Physicians' Preferences for Reporting Alcohol-Impaired Drivers

Physicians are often asked to report patient health conditions that can affect the public’s health and safety. However, they do not consistently report alcohol-impaired drivers who present after a motor vehicle crash. As a result, these unreported drivers do not face legal consequences for their risky behavior and may continue to endanger the public.

To examine physicians’ attitudes about reporting alcohol-impaired drivers, researchers presented 3 clinical case scenarios in a questionnaire to physicians (including primary care physicians, emergency medicine physicians, and general surgeons) in Rhode Island. The scenarios involved treating an alcohol-impaired male driver who presents with minor injuries 1 hour after a motor vehicle crash and has 1 of 3 levels of intoxication: clinical diagnosis of intoxication, blood alcohol concentration (BAC) of 80 mg/dL, or BAC of 240 mg/dL.

Respondents (261, response rate of 49%) were more comfortable reporting the driver to a medical review board of the Department of Motor Vehicles (DMV) than to the police (66% versus 36% if clinical diagnosis; 63% versus 32% if BAC 80 mg/dL; and 81% versus 53% if BAC 240 mg/dL). The most common reasons for not reporting included physician-patient confidentiality and perceived threat of civil action. Comfort with reporting did not differ among specialties.

Comments:

The results indicate physicians are willing to report alcohol-impaired drivers to authorities but prefer using a DMV medical board rather than the police. Reporting alcohol-impaired drivers may reduce alcohol-related motor vehicle crashes and injuries. Physician preferences should be heeded when reporting systems in clinical settings are developed and implemented.

Kevin L. Kraemer, MD, MSc

Reference:

Mello MJ, Nirenberg TD, Lindquist D, et al. Physicians’ attitudes regarding reporting alcohol-impaired drivers. Subst Abus. 2003;24(4):233–242.
(view abstract)