Should primary care doctors assess safety of older drivers?

In an editorial published in the April issue of the Journal of General Internal Medicine, Malaz Boustani, M.D., M.P.H., of the Indiana University Center for Aging Research and the Regenstrief Institute, Inc. writes that assessing the safety of older drivers is not a responsibility that should reside with the primary care physician.

"This editorial sheds some light on the potential negative impact of adding more tasks onto the primary care physician's 'to-do list' and reflects on the importance of resource reallocation within the human and financial constraints of the primary care system," said Dr. Boustani, a geriatrician who also is assistant professor of medicine at the Indiana University School of Medicine.

Dr. Boustani's editorial accompanies a research paper by Canadian researchers who surveyed 468 Canadian family physicians. More than 45 percent of the Canadian doctors reported that they were not confident in assessing driving fitness of older adults. About three-quarters of the physicians said they felt that reporting a patient as an unsafe driver places them in a conflict of interest and negatively impacts the patient and the doctor–patient relationship.

Physicians should focus on the many health issues of older adults and let others such as police or motor vehicle departments assess driving ability. He wrote "A primary care provider with a mission of improving the mortality profile of all Americans may have a hard time justifying the time and resources required to obtain the requisite skills and to routinely assess the driving fitness of his or her older patients."

He concludes that "…retraining overworked, dissatisfied, and underappreciated primary care physicians to assess driving fitness in older adults may negatively impact the entire health care system via resource shifting and redistribution."