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

  • Raymond W. Jang
  • Malcolm Man-Son-Hing
  • Frank J. Molnar
  • David B. Hogan
  • Shawn C. Marshall
  • Julie Auger
  • Ian D. Graham
  • Nicol Korner-Bitensky
  • George Tomlinson
  • Matthew E. Kowgier
  • Gary Naglie
Original Article

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

survey older drivers medical fitness to drive family physicians 

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Copyright information

© Society of General Internal Medicine 2007

Authors and Affiliations

  • Raymond W. Jang
    • 1
  • Malcolm Man-Son-Hing
    • 2
    • 3
    • 4
  • Frank J. Molnar
    • 2
    • 3
    • 4
    • 5
  • David B. Hogan
    • 6
  • Shawn C. Marshall
    • 3
    • 4
    • 7
  • Julie Auger
    • 8
  • Ian D. Graham
    • 3
    • 9
  • Nicol Korner-Bitensky
    • 10
  • George Tomlinson
    • 11
    • 12
  • Matthew E. Kowgier
    • 12
  • Gary Naglie
    • 13
    • 14
    • 15
    • 16
  1. 1.Department of MedicineUniversity of TorontoTorontoCanada
  2. 2.Division of Geriatric Medicine, Department of MedicineUniversity of OttawaOttawaCanada
  3. 3.Clinical Epidemiology ProgramOttawa Health Research InstituteOttawaCanada
  4. 4.Canadian Institutes of Health Research (CIHR) CanDRIVE Research TeamÉlisabeth-Bruyère Research InstituteOttawaCanada
  5. 5.CT Lamont Centre for Primary Care ResearchÉlisabeth-Bruyère Research InstituteOttawaCanada
  6. 6.Division of Geriatric Medicine, Department of MedicineUniversity of CalgaryCalgaryCanada
  7. 7.Division of Physical Medicine and Rehabilitation, Department of MedicineUniversity of OttawaOttawaCanada
  8. 8.Department of Family Medicine and Continuing CareTimmins and District HospitalTimminsCanada
  9. 9.School of Nursing and Department of Epidemiology and Community MedicineUniversity of OttawaOttawaCanada
  10. 10.School of Physical and Occupational Therapy, Faculty of MedicineMcGill UniversityMontrealCanada
  11. 11.Department of MedicineUniversity Health NetworkTorontoCanada
  12. 12.Department of Public Health SciencesUniversity of TorontoTorontoCanada
  13. 13.Division of General Internal MedicineUniversity Health NetworkTorontoCanada
  14. 14.Geriatrics ProgramToronto Rehabilitation InstituteTorontoCanada
  15. 15.Departments of Medicine and Health Policy Management and EvaluationUniversity of TorontoTorontoCanada
  16. 16.Toronto Rehabilitation InstituteTorontoCanada

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