Discussing Driving Concerns With Older Patients

Reporting Requirements, Confidentiality, and Legal Immunity for Physicians Who Report Medically Impaired Drivers

“…Ophthalmologists, among other specialists, are routinely asked to evaluate patients’ fitness to drive; however, education on policies and best practices surrounding medically impaired driver reporting is not a standard part of graduate medical education. Furthermore, studies have reported that clinicians in family medicine, geriatrics, ophthalmology, and optometry are unaware of state reporting requirements and actions to take if a patient appears unsafe to drive . This lack of awareness may be explained in part by our finding that one-third of DMV websites have no information regarding physician reporting of medically impaired drivers.…”

“…Furthermore, studies have reported that clinicians in family medicine, geriatrics, ophthalmology, and optometry are unaware of state reporting requirements and actions to take if a patient appears unsafe to drive. 4,[8][9][10][11][12] This lack of awareness may be explained in part by our finding that one-third of DMV websites have no information regarding physician reporting of medically impaired drivers. In addition, there is a dearth of published information on this topic.…”

“…1 , 13 A study of vision care clinicians reported that they cite liability risk for reporting and for not reporting as barriers to reporting unsafe drivers. 9 At the time of this study, universal legal immunity did not exist in the US. Legal immunity for not reporting may be just as important as immunity for reporting.…”

“…The American Medical Association and the American Academy of Neurology, among other professional organizations, recognize the importance of safeguarding physicians from liability when they report patients in good faith . A study of vision care clinicians reported that they cite liability risk for reporting and for not reporting as barriers to reporting unsafe drivers . At the time of this study, universal legal immunity did not exist in the US.…”

“…The National Highway Traffic Safety Administration may be well positioned to help state DMVs establish best practices on how to present instructions and resources regarding physician reporting of medically impaired drivers; furthermore, state legislatures hold the power to regulate these policies and provide resources to make reporting systems available. One risk associated with reporting a medically impaired driver is potential damage to the physician-patient relationship . Physicians may fear that reporting a medically impaired driver may lead patients to seek care from other clinicians, withhold information regarding their symptoms, and, potentially, retaliate against them.…”