Michigan Doctors Back Bills to Report Unfit Drivers

September 29, 2008

Dr. Paul Cullis of Michigan says most patients who have had seizures or blackouts get the message loud and clear: Don’t drive for six months.

But some get behind the wheel anyway, not waiting to see if their unconscious spells or other medical issues persist.

“It’s in everyone’s interest to have these patients reported to the state,” said Cullis, chief neurologist at St. John Hospital and Medical Center in Detroit.

Michigan physicians, however, worry about getting sued if they alert the secretary of state’s office to unfit drivers.

Bills passed by the state Senate this month are designed to fix the problem by shielding doctors from lawsuits.

Though physicians wouldn’t have to warn the state about drivers whose physical or mental conditions make them unfit to drive, the legislation would specifically allow them to act. If they file a report to the state, they would have to recommend a minimum six-month suspension of a driver’s license or one-year suspension of a commercial license.

Doctors say the bills would help clear up confusion over doctor-patient confidentiality and concerns about getting blamed for untruthful medical histories given by patients.

Michigan is among 18 states without legal protections for doctors who report or don’t report unsafe drivers, according to Dr. Marianna Spanaki, a neurologist at Henry Ford Hospital in Detroit.

“This is optional and we want to keep it optional,” Spanaki said of reporting motorists. “If we choose to fill out a report, then we need to be protected.”

The state trial lawyers’ group supports the idea behind the legislation but wants to see a change, however.

“We feel (doctor) reporting should be mandatory and not just optional,” said Jesse Green, spokesman for the Michigan Association for Justice. He cites public safety and points to laws requiring teachers and others to report suspected child abuse.

Doctors respond that mandatory reporting could compromise their relationship with patients and argue they can be trusted to flag dangerous drivers without requirements.

Physicians have talked about the issue for 20 years but only recently got a lawmaker interested enough to sponsor legislation – Sen. Dennis Olshove, a Warren Democrat. Because the bills passed 34-3 in a bipartisan fashion in the Senate, they may not run into much opposition in the House. Leaders of legislative judiciary committees plan to discuss the legislation this week.

Lawmakers have three months to approve the two bills before they die at the end of the legislative session.

Issues surrounding unsafe drivers often affect neurologists because they treat epilepsy and other diseases involving cognition, consciousness or motor skills. The legislation also could apply to diabetes, hypoglycemia, heart problems or other conditions that impair “driving judgment.”

“People with advanced dementia shouldn’t be driving either,” Cullis said. “That’s a huge problem. They don’t understand why they can’t drive and don’t remember you told them not to drive.”

The Michigan Department of State, which supports the bills, gets about 5,000 requests a year to test drivers of all ages based on concerns about physical or mental impairments. Roughly 2,000 are removed from the road.

Most referrals are submitted by law enforcement, but referrals also are made by health care workers, family and friends. A physician’s report would be deemed confidential if the bills become law.

The issue is a sensitive one for doctors, who risk alienating patients determined to drive to get to their jobs or fearing the isolation that would come with giving up their driving privileges.

At times, doctors are compelled to act when the state asks about patients who get in accidents for medical reasons. Or people renewing their licenses are honest and tell secretary of state workers about their health problems.

“Unfortunately … most people say, ‘No, I haven’t had a seizure,”‘ Cullis said.

The legislation could affect motorists of all ages.

There has been some debate in the past about requiring seniors to renew their license in person on a shorter timetable than other drivers. There can be an eight-year gap between visits, causing concerns that diminishing eyesight or health among seniors could lead to accidents.

Secretary of State Terri Lynn Land has said treating seniors differently would be age discrimination.

The driving bills are Senate Bills 1414-15.

On the Net:
Michigan Legislature: http://www.legislature.mi.gov
Michigan Department of State: http://www.michigan.gov/sos
Michigan State Medical Society: http://www.msms.org

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