Physicians and other primary care providers are encouraged to refer to the American Medical Association's Impaired Drivers and Their Physicians – guidelines promulgated by the AMA Council on Ethical and Judicial Affairs and adopted in December 1999.

The essential elements of the guidelines, the purpose of which "is to articulate physicians' responsibility to recognize impairments in patients' driving ability that pose a strong threat to public safety," are as follows:

• Physicians should assess their patients for physical and mental impairments that impact on the ability to drive in a safe manner, i.e., "pose a clear risk to public safety."
  
• Before referral to the MVA, initial steps include a "tactful but candid discussion with the patient and family about the risks of driving," consideration to seek further treatment, such as driving occupational therapy, and encouraging the patient/family to consider self-imposed driving restrictions. As a result of these steps a workable plan may render reporting unnecessary.
  
• The need to report is also addressed in the guidelines, "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 Department of Motor Vehicles." In Maryland, this is the MVA. Physicians should disclose and explain to their patients that they have an ethical responsibility to report.
  
• When reporting, "physicians should protect patient confidentiality by ensuring that only the minimal amount of information is reported and that reasonable security measures are used in handling that information."
  

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