General practitioner attitudes and practices in medical fitness to drive in Ireland

Abstract

BackgroundIn Ireland, assessing medical fitness to drive (MFTD) is performed by general practitioners (GPs) despite not receiving training in traffic medicine. AimTo investigate current attitudes, resources and practices of GPs towards evaluating MFTD prior to the publication of comprehensive national guidelines. Design and settingQualitative study of GPs registered with the Irish College of General Practitioners. MethodWe mailed a questionnaire-survey to GPs (n=1000) in November 2012. ResultsThe response rate was 52%. A majority of GPs were confident (58%) or very confident (11%) in assessing MFTD. However, they were evenly divided as to whether GPs or practitioners specially trained for assessing MFTD should be primarily responsible (48%, 51%, respectively). Many (71%) expressed concern regarding the liability of such assessments. A significant minority reported pressure from patients and/or their families to reconsider decisions on MFTD. When seeking guidance for assessing MFTD, the majority were found to either use existing rudimentary Irish guidelines or refer to a consultant opinion (69%, 66%, respectively). ConclusionAlthough Irish GPs report high levels of confidence in assessing MFTD, as a group they express ambivalence about who should be primarily responsible for such assessments. This would indicate that some would consider deferring to a consultant opinion or at least recognize limitations of their skill set in this area. Further exploration is needed to determine which aspects of MFTD should be included in information and training for GPs, and to help address concerns regarding liability and patient/family communication issues.