Taking away a driver's license

I hate having to pull a driver’s license – a lot.

Patients often believe I get some perverse pleasure out of it or that I do it to "get even" with them for some reason, but I don’t.

Like most neurologists, I don’t take this lightly. If I’ve gone to the length to fill out the paperwork and notify the state that you shouldn’t be driving, it means you’ve given me a really good reason.

Here in Arizona we operate on the honor system. So if I have to suggest revoking a seizure patient’s license, it means I’ve clearly caught them driving after I’ve told them not to.

Dementia patients are trickier, with more shades of gray than simple black or white. I tend to err on the side of caution and tell them to stop driving when I become concerned. If they won’t stop or refuse to take a behind-the-wheel test, then I notify the state.

The scariest patients are those without insight into their impairments and either no family to work with or a family that’s indifferent. There are no easy answers in those cases because the patient will likely be oblivious to the fact that his license has been taken away and will not stop driving.

I feel bad about taking away a license. In modern society, the ability to safely operate a car is independence for many. My city isn’t notable for being easy to walk around or for having an exceptionally easy public transportation system.

But I still do it. My criterion, besides state law, comes down to what I call the "kid question": Do I want this person out on the road, knowing that my children are riding around on it, too?

And if the answer is no, it’s time to reach for the department of motor vehicles form.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

I hate having to pull a driver’s license – a lot.

Patients often believe I get some perverse pleasure out of it or that I do it to "get even" with them for some reason, but I don’t.

Like most neurologists, I don’t take this lightly. If I’ve gone to the length to fill out the paperwork and notify the state that you shouldn’t be driving, it means you’ve given me a really good reason.

Here in Arizona we operate on the honor system. So if I have to suggest revoking a seizure patient’s license, it means I’ve clearly caught them driving after I’ve told them not to.

Dementia patients are trickier, with more shades of gray than simple black or white. I tend to err on the side of caution and tell them to stop driving when I become concerned. If they won’t stop or refuse to take a behind-the-wheel test, then I notify the state.

The scariest patients are those without insight into their impairments and either no family to work with or a family that’s indifferent. There are no easy answers in those cases because the patient will likely be oblivious to the fact that his license has been taken away and will not stop driving.

I feel bad about taking away a license. In modern society, the ability to safely operate a car is independence for many. My city isn’t notable for being easy to walk around or for having an exceptionally easy public transportation system.

But I still do it. My criterion, besides state law, comes down to what I call the "kid question": Do I want this person out on the road, knowing that my children are riding around on it, too?

And if the answer is no, it’s time to reach for the department of motor vehicles form.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

I hate having to pull a driver’s license – a lot.

Patients often believe I get some perverse pleasure out of it or that I do it to "get even" with them for some reason, but I don’t.

Like most neurologists, I don’t take this lightly. If I’ve gone to the length to fill out the paperwork and notify the state that you shouldn’t be driving, it means you’ve given me a really good reason.

Here in Arizona we operate on the honor system. So if I have to suggest revoking a seizure patient’s license, it means I’ve clearly caught them driving after I’ve told them not to.

Dementia patients are trickier, with more shades of gray than simple black or white. I tend to err on the side of caution and tell them to stop driving when I become concerned. If they won’t stop or refuse to take a behind-the-wheel test, then I notify the state.

The scariest patients are those without insight into their impairments and either no family to work with or a family that’s indifferent. There are no easy answers in those cases because the patient will likely be oblivious to the fact that his license has been taken away and will not stop driving.

I feel bad about taking away a license. In modern society, the ability to safely operate a car is independence for many. My city isn’t notable for being easy to walk around or for having an exceptionally easy public transportation system.

But I still do it. My criterion, besides state law, comes down to what I call the "kid question": Do I want this person out on the road, knowing that my children are riding around on it, too?

And if the answer is no, it’s time to reach for the department of motor vehicles form.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.