Commentary: evaluation of driver fitness--the role of continuing medical education.

Faced with demographic trends that predicted large increases of older drivers within a relatively short period combined with the realization that screening for driver fitness was largely dependent upon health professionals, principally physicians, in 2004 the Société de l'assurance automobile du Québec (SAAQ) initiated measures that sought to achieve better cooperation with the health professionals performing the screening. A program was initiated that sought to improve the health professionals' understanding of road safety considerations. This article examines the measures included in this program and their results. SAAQ statistics show the benefit of the SAAQ's continuing medical education (CME) program. Since the initiation of the program the number of reports submitted by physicians has increased exponentially, whereas police reports have remained constant. Informed physicians report drivers with medical problems that may affect driver fitness when they are aware that the licensing agency's decisions are based principally upon valid functional evaluations. Discretionary reporting may be as effective as mandatory reporting when physicians are knowledgeable about the road safety implications of medical conditions.