Illustration: Damon Dahlen/HuffPost; Photos: Getty Doctors' groups continued to fund pro-NRA politicians like Pete Sessions, Ted Cruz and Steve Scalise, even as the organizations and their members opposed the NRA’s agenda.

Until recently, it would have been unusual to see a doctor publicly telling the National Rifle Association to “shut the fuck up.”

But in recent months, gun reform advocacy has taken on a bold new face in the medical community. The shift began in November when the NRA told doctors to “stay in their lane” in response to new guidelines from the American College of Physicians on how to protect patients from firearm injury or death.

Doctors defiantly embraced the gun group’s slight, launching a campaign of activism under the banner “This is our lane.” They’ve been speaking out about the need to confront gun violence ever since, sharing stories from the frontlines of what they’ve deemed a public health crisis, championing policy measures like universal background checks for firearm sales, and even launching the occasional profanity at the NRA.

The medical profession is now being painted as a foil to the NRA ― an altruistic counterweight to a gun lobby that reliably thwarts progress on reform. A number of professional associations that represent doctors have also stepped up their advocacy. In December, a handful of these groups announced a partnership with Giffords, the gun violence prevention nonprofit founded by former Rep. Gabrielle Giffords (D-Ariz.), in an effort to push Congress to fund research on firearm injury and death through the Centers for Disease Control and Prevention.

As many of these doctors’ groups have touted gun reform, however, they’ve also continued to support some of the very members of Congress most responsible for blocking those efforts. Over the 2018 election cycle, the political action committees of seven leading organizations donated some $162,000 to a total of 18 U.S. House and Senate candidates who had received an A-plus rating from the NRA, a HuffPost review of campaign finance data found.

There are plenty of lawmakers who would likely oppose any new gun restrictions, but the NRA reserves its A-plus rating for its staunchest allies ― legislators who both consistently oppose new firearm regulations and are most likely to lead the charge to roll back existing gun laws.

The largest contributions include nearly $55,000 from the American Medical Association, $54,000 from the American College of Emergency Physicians and $23,500 from the American College of Surgeons.

Critics say these donations call into question whether the medical groups truly are committed to gun reform.

The organizations purport to represent the views of their rank-and-file members, many of whom are now openly advocating for stronger gun laws and other firearm safety initiatives. Though typically delivered in more muted tones, the groups’ own advocacy has included position papers and policy recommendations aimed at curbing gun violence.

While this narrative plays out in public, the PACs funded by these doctor groups have been discreetly boosting candidates who vehemently oppose such reform efforts. Much of the money these PACs spend on political donations comes from contributions paid to the doctors’ groups by their members, some of whom may not realize their money was used to help elect extremely pro-gun politicians.

This pattern of campaign donations goes “beyond hypocrisy,” said Dr. Liza Gold, a psychiatrist and Georgetown University professor who led an unsuccessful push to get the American Psychiatric Association’s PAC to stop giving to pro-gun candidates.

‘Beyond Hypocrisy’

The American Psychiatric Association was among the top medical organizations that co-authored a 2015 paper calling gun violence a public health problem and renewing their commitment to gun violence prevention policies. Other signatories included the American College of Emergency Physicians, the American College of Surgeons, the American Academy of Family Physicians and the American College of Physicians, all of which donated to candidates with A-plus ratings from the NRA in 2018.

If these groups were truly invested in firearm reform, they’d recognize that financial support for extreme pro-gun lawmakers is self-defeating, Gold said.

“It’s absolutely true that the reason we don’t have gun reform legislation in the United States is because the NRA-bought politicians have consistently blocked it,” she said. “I don’t think there’s a way around that. It’s a very obvious issue.”

According to the medical PACs shelling out the money, however, their political donations are hardly noteworthy. HuffPost reached out to all seven of the groups on the list above. Only the American Psychiatric Association declined to comment. The others responded with a common explanation: They are bipartisan and not “single-issue” organizations, so they don’t withhold support from lawmakers due to disagreement in one area of policy.

“We know of no candidate or member of Congress who agrees with us on every one of the thousands of policies that guide the AMA’s advocacy,” said Dr. Barbara McAneny, president of the American Medical Association.

“There’s a high priority on [gun violence], but I can’t tell you that this issue is our top priority,” said Christian Shalgian, director of advocacy and health policy at the American College of Surgeons.

I understand that this is business as usual inside the Beltway, but it’s not OK for me on this issue. Dr. Liza Gold, a professor at Georgetown University

To be sure, these doctors’ groups are not primarily dedicated to gun violence prevention. And their donations to lawmakers with A-plus ratings from the NRA constitute only a small share of the millions of dollars in campaign contributions they make in a given election cycle.

PACs for organizations like the American Medical Association and the American College of Surgeons focus on a range of issues, including health coverage for the uninsured, the opioid crisis, drug pricing, liability reform and reduction of medical paperwork. With such a broad agenda, representatives for the groups argued that they couldn’t be expected to take a principled stand on a single matter to the detriment of others — especially an issue such as gun reform, where the deep partisan divisions extend to their own members.

To pursue that agenda, the American Medical Association donated to 17 candidates with A-plus ratings from the NRA who ran in 2018. They gave $5,000 each to the campaigns of Sen. Ted Cruz (R-Texas) and Rep. Steve Scalise (R-La.), both of whom have supported arming teachers in response to school shootings, a proposal the AMA has publicly opposed. The group also gave to a number of lawmakers who’ve gotten behind an NRA-backed proposal to force states and localities to recognize concealed carry permits issued in other states, even when the licensing process there is less stringent.

The American College of Surgeons donated to four candidates with A-plus ratings from the NRA, including $10,000 to Scalise and $4,500 to then-Rep. Pete Sessions (R-Texas). Sessions was widely regarded as a top NRA ally until he was defeated in November by Democratic challenger Colin Allred, who ran on a platform that included a commitment to gun safety. Gun violence prevention organizations contributed to Allred’s campaign. The ACS did not.

Politics vs. Principles

Viewed through the lens of Washington power-broking, medical PACS don’t operate much differently than the countless lobbying groups that use their checkbooks to jockey for political access in Congress. While certain organizations may take a more scrupulous or targeted approach than others, the political influence game is largely driven by money, not rigid ethical standards. PACs can be shrewd and pragmatic, donating to whomever is most likely to win or even supporting candidates on both sides of the aisle in order to hedge their bets.

But Gold and other critics argue that playing the political game is no excuse for abandoning principles ― especially when these doctors groups are largely in agreement that gun violence is a major public health issue.

“I understand that this is business as usual inside the Beltway, but it’s not OK for me on this issue,” Gold said. “It’s become very, very clear that if we continue to do business as usual and if we accept the status quo, we’re not going to be able to effect meaningful gun reform.”

Gold challenged medical organizations to “step up and be leaders” by refusing to spend their money on candidates who undercut their advocacy on gun violence.

“If we were talking about some kind of infectious illness taking out 35,000 people a year and the government didn’t want to do anything about it, I find it hard to believe that these medical organizations would continue to donate to politicians who refused to address the illness,” she said.

If we want this to be our lane, we can’t have our organizations supporting legislators who are destroying legislation that we think is important. Dr. Michael Siegel, a professor at Boston University School of Public Health

Indeed, there appears to be widespread consensus among doctors on gun violence advocacy. In a survey of more than 250 members of the American College of Surgeons’ trauma committee (taken in late 2015 and early 2016), 88 percent of respondents said that reducing firearm injuries should be either a high priority or the highest priority for the group.

Doctors who belong to these industry organizations may be completely unaware that the PACs are funneling their money to pro-gun politicians, said Dr. Michael Siegel, a professor at Boston University School of Public Health.

“Part of what we’re trying to do is simply raise awareness and educate physicians who may be members of these organization that this is what’s going on,” Siegel said.

Since November, he has published a series of blogs and spoken to the media, criticizing medical PAC donations to pro-gun politicians and encouraging them to stop the practice. Siegel said he plans to do a full accounting of the groups’ support for NRA-funded candidates ― that information, he said, should make doctors “uncomfortable” ― and ultimately to initiate campaigns to stop similar donations in the future at each of those groups.



“Where you put your money basically tells the world where your priorities are,” Siegel said.

So far, the doctors groups don’t seem too concerned. In November, Bob Doherty, a senior vice president at the American College of Physicians, struck back at Siegel in a blog post calling his criticism “wrong-headed” and defending the organization’s campaign contributions and advocacy efforts.

Doherty concluded that Siegel’s objections would end up creating division among physicians, which would only serve to benefit the gun lobby.

It’s not clear if doctors will react to these campaign donations in the way Siegel hopes either. But if enough of them feel their money shouldn’t be spent this way, they can push back. Doctors could go so far as to refuse to pay dues or contribute further, depriving their organizations of money and member support until they reconsider backing pro-gun lawmakers.

For Siegel, it’s a matter of being consistent.

“If we want this to be our lane, we can’t have our organizations supporting legislators who are destroying legislation that we think is important,” he said.

For medical professionals like Dr. Adam Schechner, a Maryland-based trauma surgeon who treats gun violence victims on a routine basis, the apparent lack of conviction among the medical organizations has already led him to forgo membership.

“I don’t necessarily feel that any professional doctors group supports my interests, and this is exactly why,” Schechner said. “It is a prime example of hypocrisy at its very worst.”

Are you a member of one of these medical organizations who wants to share your thoughts on these donations? Email: erin.schumaker@huffpost.com.