title: Self-Reporting by Unsafe Drivers Is, with Education, More Effective than Mandatory Reporting by Doctors.
abstract: OBJECTIVE
  Health professionals are frequently required to report to relevant authorities all drivers who are potentially unsafe due to medical conditions. We aimed to assess both the effect of mandatory reporting (MR) on patient self-predicted behavior and what factors might encourage unsafe drivers to self-report to these authorities.
  
  
  METHODS
  We included 5 questions in the South Australian Health Omnibus Survey, an annual, community based, face-to-face survey. We asked (1) how subjects would behave towards their doctor in light of MR if they believed their licences were at risk due to a medical condition; and (2) which factor(s) would cause them to self-report to the same authorities.
  
  
  RESULTS
  Responses to 3,007 surveys (response rate 68.5%, age 15-98) showed that 9.0% would avoid diagnosis, lie to their doctor, or doctor shop in order to keep their licence; 30.8% were unaware of the legislated requirement to self-report; and 37.9% were unaware of potentially jeopardizing insurance support if they failed to comply. If educated in these 2 areas, warned about the dangers of driving against medical advice and instructed to do so by their doctor, then 95.8% of people would self-report to the authorities, a number significantly higher than could be reported by their doctors (91.0%).
  
  
  CONCLUSIONS
  MR causes 9.0% of people to predict to behave towards their doctor in a manner that reduces road safety. With education and encouragement to do so, more people will self-report to the authorities than could be reported by their doctors via the MR pathway.
  
  
  CONCLUSIONS
  A commentary on this article appears in this issue on page 287.
authors.affiliation: Respiratory Medicine Unit, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Elgar
authors.affiliation: School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Esterman
authors.affiliation: Adelaide Institute for Sleep Health, Repatriation General Hospital, Daw Park, South Australia, Australia.
authors.forename: Nick A
authors.initials: NA
authors.lastname: Antic
authors.affiliation: Respiratory Medicine Unit, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.|Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Smith
mesh_terms: D001315:Australia; D001334:Automobile Driving / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D008297:Male; D019221:Mandatory Reporting; D010820:Physicians; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: automobile driving; confidentiality; education; mandatory reporting; safety