Abstract
The increasing proportion of older adult drivers presents a growing road safety challenge in Korea, highlighted by a significant rise in traffic accidents involving individuals aged 65 years and older. In response, Korean authorities have implemented mandatory cognitive and physical assessments for license renewal, complemented by community-based educational programs. However, international comparisons reveal that the involvement of physicians as gatekeepers in assessing driver fitness is more robust in the United States and Canada, where legal frameworks either permit or require healthcare professionals to report medically at-risk drivers to licensing authorities. These systems balance public safety with patient confidentiality by providing statutory protection for reporting physicians, though barriers such as legal ambiguity, concerns over liability, and inconsistent practices persist. Evidence suggests that mandatory reporting laws increase physician engagement and reporting rates, yet emotional and ethical dilemmas may hinder compliance. In Korea, strengthening the physician's role in the driver license management system-supported by legal immunity and clear guidelines-could enhance early identification of at-risk drivers and reduce accident rates among older adults. A multidisciplinary approach, involving secondary assessments by occupational therapists and licensing authorities, is recommended to ensure objective evaluation of driving competence. Adopting a reporting model may further clarify responsibilities and improve outcomes. Ultimately, integrating physicians more actively into the licensing process is essential for safeguarding both older adult drivers' autonomy and public safety in an aging society.