In particular, a majority of physicians who responded to the survey said they were worried about the potential ethical consequences in the doctor-patient relationship if they participated in the concealed-weapon permit process.
"This is not a small problem," said Dr. Adam Goldstein, corresponding author of the study and a professor in the Department of Family Medicine at the University of North Carolina School of Medicine. "More than 20 percent of the physicians we surveyed have been asked to sign competency permits for concealed weapons, and a majority of them do not feel they can adequately assess the physical or mental competence of their patients to safely have a concealed weapons permit."
The study, published as a research letter in the June 29, 2014 issue of the New England Journal of Medicine
, is believed to be the first that examines physicians' attitudes, beliefs and behaviors regarding their emerging role in the assessment of physical and mental competency and the licensing of concealed weapons.
First author of the study is John Pierson, a second-year medical student at UNC. Co-authors are Adam Goldstein, MD, MPH; Anthony Viera, MD, MPH; and Kathy Barnhouse, MD from the UNC School of Medicine; James Tulsky MD from the Duke University School of Medicine; and Barak Richman, JD, PhD from the Duke University School of Law.
The survey was sent to 600 physicians registered with the North Carolina Medical Board and in active practice in October 2013. Of the 600 surveys sent, 225 completed surveys were returned.
The survey found that physicians involved in concealed-weapon permitting sign off on permits almost 80 percent of the time, despite their uncertainty. "If physicians do not feel that they can adequately assess their patients' competence yet are still giving approval for concealed-weapon permits, then there is something wrong with the system," Pierson said.
"There are things we can do now to change this," said Barnhouse, a professor of Family Medicine at UNC. "We discovered that the great majority of physicians feel that assessments for concealed weapons permits should best be done by providers specifically trained in making such assessments, presumably with standards to make assessments about mental and physical competence."
The study concludes that more research in this area is needed.