I’ve been a participant and observer in the American Academy of Physician Assistants (AAPA) House of Delegates (HOD) deliberations for most of my 15 years as a PA. It’s an exciting, vibrant body of PAs who represent states, specialty organizations, and now caucuses. The policies made by the AAPA play a key role in projecting the identity and ideals of the PA profession to the world. 

Anyone who has been a PA knows that the diversity of our profession is one of its many strengths. But with this diversity comes challenges, and one of those challenges is finding common ground regarding gun policies.

It seems that about every other year, a major gun control policy or two will be introduced at HOD, often following a high-profile mass shooting. After the 2012 Sandy Hook shooting that killed 20 children, several policy efforts came to the 2013 HOD. Such measures typically support the AAPA taking a stand for increased gun control by supporting stricter background checks, decreased access to weapons designed for combat-type use, increased outreach to families regarding safe storage of weapons, etc. Of course, none of these AAPA policies have any legal standing or effect; they are instead proposed as statements of organizational philosophy. They usually appear to be intended as moderate ways for PAs to express concern about the carnage in our communities from gun violence. 


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The 2013 HOD was a frustrating few days for supporters of the post-Sandy Hook policy initiatives. While there was support from many delegates, the discussion also included angry and emotional denunciations of the proposed policies, criticizing them as overreaching, pie-in-the-sky, uninformed, and unwelcome. When gun issues come up, there is usually at least one delegate who threatens to renounce their AAPA membership if such policies are enacted. Proponents of such policies often retreat quickly in the face of such strong and heated denouncements.

Personally, I usually conclude that if such moderate safety policy initiatives fail so completely, even in the context of some recent multi-victim shooting, then maybe it’s not worth the effort to continue to bring such initiatives forward. Maybe that’s fatalistic and cynical, but I see fewer and fewer PAs who have the appetite for such heated discussions.

Some of this gun control opposition relates to the PA profession’s proud military origins. As a result, many members have been around guns and military weapons for much of their lives and feel comfortable with their use and presence in society. And without a doubt, many PAs also obtain permission to carry concealed weapons and may even carry those weapons at the HOD sessions (realizing this has been a major adjustment for me).

What proponents of gun control see as modest public safety efforts are framed as foreboding harbingers of massive government agency gun grabs by PAs who oppose increased gun control. At the 2013 HOD after Sandy Hook, some of those opposed to the initiatives would rise to speak and start their comments with “as a proud lifetime member of the National Rifle Association…” Others described heirloom weapons that had been handed down by family members, which might become illegal if assault weapons were restricted (prompting some lighthearted back-and-forth by those giving testimony about offering to buy such weapons from each other). For me, it was painful to watch in the wake of Sandy Hook. I consider myself a friend and colleague to some of those who offered such testimony, further solidifying my feeling of hopelessness about passing such policies.

Now, with the gun-massacre-of-the-week events becoming commonplace in the United States, it appears that those opposing any sort of pro-gun control policy response are more dug-in than ever.

It will be interesting to see if any such initiatives come forward in the 2016 AAPA House of Delegates. If they do, it’s a sure thing that some delegates will describe the policies as over-reaching, uninformed products of people who know nothing about guns. And once again, someone will threaten to quit the AAPA should such policies pass.

The only way to ever pass such policies will be to bring together the gun safety  advocates and PAs who know guns, know shooting, and may even carry concealed weapons at HOD. Such an unlikely collaboration might actually be able to create policy initiatives that are well-reasoned, accurate, and based on knowledge of weaponry. Whether such collaboration can occur is yet to be seen, but it’s worth a try. Any takers?

Jim Anderson, MPAS, PA-C, ATC, DFAAPA, is a physician assistant in Seattle.