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by Jean M. Lang, From the AARP Bulletin Print Edition, November 1, 2010
Robert Lebow, M.D., has never called the Massachusetts Registry of Motor Vehicles to recommend a patient's license be taken away. But with Massachusetts' new safe driving law clearing the way, he might do so now.
The law, which took effect Sept. 30, is best known for prohibiting "texting" while driving. It also requires drivers 75 and older to renew their licenses in person and pass an eye exam every five years, rather than 10 for everyone else.
But it also encourages health care providers to inform the registry when they believe someone is not fit to drive, in part by shielding them from lawsuits.
Lebow said he was previously reluctant to inform the registry because he did not have immunity.
Lebow, 66, is medical director of Radius HealthCare Center at Southbridge in central Massachusetts. He sees thousands of patients each year, most 65 and older. Occasionally, he said, family members ask for help in getting an older parent to stop driving.
Sometimes patients agree. But other times a family may have to sell a car or hide keys to get them off the road. If patients aggressively refuse to heed his advice, now he can opt to contact authorities to recommend retesting.
AARP Massachusetts supported the medical reporting provision. "We're hoping this new provision will encourage these tough conversations to happen between a doctor and patient and the driver's family,'' said Deborah Banda, AARP Massachusetts state director. "It has the ability to get unsafe drivers of all ages off the road.''
Registry officials consider whether someone who is impaired is able to control it or make adjustments so that they do not pose a danger to themselves or others.
"This is to keep everybody safe," said Rachel Kaprielian, the state's registrar of motor vehicles.
If the registry receives a recommendation from a health care provider or law enforcement official, the driver in question has 10 days to surrender the license or request a hearing, according to Steve Evans, director of medical affairs for the registry.
He said a report coming from a doctor or police officer carries more weight than if it is made by an average citizen.
"If a doctor is telling me 'Get my patient off the road,' I'm going to listen," he said.
Drivers may provide evidence from another physician to refute an adverse assessment. They might also be asked to take a road test.
"Depending on the case and the story, we will work with people, but we also have a charge for public safety and we need to make sure our roads are safe," Evans said.
In addition to protecting doctors from civil liability, the new law requires the registry to retest any driver who is cited for three significant moving violations within 24 months.
Advocates of the new measures cite a Missouri study that showed a decrease in crashes after a similar law passed there. The study indicated 96.5 percent of people who had been reported stopped driving at some point in the review process. In some cases, drivers surrendered their licenses upon receiving the initial letter from the motor vehicle bureau.
"As physicians get the information, get experience and don't have to worry about getting sued, the system will function much better than it has," said Elizabeth Dugan, author of a book and website entitled The Driving Dilemma: The Complete Resource Guide for Older Drivers and Their Families.
"That it wasn't done before is mystifying," she said.
The chief sponsor of the bill for stronger medical reporting was Rep. Kay Khan, D-Newton, a psychiatric nurse clinical specialist who is married to a physician.
She called the law a “public safety measure for both the driver and the public [that] may help families who need to address unsafe driving capabilities with a family member.”
Asked whether the new measure would harm the doctor-patient relationship or make patients wary about revealing problems for fear of losing their licenses, Lebow said he did not think so.
Dugan agreed. She said more families are looking for guidance.
Jean M. Lang is a freelance writer and lecturer at Northeastern University in Boston.
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