Bad news, grandpa: Turn in your license!

I am afraid to write this column. Very afraid. Normally in my office, I feel like a rock star! I like my patients and my patients like me.

However, there are times when I go from being Bono of U2 to Janet Jackson at the Super Bowl– times when I have to do the unthinkable: take away someone's driver's license. (Insert music from Psycho here: eek, eek, eek...) For me, taking away a person's driver's license is as enjoyable as listening to Rosanne sing the National Anthem at a baseball game.

How can it be so traumatic to restrict a person's driver's license?

When I was a medical student at UVA, one of my professors said, "The difference between a lawyer and a doctor is the type of customer service we deliver. In general, lawyers want to please their clients and do what is asked of them. Doctors do what is best for the clients and that might go against what the patient wants." Confucius couldn't have said it better.

Thirteen percent of Americans are 65 years or older, and by 2020, 50 million Americans will be in that age category– half of them older than 75. I originally thought elderly people were involved in fewer car accidents than people in other age groups; however my research in the medical literature reveals that elderly drivers are involved in more fatal car crashes per miles driven than any other age groups, except for teenagers.

Drivers over 75 years old have more traffic violations and nonfatal collisions than younger drivers. Failure to yield right-of-way and to follow traffic signs are the most common violations. These violations often lead to accidents at intersections where full peripheral vision and quick responses are necessary. Mad Max, eat your heart out.

So when is it time to hang up the car keys? Driving is such a huge part of our culture, one of the things that provide us independence and freedom. Look at LA: people who live in small apartments drive cars that cost as much as a villa in France. In 1999, the California State Senate debated whether to require people 75 and older to take driving tests, but that plan died faster than a suggestion that the Academy Awards inaugurate an Adult Movies category.

Age alone is not a reason to stop driving. Medical condition(s) that can lead to traffic accidents are reasons to stop driving. These include poor vision, poor memory and thinking ability, history of falls in the past 1-2 years, frequent car accidents and traffic violations, and taking mind-altering medicines like tranquilizers.

The sad fact is I have never seen an entire family happy with the decision to revoke a driver's license. One family called me Mussolini when I revoked the driver's license of a grandma who couldn't remember where she was and what the red light meant on those funny boxes dangling over intersections.

What I don't understand is how a family member can sleep at night knowing their demented loved one might be lost on the roads, causing an accident, or being involved in an accident. True, the loss of independence is a huge blow to the elderly person, in particular if she or he lives in the country with limited (or no) public transportation.

Not many states require physicians to revoke drivers' licenses, and in a recent survey, 30 percent of geriatricians (doctors who specialize in elderly health care) did not know how to go about reporting dangerous drivers. (See, geriatricians like to be rock stars, too!)

However, I'd rather be called Mussolini than let my patient get hurt. Just don't ask me to put my hand inside my vest and pose.

Got a medical question? Dr. Hook wants to hear from you!