Are medical reports on fitness to drive trustworthy?

Purpose: Previous studies have shown that physicians often have poor knowledge of the medical restriction on fitness to drive, or submit poor quality medical reports. To determine the reliability of physicians' reports on fitness to drive, the medical data provided on the standard medical fitness form was compared with the additional data collected on repeated assessment. Methods: A random sample of 100 applicants for a driver's licence aged more than 49 years who submitted the standard medical form were asked to provide, from their regular family doctor, confirmation of their health status and/or additional medical data in order to make a re-evaluation. Results: The rate of rejection for a licence for medical reasons was 3% on the basis of the standard evaluation and 17% on the basis of the re-evaluation (p<0.001). Conclusion: This study shows that the random evaluation of physician assessments of applicants for a driver's licence increases the detection rate of medical problems that can affect fitness to drive. The alarming difference in the rate of rejection between the two assessments may reflect a lackadaisical attitude of medical professionals toward the licence assessment procedure and/or physician unawareness of the medical restrictions on fitness to drive. Results of this study suggest that this subject must be included in medical education programmes.