MADISON, Wis. — About four in 10 U.S. adults live in a household with a gun, according to Pew Research Center.

Thirty-two percent of those people say they personally own one.

That’s why Dr. James Bigham, a family doctor in Madison, is on a mission to teach more medical students, doctors and behavioral therapists about guns, specifically, how to safely lock and store them. He said his goal is to make sure firearm safety is part of routine checkups and counseling appointments. 

“Trying to get folks to have actual lived experience and understand why an individual would want to own a firearm; or even how a firearm works, is really imperative,” he said.

As part of that work, Bigham and a group of doctors visited a shooting range at Max Creek Outdoors in Oregon, Wisconsin. He said by gaining experience in how to hold, handle and shoot a firearm, doctors gain experience and knowledge to have better-informed conversations with patients who own guns.

“I didn’t have much time dedicated to this, in medical school or during residency,” Bigham said. “As a primary care physician practicing in Wisconsin, where over half the homes have firearms, I feel like I have to know what I’m talking about with patients, and how to reduce harm from firearms.”

He partnered with the owner of Max Creek Outdoors, Steve D’Orazio, to create the “Lock, Stock and Barrel” course for medical professionals. So far, more than 200 people have participated. Sadly, Steve D'Orazio passed away from natural causes as this story was being put together. His family wants the message and story to still get out there to honor the work their loved one was so passionate about. 

“Dr. James and I may just be two people, but when we have an audience of 10 to 20 people show up, that means all of them are having these conversations with their patients, and telling them to lock up your guns,” D’Orazio said.

In the course, Bigham and D’Orazio teach professionals how to operate guns and share detailed information on gun locks and safe storage. They also talk about voluntary transfer — a safety option they said they don’t think is stressed enough. Voluntary transfer means that in times of crisis, heightened risk or suicidal thoughts, a gun owner can and should surrender their gun.

“To a family, friend or trusted person to hold your firearm for you,” said Bigham. “Steve is one of at least 40 guns shops in the state that will take your gun and hold it for you for however long you need. No questions asked.”

The course’s subject matter is resonating with students.

“Their modeling of ways to have these discussions is helpful and can help facilitate a more natural discussion on the topic,” said Dr. Steve Almasi with Group Health Cooperative of South Central Wisconsin, who took the course.

Bigham and D’Orazio said they hope to eventually expand their program to all 50 states, reaching health care professionals across the country.

“We have a chance to actually shift the culture around how we talk about firearms in clinical settings, and it’s going to benefit our patients and our communities,” said Bigham.“We have a chance to actually shift the culture around how we talk about firearms in clinical settings, and it’s going to benefit our patients and our communities,” said Bigham.

Bigham also created the “firearm injury prevention” course, which he teaches to medical students at the University of Wisconsin School of Medicine and Public Health. Those who take the class learn the basics of guns and how to use them properly. That includes how to have judgement-free conversations about safe gun storage and suicide risk assessment.

In an often-divisive political climate, Bigham said the course is not about changing anyone’s stance on gun ownership.

“We need to come back to a place where there is no judgment or politics,” he said. “All we have is leaning into solutions that are going to work for the individual who decided to own a firearm.”

For many of the students, it’s the first time they’ve received any formal training on firearms.

“He gave us a lot of information on being able to properly store firearms, and talk to patients a lot easier about it,” said student Felix Mannella. “I’ll for sure use this in my future practice.”

Bigham said he’s noticed results.

“As we have more discussion with our patients around this, we begin to see more responsible firearm ownership and use,” he said. “Engaging with patients to do meaningful things — like secure their firearms and have a plan in place if they are having suicidal thoughts — we should, and can, make a difference in reducing injury from firearms.”

For more information on Bigham’s firearm injury prevention course, contact james.bigham@wisc.edu with the subject “Lock, Stock and Barrel.”

A celebration of life for D'Orazio will be held at the Oregon Sportsman's Club, 1726 Sand Hill Road, Oregon, Wis., from 1 p.m. until 5 p.m. on Friday, June 6, 2025. In an online obituary, the family asked people to honor D'Orazio by "enjoying the peace of nature and listening for the whistle of the quail." Online condolences may be made, here.