Stethoscope

#87 Saving a life is worth the difficult conversation


 

4 July 2019

It is not easy to tell someone they should not be driving. People immediately fear losing their licence, their independence and life as they know it. However, the repercussions of not having this conversation can be far worse.

Unfortunately each year a number of crashes on Victorian roads involve drivers with medical conditions. Tragically, some of these collisions also result in passengers, innocent road users, or the drivers themselves being killed. Medical professionals have a crucial role to play in making sure everyone using the road arrives home safely to their family and friends. This begins with a conversation about being fit to drive. 

It is important for people to understand the impact medical conditions, medications and the ageing process can have on their ability to drive. The physical signs of ageing are easy to notice, but the cognitive ability to judge the speed of oncoming vehicles or a safe gap in traffic is often forgotten until a near miss occurs. Even then, it is often ignored. 

Some are not so lucky and that near miss turns into a collision. To avoid these incidents it is important that medical professionals are having the conversation with their patients both early and frequently about being fit to drive. The conversation does not need to stop with their general practitioner or treating hospital team, but should also be flowing through to friends, family and loved ones. 

Driving is a complex task requiring good vision, judgement, perception and physical abilities. Many health conditions and disabilities may affect a patient's ability to drive, so fitness to drive is an important consideration when assessing and managing patients.

The good news is that the solution does not have to be black and white. There is often false perception among the community that when a licence review is requested it means the person will automatically lose their licence. In fact only 12 per cent of referrals result in people having to retire from driving. A range of restrictions can be introduced to a driver’s licence that allows them to keep their mobility and independence, while also keeping them safe behind the wheel. This could be only driving during the day or within a certain distance from home. Modifications can also be made to vehicles to assist with particular medical conditions. 

It goes without saying that sometimes conversations about being fit to drive can be tricky to navigate.The ability to provide good and ongoing patient care often relies on the trust or relationship a doctor has with their patient. Without this, doctors often find patients withholding essential information about their deteriorating health or going elsewhere for medical advice. Starting the conversation early, preferably prior to the onset of any problems, may help keep this positive relationship and assist in making the transition to a non-driver a gradual and supported process. 

In Victoria, anyone who has concerns about a person’s driving can anonymously report this to the VicRoads Medical Review Section. While it is the responsibility of the patient to self-report serious injuries, a disability or medical condition, doctors are encouraged to frequently inform patients of their legal obligation to self-report anything that may affect their ability to drive.

This open and frequent conversation is a vital part of people being able to acknowledge when it is no longer safe to drive a vehicle. Knowing what signs to look out for and how to self-regulate driving habits plays an important part in this There will always be people who struggle to make this acknowledgement, but that is when the role of a medical professional is crucial.

We need the help of medical professionals to encourage people to assess their ability and confidence to drive, and provide advice on when to retire from driving. If your patient does not wish to report and you have concerns about their ability to drive it is all the more critical to make sure they receive the licence review they need. Without it, innocent lives may be lost.

Road safety is a shared community responsibility and the medical profession is a key component to keeping Victorian roads safe. Victoria Police urges all medical professionals to start the conversation early and frequently about being fit to drive. With your support we can be one step closer to having zero deaths on Victorian roads.
 

Stephen Leane
Assistant Commissioner
Road Policing
Victoria Police

 

Medical forms and fact sheets, information about being fit to drive and licence review requests can be found at www.vicroads.vic.gov.au/licences/health-and-driving

 

This article appears in the June 2019 edition of Vicdoc.

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