Doctors and the driving test dilemma

Seniors are often faced with the prospect of a physical and mental fitness examination in a doctor’s office.

Doctors are duty bound, by licensing authorities, to report any patient conditions which would prevent them from properly operating a motor vehicle on our highways. Doctors are put in an untenable position when this is the case. How do they decide who should keep their licence and who should lose it?

There are some simple in-office cognitive tests that many doctors use to determine the patient’s fitness to drive. Counting backwards in increments is one such test. Another involves remembering a list of 10 or more items presented to the patient a few minutes prior to the actual appointment time.

One such senior showed a shopping list to the doctor at the beginning of the appointment. He asked the doctor to read the list, saying that he always had trouble reading his wife’s writing.

The doctor complied. When it came time for the patient to recall the 10 items first presented to him at the beginning of the appointment, he could only remember six. The doctor explained that his performance was not good enough and he would likely have to take a driver’s test. The patient disagreed, stating that his bad memory had nothing to do with his driving ability. The doctor insisted and repeated his opinion. The senior pulled the shopping list from his pocket and asked the doctor to remember the items which had been written by the patient’s wife. The doctor could only remember five items.

The elderly patient had made his point. But it was what the patient did next that sealed the deal and gave greater comfort to the doctor in this potentially confrontational situation.

The senior driver had been much more prepared for the medical appointment with this doctor than first thought. He had brought his driving abstract to the appointment. His driving record was without infractions for the time period normally quoted, namely the last five years. He also brought a copy of his vehicle insurance. The maximum discount for safe driving was clearly visible on the policy.

The patient then produced a report from a professional driving school. The report was a comprehensive assessment of the senior driver’s abilities in both urban and rural settings, and at high and low speeds. The doctor was not perturbed in the slightest. In fact, he was pleased beyond belief.

He now had a driving record, and insurance document and a performance report from a professional driving instructor that he could use to make an educated decision. The doctor’s report was filed with the proper authority and no driving test was required or requested.

The situation described above is the exception rather than the rule. Most doctors are put in the position of making such a decision without any accompanying documentation or reports. How can they make an educated decision without the co-operation of the patient? Doctors must be mindful of the safety of not only the driving public, but also pedestrians and cyclists. If the doctor is unsure of the driving ability of any patient, the decision to recommend a driving test becomes academic. Doctors must consider their own professional liability insurance position when making decisions that contribute to the judgement about who should or should not continue to drive. They have my sympathy and concern for the position in which they have been put by governments everywhere.

As the senior left the doctor’s office, he smiled and wished the doctor well, and served notice that he would like to see the doctor’s driving abstract and insurance policy upon his next scheduled visit.

Steve Wallace is a member of the College of TEachers and the owner of Wallace Driving School on Vancouver Island and the Interior of B.C.