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Am Fam Physician. 2007;76(1):139-142

AAN Guidelines on Reporting Medical Conditions That May Affect Driving Competency

Guideline source: American Academy of Neurology

Literature search described? No

Evidence rating system used? No

Published source: Neurology, April 10, 2007

Driving laws for persons with medical conditions that affect cognition, consciousness, vision, or motor skills vary from state to state. Physicians are expected to report a patient's driving-related condition to authorities if the condition might pose a safety risk, especially when the patient does not comply with requests to be tested or stop driving. Requiring mandatory reporting, however, may negatively affect the patient-physician relationship. Reporting also may not result in safety benefits to the public or the patient, who may consequently withhold important medical information.

Poorly designed reporting laws may also expose physicians to liability for a patient's driving outcomes, even when a physician has followed all applicable laws. Most states have full legal immunity for physicians who follow applicable laws in good faith. However, physicians in some states (e.g., Arkansas, Georgia) may be sued for reporting a patient with questionable driving abilities, resulting in a suggested violation of patient-physician privilege. In other states (e.g., Michigan, Montana), a physician who does not report a patient who appears to be a sound driver is at risk of being sued if that patient later causes an accident.

The American Academy of Neurology (AAN) encourages physicians to review applicable driving laws with their patients and to discuss and document their medical recommendations with their patients. The AAN also supports optional reporting of persons with medical conditions that may affect their ability to drive safety, especially for cases in which public safety has already been compromised or when the person clearly no longer has the skills to drive safely.

Physician immunity policies should be clarified so that physicians are granted immunity for reporting or not reporting a patient's condition when such action is taken in good faith, when the patient is reasonably informed of his or her driving risks, and when such actions are documented by the physician in good faith.

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