Journal of General Internal Medicine

, Volume 22, Issue 4, pp 531–543

Family Physicians’ Attitudes and Practices Regarding Assessments of Medical Fitness to Drive in Older Persons

Authors

  • Raymond W. Jang
    • Department of MedicineUniversity of Toronto
  • Malcolm Man-Son-Hing
    • Division of Geriatric Medicine, Department of MedicineUniversity of Ottawa
    • Clinical Epidemiology ProgramOttawa Health Research Institute
    • Canadian Institutes of Health Research (CIHR) CanDRIVE Research TeamÉlisabeth-Bruyère Research Institute
  • Frank J. Molnar
    • Division of Geriatric Medicine, Department of MedicineUniversity of Ottawa
    • Clinical Epidemiology ProgramOttawa Health Research Institute
    • Canadian Institutes of Health Research (CIHR) CanDRIVE Research TeamÉlisabeth-Bruyère Research Institute
    • CT Lamont Centre for Primary Care ResearchÉlisabeth-Bruyère Research Institute
  • David B. Hogan
    • Division of Geriatric Medicine, Department of MedicineUniversity of Calgary
  • Shawn C. Marshall
    • Clinical Epidemiology ProgramOttawa Health Research Institute
    • Canadian Institutes of Health Research (CIHR) CanDRIVE Research TeamÉlisabeth-Bruyère Research Institute
    • Division of Physical Medicine and Rehabilitation, Department of MedicineUniversity of Ottawa
  • Julie Auger
    • Department of Family Medicine and Continuing CareTimmins and District Hospital
  • Ian D. Graham
    • Clinical Epidemiology ProgramOttawa Health Research Institute
    • School of Nursing and Department of Epidemiology and Community MedicineUniversity of Ottawa
  • Nicol Korner-Bitensky
    • School of Physical and Occupational Therapy, Faculty of MedicineMcGill University
  • George Tomlinson
    • Department of MedicineUniversity Health Network
    • Department of Public Health SciencesUniversity of Toronto
  • Matthew E. Kowgier
    • Department of Public Health SciencesUniversity of Toronto
    • Division of General Internal MedicineUniversity Health Network
    • Geriatrics ProgramToronto Rehabilitation Institute
    • Departments of Medicine and Health Policy Management and EvaluationUniversity of Toronto
    • Toronto Rehabilitation Institute
Original Article

DOI: 10.1007/s11606-006-0043-x

Cite this article as:
Jang, R.W., Man-Son-Hing, M., Molnar, F.J. et al. J GEN INTERN MED (2007) 22: 531. doi:10.1007/s11606-006-0043-x

Abstract

Background

Higher crash rates per mile driven in older drivers have focused attention on the assessment of older drivers.

Objective

To examine the attitudes and practices of family physicians regarding fitness-to-drive issues in older persons.

Design

Survey questionnaire.

Participants

The questionnaire was sent to 1,000 randomly selected Canadian family physicians. Four hundred sixty eligible physicians returned completed questionnaires.

Measurements

Self-reported attitudes and practices towards driving assessments and the reporting of medically unsafe drivers.

Results

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.

Conclusions

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.

Key words

surveyolder driversmedical fitness to drivefamily physicians

Copyright information

© Society of General Internal Medicine 2007