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Editor,—We were interested to read the article by Kelly et al on the awareness of patients and doctors of medical restrictions to driving published recently.1 It reported that “Doctors' knowledge of current licensing policy and action to be taken if a patient was not eligible to drive was poor”.
This led us to conduct our own research among hospital doctors, general practitioners (GPs), and medical students. We used the doctors' questionnaire from the study by Kelly et alto investigate local knowledge of driving restrictions. We interviewed 50 hospital doctors from a variety of specialties (14 house officers, 12 senior house officers, 14 registrars, and 10 consultants) at the Queen Elizabeth Hospital, Birmingham; 23 GPs from five different practices around Birmingham with experience ranging from GP registrar to those qualified 30 years; and 30 fourth year medical students. Participation was voluntary and anonymous.
Our results were similar to those reported by Kellyet al. Knowledge of the age at which licences should be reviewed for fitness to drive was generally around the correct age of 70 years (see table 1).
When asked to name conditions that should be reported to the Driving Vehicle Licence Authority (DVLA) epilepsy, stroke, and diabetes were the most frequently given answers in all three study populations. Four hospital doctors and one medical student did not know that conditions should be reported to the DVLA. Nobody stated that the patient's insurance company should be informed. Table 2 summarises the knowledge of specific restrictions among the three study populations.
For the five conditions for which specific restrictions were asked an average of 15.6% of GPs gave correct complete advice, while hospital doctors scored 14.6%, and medical students 5%. A χ2test demonstrated that there was no significant difference in knowledge between GPs and hospital doctors (p=0.85). Interestingly, 83% of GPs said that they would obtain further information about driving restrictions from leaflets produced by the DVLA, while only 16% of hospital doctors and no medical students knew about such publications.
These results appear to agree with the findings of Kellyet al.1 They indicate that there may be a failure to communicate driving restrictions to patients as many medical practitioners are unaware of the existence or specific details of present legislation. GPs' spontaneous knowledge of driving restrictions is generally poor. However, with frequently changing legislation it could be argued that the high levels of awareness and access to DVLA publications may be sufficient to advise patients accurately. The success of this strategy relies on basic knowledge being sufficient to know when to refer to such information.
Medical restrictions on driving form an important subject area because of the implications for both the individual and other road users. Many in the medical profession are not sufficiently well aware of the requirements of existing legislation. Undergraduate and postgraduate teaching on the subject have been suggested as mechanisms to increase awareness about restrictions. With only 36% of students recalling having had some teaching on driving restrictions and knowledge among this group being poor, there remains potential for improvement in this area.