Driving Privileges Questions
A 62 year-old male was about to be discharged from the hospital. He was diagnosed with a stroke and was started on medications. He regained some of his strength in both upper and lower extremities but still has a visual field defect with loss of vision on the same side of both eyes. He has an outpatient appointment with a neurologist in two weeks. He is a commercial truck driver and the primary breadwinner for his family. You advised him not to drive until he regains full strength and complete vision. However, the patient reports that he cannot afford not to work and expresses strong desire to drive from tomorrow. What is the most appropriate step in the management of this patient regarding his driving?
- Advise him to keep his appointment with his neurologist and follow his advice regarding driving in the future
- Call patient in two days to warn him not to drive in current condition
- Report patient to state motor vehicle department
- Document your instructions to the patient in the chart and leave it there
- Refer him to physical therapy and ophthalmology to help him drive well
Correct Answer is C. Patients who lack awareness of their deficits, exhibit poor judgment, have significant physical weakness or vision problems that impair driving, or who express the intention to drive after discharge despite counseling otherwise should be reported to their state motor vehicle department.
Incorrect Answers:
A.Allowing a patient to drive till his appointment with his neurologist after 14 days is inappropriate because he has significant risk for hazardous driving.
B.Patient who has not listened to your advice in a face-to-face conversation today, most likely, is not going to listen to you in a phone conversation two days later.
D.You should document your instructions to the patient in his chart but you should not leave it there. Physicians have a responsibility to protect highways and byways from drivers who should not be driving.
E.Refer him to physical therapy and ophthalmology to help him drive well is a good part of the management. However, physicians have a responsibility to prevent this patient from driving.
References:
Current Medical Diagnosis & Treatment 2024
Maxine A. Papadakis, Stephen J. McPhee, Michael W. Rabow, Kenneth R. McQuaid, Monica Gandhi
CURRENT Diagnosis & Treatment: Physical Medicine & Rehabilitation
Ian B. Maitin, Ernesto Cruz
https://jamanetwork.com/journals/jamaneurology/fullarticle/1107815
