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The Role of Physicians in Assessing Older Drivers: Barriers, Opportunities, and Strategies

From the Department of Family Practice and Community Medicine, University of Pennsylvania School of Medicine, Philadelphia (HRB, JBS, JJG), Department of Mental Hygiene, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland (GWR), and Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland (PMK). Address correspondence to Hillary R. Bogner, MD, MSCE, Department of Family Practice and Community Medicine, The University of Pennsylvania, 3400 Spruce Street, 2 Gates Building, Philadelphia, PA 19104 (e-mail: bogner{at}mail.med.upenn.edu)

Background: Evaluation of the older driver is a difficult task for primary care physicians. We investigated the physician-perceived barriers to assessing older drivers in primary care practice.

Methods: Twenty family physicians whose patients had completed a clinical questionnaire and neuropsychological tests participated in one of 2 focus groups. Physicians were asked about barriers to assessing older drivers in primary care and the usefulness of neuropsychological tests for assessing driving ability.

Results: A number of themes emerged related to barriers in the assessment of the older driver. Major themes included concerns about being liable for the results of driving related screening and about patients reacting unfavorably to a driving assessment including cognitive tests. Physicians uniformly agreed that a protocol to guide driving assessment would be useful.

Conclusions: Physicians encounter a number of barriers to assessing older drivers but recognize the importance of driving within the context of geriatric functional assessment.