Elgar Nathan J, Smith Brian J
Department of Respiratory Medicine, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
Intern Med J. 2018 Mar;48(3):293-300. doi: 10.1111/imj.13620.
Medical fitness to drive is one way governments control the issuing and renewal of driving licences, and some jurisdictions demand mandatory reporting (MR) of unsafe drivers by doctors.
To determine the views, adherence rate and experiences of sleep physicians and electro-physicians with regards to South Australia's (SA) MR law.
Self-administered surveys were delivered by post and email to all SA Medical Board-registered sleep physicians (n = 49) and electro-physicians (n = 11). Twenty-nine sleep physicians and six electro-physicians returned surveys, giving a 61% response rate.
Of the doctors, 8 agreed with MR, 19 thought reporting should be voluntary and 6 that doctors should never report. Four doctors had reported all reportable patients, five had never reported any and the rest inconsistently applied the law. MR affected doctors' relationships with their patients as follows: 28 had experienced abuse by patients, 25 suspected patients of doctor shopping and 33 suspected patients of withholding information for fear of loss of licence. Only eight thought they were the most appropriate person to determine their patient's fitness to drive; 29 had not received any training with regards to making such determinations, yet, of these, 27 desired training.
Widely disliked and causing deterioration of doctor-patient relationships, the MR law is ignored by some and inconsistently applied by most of the doctors surveyed. Further clinician and community education is required regardless of whether the law is abandoned, modified or left unchanged.
医学上是否适合驾驶是政府控制驾照发放和续签的一种方式，一些司法管辖区要求医生强制报告（MR）不安全驾驶人员。
确定睡眠医学医生和电生理医生对南澳大利亚（SA）MR法律的看法、遵守率和经历。
通过邮寄和电子邮件向所有南澳大利亚医学委员会注册的睡眠医学医生（n = 49）和电生理医生（n = 11）发放自我管理调查问卷。29名睡眠医学医生和6名电生理医生回复了调查问卷，回复率为61%。
在这些医生中，8人同意强制报告，19人认为报告应该是自愿的，6人认为医生绝不应该报告。4名医生报告了所有应报告的患者，5名医生从未报告过任何患者，其余医生对法律的适用不一致。强制报告对医生与患者的关系产生了如下影响：28人曾遭受患者辱骂，25人怀疑患者就医欺诈，33人怀疑患者因担心驾照被吊销而隐瞒信息。只有8人认为他们是确定患者是否适合驾驶的最合适人选；29人未接受过任何关于做出此类判定的培训，然而，在这些人中，27人希望接受培训。
强制报告法律广受厌恶并导致医患关系恶化，一些医生忽视该法律，大多数接受调查的医生对其适用不一致。无论该法律是被废除、修改还是保持不变，都需要进一步对临床医生和公众进行教育。
