Takeaway
Addressing driving concerns requires balancing patient independence with public safety. Suggest a graduated path forward—like restricting driving to daytime hours and/or familiar routes—so patients can maintain autonomy while reducing risk.
Lifelong learning in clinical excellence | June 9, 2026 | 2 min read
By Havisha Gadepalli, MD, Johns Hopkins Medicine
A patient’s daughter sat with her father in the exam room. He was one of my longtime patients, and we were talking about a recent fender bender. “Just bad luck,” he said.
Later, in the hallway, the daughter whispered to me, “I’m scared he’s going to hurt someone—or himself.”
Moments like this ask more of us than clinical knowledge—they also ask us to understand the role we play in balancing patient independence with public safety.
Why this conversation is so hard
Driving represents autonomy, competence, and dignity. When we raise concerns, patients may hear, “You’re declining.” Families may hear, “We must do something right away.” And we may feel caught between preserving independence and preventing harm.
I live in Maryland, where there’s another added layer—healthcare professionals are not required to report unsafe drivers—but they are also explicitly allowed to. The flexibility is both a gift and a burden.
Here’s what I’ve found helpful when talking with patients and families about driving concerns:
1. Start with curiosity, not conclusions.
Open-ended questions are a great way to start difficult conversations. Trying saying, “Tell me about your driving these days.” “Any close calls or changes you’ve noticed?” Many patients sense these shifts—slower reaction time, trouble navigating, near misses—but haven’t said them aloud. Naming these changes together creates shared ground. Then, gently connect clinical findings to safety.
2. With the patient’s consent, invite families to join the discussion.
Most states have provisions that allow (and sometimes require) concerned parties, including family members, to report potentially unsafe drivers. However, the clinical conversation should come first whenever possible. In the room, validate both sides. Independence and safety are not opposing values.
3. Offer a path forward
Instead of telling patients to suddenly stop driving, offer a structured plan. Shared decision making is beneficial here. The plan could include limiting driving to daytime and familiar routes, and/or a formal driving evaluation with the MVA.
If concerns persist, most states allow clinicians to refer patients to the MVA/DMV for further review. This can lead to retesting for a driver’s license and, if needed, license restriction or suspension. Framing this as a safety evaluation—not a punishment—can make it more acceptable to patients.
Know your role and protections as a healthcare professional
Most states allow (and in six states, require) physicians to report drivers whose medical conditions may make driving unsafe. In most states, reporting is voluntary, not mandatory. Reports are typically confidential, and clinicians are protected from liability when acting in good faith. This means the decision to report is a clinical and ethical judgment—not just a legal one.
A few more tips for clinicians:
1. Start the conversation early—don’t wait for a crash or crisis.
2. Use neutral, observational language like, “I’ve noticed . . .”
3. Ask permission to involve family and align around shared goals.
4. Be transparent about your option to report as well as your reasoning.
5. Document concerns and revisit the conversation.
Handled thoughtfully, these conversations can strengthen trust and help patients and families navigate a difficult transition in care.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.