Several letters question the quality of the survey reported in our article. Readers should be aware that this survey was conducted by NORC (the National Opinion Research Center), an independent survey science center based at the University of Chicago. The NORC is one of the United States' leading survey research organizations; it has a national and international reputation for highly sophisticated and rigorous methods and is especially experienced in surveys involving physician respondents. Scientists at NORC constructed the survey to be statistically representative of the full geographic and demographic spread of the more than 160 000 members of ACP and the American College of Surgeons. The NORC also has decades of experience with balanced, unbiased survey questions about gun ownership and firearm policy attitudes in their general social survey.

Dr. Faria believes that considering firearm injury a public health problem is misguided. The ACP disagrees with his position, and is on record supporting the Centers for Disease Control and Prevention (CDC) programs to study the epidemiology of injury and consequences of different approaches to injury prevention throughout the United States. The reports cited by Dr. Faria claiming that gun ownership increases personal safety are contradicted by other studies published in peer-reviewed medical journals [1]. Conflicting studies are probably inevitable in addressing questions for which epidemiologic techniques must be used to study complex and emotionally charged issues often associated with political and ideologic conflicts. We believe that the CDC has the scientific expertise to conduct the research needed to create national public health policy, balancing individual freedoms with public safety-much as we have done with product and food safety regulations, alcohol and tobacco use, and traffic safety, among others.

The premise of the ACP position paper is not to pass judgment on guns or gun owners. To the contrary, many respondents to our survey are themselves gun owners. They see that the public health implications of firearm injury and death, most of which occurs not in a criminal context but in accidents or suicide, call for policies that can diminish these injuries and deaths. Physicians, among others, are concerned with these measures, much as they are with the use of seat belts, reduction of drunk driving, safe sex practices, and bicycle helmets. None of these practices are inherently medical, but physicians can be effective in reinforcing behaviors that improve health and reduce risk for injury.

Of course, physicians are increasingly pressed for time in their interactions with patients, and yet managed care organizations encourage physicians to include these preventive counseling in their practice, including questions about gun ownership and safety measures.