To support their view that guns are a public health issue, the association of 137,000 internal medicine physicians (Murthy is an internist himself) noted that there are about 11,000 homicides, 19,000 suicides and more than 2,000 fatal accidents involving guns every year. The total is down from its 1993 peak, and the number of gun homicides has declined even more rapidly, but the figure is still one of the highest in the developed world.

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The average of 88 gun deaths per day is "a good-sized airplane crash every three days," said Molly Cooke, the organization's president.

Moreover, the position paper noted, a study of three U.S. cities shows that for every time a gun is used for self-defense, there are four accidental shootings, seven criminal assaults or homicides and 11 attempted or completed suicides. In 12 states and the District of Columbia, firearm-related deaths exceed deaths from car accidents.

Some of the group's recommendations are sure to draw fire from gun-rights groups, including:

• Doctors should counsel patients on the risks of having guns in the home, particularly if children, adolescents, people with dementia, the mentally ill or people with substance abuse problems live there.

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• Universal background checks for gun-buyers, a ban on guns that don't show up on metal detectors and tracers and tags on guns and ammunition.

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• Laws to ban the sale and manufacture of guns for civilians that are designed with features that "increase their rapid killing capacity," i.e. assault weapons and semiautomatic weapons. Cooke called assault weapons "rapid slaughter machines" that were developed for military purposes. "We really could not persuade ourselves that there was a good reason for the average Joe Citizen to have a gun like that," Cooke said.

• Built-in trigger locks and signals that guns are loaded.