Family Physicians’ Attitudes and Practices Regarding Assessments of Medical Fitness to Drive in Older Persons
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Higher crash rates per mile driven in older drivers have focused attention on the assessment of older drivers.
To examine the attitudes and practices of family physicians regarding fitness-to-drive issues in older persons.
The questionnaire was sent to 1,000 randomly selected Canadian family physicians. Four hundred sixty eligible physicians returned completed questionnaires.
Self-reported attitudes and practices towards driving assessments and the reporting of medically unsafe drivers.
Over 45% of physicians are not confident in assessing driving fitness and do not consider themselves to be the most qualified professionals to do so. The majority (88.6%) feel that they would benefit from further education in this area. About 75% feel that reporting a patient as an unsafe driver places them in a conflict of interest and negatively impacts on the patient and the physician–patient relationship. Nevertheless, most (72.4%) agree that physicians should be legally responsible for reporting unsafe drivers to the licensing authorities. Physicians from provinces with mandatory versus discretionary reporting requirements are more likely to report unsafe drivers (odds ratio [OR], 2.78; 95% confidence interval [CI], 1.58 to 4.91), but less likely to perform driving assessments (OR, 0.58; 95% CI, 0.39 to 0.85). Most driving assessments take between 10 and 30 minutes, with much variability in the components included.
Family physicians lack confidence in performing driving assessments and note many negative consequences of reporting unsafe drivers. Education about assessing driving fitness and approaches that protect the physician–patient relationship when reporting occurs are needed.
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Journal of General Internal Medicine
Volume 22, Issue 4 , pp 531-543
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- older drivers
- medical fitness to drive
- family physicians
- Industry Sectors
- Raymond W. Jang MD (1)
- Malcolm Man-Son-Hing MD (2) (3) (4)
- Frank J. Molnar MD (2) (3) (4) (5)
- David B. Hogan MD (6)
- Shawn C. Marshall MD (3) (4) (7)
- Julie Auger MD (8)
- Ian D. Graham PhD (3) (9)
- Nicol Korner-Bitensky PhD (10)
- George Tomlinson PhD (11) (12)
- Matthew E. Kowgier MSc (12)
- Gary Naglie MD (13) (14) (15) (16)
- Author Affiliations
- 1. Department of Medicine, University of Toronto, Toronto, ON, Canada
- 2. Division of Geriatric Medicine, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- 3. Clinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, ON, Canada
- 4. Canadian Institutes of Health Research (CIHR) CanDRIVE Research Team, Élisabeth-Bruyère Research Institute, Ottawa, ON, Canada
- 5. CT Lamont Centre for Primary Care Research, Élisabeth-Bruyère Research Institute, Ottawa, ON, Canada
- 6. Division of Geriatric Medicine, Department of Medicine, University of Calgary, Calgary, AB, Canada
- 7. Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- 8. Department of Family Medicine and Continuing Care, Timmins and District Hospital, Timmins, ON, Canada
- 9. School of Nursing and Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON, Canada
- 10. School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada
- 11. Department of Medicine, University Health Network, Toronto, ON, Canada
- 12. Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada
- 13. Division of General Internal Medicine, University Health Network, Toronto, ON, Canada
- 14. Geriatrics Program, Toronto Rehabilitation Institute, Toronto, ON, Canada
- 15. Departments of Medicine and Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
- 16. Toronto Rehabilitation Institute, Toronto, ON, Canada