Legal Advisor: Reporting Patients to the Registry of Motor Vehicles

The American Medical Association (AMA) Weighs In

The AMA published an interesting pamphlet on this issue. The pamphlet recognizes the potential liability for breaching patient confidentiality, but glosses over the substantial HIPAA and state law penalties for unauthorized disclosure while concluding that potential lawsuits "should not dissuade physicians from reporting when it is necessary and justified, as reporting may provide protection from liability for future civil damages [by third parties or the patient should the patient be involved in a motor vehicle accident," The AMA goes on to state:

The physician's first priority is to ensure that the unsafe driver does not drive. If this can be accomplished without having the patient's license revoked, then there may be no need to report the patient to the [R]MV. However, if your patient refuses to stop driving despite your best efforts, then you must consider which is more likely to cause the greatest amount of harm: breaching the patient confidentiality vs. allowing the patient to potentially injure himself/herself and third parties in a motor vehicle crash.

(Physician's Guide to Assessing and Counseling Older Drivers, Chapter 7, pages 70-72.) Similarly, an AMA Ethical Opinion (E-2.24) states that "in situations where clear evidence of substantial driving impairment implies a strong threat to patient and public safety, and where the physician's advice to discontinue driving privileges is ignored, it is desirable and ethical to notify the [RMV]." Following this opinion may subject a physician to legal claims for breach of confidentiality.  See Resources section.

Next: Board of Registration in Medicine (BRM) Considerations