play a more active role in trying to prevent the injuries, an accompanying position paper says, whether it’s supporting more stringent gun-control legislation or simply taking time to counsel patients.

The position paper predicted that bullets will kill more people than automobile accidents by 2003.

The authors also noted that more teens today die from gunshot wounds than from all natural causes combined, and that firearms in the home make homicide three times more likely.

The survey involved 915 doctors who answered 55 questions, including the extent of their personal and medical experience with firearms and their opinions on public policy.

Less than 20 percent of the surgeons and internists reported discussing firearm ownership or storage with their patients.

The survey showed that 64 percent of the surgeons and 84 percent of the internists said they thought stronger measures were needed to reduce gun-related deaths, which reached 39,720 in 1994. That includes 13,593 slayings and 20,540 suicides, the journal said.

There were also 1,610 accidental shootings, and the remainder were classified as firearm-related incidents.

The accompanying position paper noted that annual firearmrelated deaths increased by more than 60 percent from 1968 to 1994.

“If this was any other disease, if this was a virus, the public would be demanding a cure,” said Schwab, who co-wrote the journal’s article about the survey. “They’d want something done about it. The problem is nobody is willing to come out and say ‘This is a public health emergency”’ as former Surgeon General C. Everett Koop did with AIDS, he said.

The doctors who said they didn’t believe gunshot wounds were a health epidemic tended to be older men who work in smaller cities.