There’s a sign on the soda machine at my office that says, “Please open bottles slowly.” Every time I see it, I roll my eyes. A soda’s not exactly a lethal weapon. If it fizzes a bit when I open it, I think I’ll survive the ordeal.

I doubt that anyone appreciates this sort of overprotective scolding, especially about something so trivial. And yet, millions of people do wield a lethal weapon every day and perhaps should be warned not to, before their actions endanger themselves and innocent bystanders—namely, senior citizens who continue to drive when they probably shouldn’t.

Seniors are the fastest growing segment of the driving population, according to the Department of Transportation. And this same group is, of course, increasingly developing age-related vision problems like glaucoma and macular degeneration. Those trends place an obligation on eye doctors to be ever vigilant for vision—and non-vision—impairments in their patients that pose a risk to safety on the roads.

A recent study found that optometrists and ophthalmologists do recognize that need, but come up short in some key ways. University of Michigan researchers surveyed 404 eye care providers about how they intervene with elderly patients who lack the capability to be safe drivers.

Encouragingly, 87% said that they consider it their responsibility to counsel the patient about their aptitude for driving; however, only about two-thirds routinely do so, mostly inquiring about their confidence driving at night and reading road signs.

Fewer than 10% of eye doctors ask about specific driving activities like merging lanes, making left turns at an intersection and driving in reverse. That’s a missed opportunity. As you well know, specific questions yield better information. Ask an emerging presbyope how his vision seems and you’ll get a vague answer; ask him if he has any trouble reading menus in restaurants and you’ll get a completely different response.

Worryingly, when an eye doctor identifies a patient with questionable driving skills, not enough is done to get the patient necessary care—or off the roads. Only 36% of the doctors in this survey refer such patients to a primary care doctor and 28% refer to a driving rehabilitation center. Not surprisingly, the reluctance stems from medicolegal concerns, with 24% worried about the consequences of taking action and 44% worried about inaction. The bottom line: You’re already involved, by dint of your exam and what it reveals, so you need to see this through.

These patients must know that you’re on their side. Stress that adherence to your care could help maintain and, in the case of AMD, restore their vision—and this may keep them independent for a bit longer. Caregivers can be an important ally. Try to get the patient and family to come to the realization on their own. Educate—don’t dictate. No one likes a scolding.

Now I think I’ll throw caution to the wind and go get a Diet Coke.

Remembering a Role Model

With great sadness, this month we mourn the loss of a friend, a publisher and a role model. Rick Bay’s contributions to this publication are innumerable. Ask anyone who worked with him how his leadership influenced them and you’ll hear many stories. Here’s just one. I first met Rick nearly 20 years ago, at the start of my career. I worked on the Review staff in the mid-1990s, editing the special supplements. One day, I had to go to Rick with some bad news: There was a mistake printed in a supplement, and the sponsor wasn’t going to like it. But another editor handled this project, so my hands were clean. I told him about the mistake, and stressed that the chain of events didn’t involve me. Rick was disappointed—not about the typo, or its consequences with the sponsor. He was disappointed in me, for only thinking about myself. He correctly saw infighting among the staff as the bigger problem. He inspired a callow youth to look beyond his own circumstances, to focus on the greater good. To him, even a setback was a chance to build unity. And as always, he led by example. Rick wasn’t just a manager; he was a mentor. I’ve learned and improved greatly during my time with him, as has everyone who had the pleasure of that experience. We’ll miss him and will strive to honor his legacy every day.