“The AMA is concerned that some patients may become reluctant to disclose symptoms, cognitive decline or safety concerns because they fear licensing consequences. This creates a significant tension between public safety objectives and open, effective healthcare.
“The review should acknowledge that the burden of implementing the standards does not sit solely within the technical assessment process. It also sits within the consultation room, where practitioners must navigate difficult conversations that can permanently alter longstanding therapeutic relationships.”
The AMA believes current discussions about AFTD often underestimate the responsibility placed on medical practitioners. Clinicians are expected to make high-stakes decisions affecting both public safety and individual liberty, often without access to the assessment services, referral pathways or implementation supports needed to make those decisions with confidence.
It says delays in access to occupational therapy driving assessments and on-road testing can result in prolonged uncertainty for patients, inconsistent decision-making, and unnecessary pressure on treating practitioners. In many areas, waiting times can be substantial, eligibility criteria restrictive, and private assessments prohibitively expensive.
“In rural and remote regions, this is compounded with access to on-road driving assessments being limited or non-existent.
“These barriers can delay decision-making, create uncertainty for patients and practitioners, and limit the practical application of the standards. An evidence-based standard is of limited value if patients cannot readily access the assessments required to apply it.”
The submission notes that the consequences of losing a driver’s licence are not experienced equally across Australia. In metropolitan areas, alternative transport options may be available. In rural and remote communities, licence loss can affect access to healthcare, employment, education, and community participation.
“These realities should be considered when developing implementation pathways and assessment supports.”
The AMA also notes ongoing concerns regarding medico-legal responsibility and the defensibility of clinical decisions.
“Practitioners require confidence that decisions made in good faith, in accordance with the standards, will be supported by regulators and licensing authorities.”
“The review should consider opportunities to strengthen implementation resources, improve education and training, clarify pathways for escalation and referral, and provide greater support for practitioners managing complex cases.”
The AMA says it strongly supports the continued role of the AFTD standards as the nationally agreed framework for assessing fitness to drive.
“General practitioners value the standards and use them regularly in practice because they provide a consistent, evidence-based foundation for making difficult decisions.
“The standards help practitioners explain decisions to patients and families, reduce variation in clinical practice, and support a common approach across jurisdictions.
“Importantly, the standards provide practitioners with an objective framework for decisions that would otherwise rely heavily on individual judgement. This is particularly important when practitioners are required to recommend licence restrictions, periodic review, or licence cancellation.
“The existence of nationally recognised standards helps shift these conversations away from a personal judgement by the practitioner and towards a transparent discussion based on agreed clinical guidance. The AMA believes maintaining national consistency should remain a central objective of the review.
“As the standards evolve, however, the review should place equal emphasis on implementation and usability. A technically sound standard that is difficult to apply consistently in clinical practice risks undermining both practitioner confidence and road safety outcomes.”
In closing its submission, the federal AMA recommends that the review:
- maintains nationally consistent, evidence-based medical standards for driver licensing;
- recognises the impact of fitness-to-drive assessments on the therapeutic relationship and patient care;
- improves access to specialist and on-road assessment services;
- supports development and evaluation of validated assessment tools that assist clinical decision-making;
- strengthens education, guidance and implementation support for health practitioners; and
- ensures proposed changes are practical, feasible, and capable of consistent application across Australia.
