What is the profit in driver education?

What is the profit in driver education?

What Is the Profit in Driver Education? HAROLD W. WOUGHTER, M.D., Flint, Michigan ITHIN one generation the promotion of W traffic safety has become ...

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What

Is the Profit in Driver Education? HAROLD W. WOUGHTER, M.D., Flint, Michigan

ITHIN one generation the promotion of W traffic safety has become a business.

cated critics began to criticize civil engineers for lack of imagination in road design and construction. Through the years people singled out such scapegoats as iII-conceived Iaws, slack Iaw enforcement and antiquated statutes. Ultimately, the persistence of these attacks has produced beneficia1 resuIts. AutomobiIes have become safer. Roads are now buiIt to protect the driver even against himseIf. Traffic contro1 systems and Iaw enforcement methods no Ionger serve as “traps” but are designed for greater safety for aI1. With professiona1 heIp, better methods have been devised for the transportation and care of the injured. Although great strides and improvements were made in a11 these fields, sIowIy and ever so sureIy came the recognition that something needed to be done about the driver himself. Somehow someone had to do something about changing the design of the person behind the wheel, and this was not an engineering probIem. The first fruits of this reaIization were pIans that published the highway deaths for a given year or hoIiday weekend, the total injuries for a period of time, the loss in doIIars caused by highway careIessness or other carefuIIy compiled statistics, a11 of which were interesting to the average person but frightening onIy to the most sensitive, deepest kind of thinker. On the whoIe, figures and statistics come woefully short of shocking the average motorist into realizing his own risks or responsibilities. It is always the other feIIow who needs to be carefuIIy taught.

Years ago the man who bought an automobiIe was considered something of an eccentric and certaimy none of his bemused neighbors was very seriousIy concerned with how he behaved behind the whee1. Today the aduIt who does not drive is more apt to be considered eccentric, and nearIy everyone is seriously concerned about how we can prevent forty miIIion drivers in this country from killing and maiming each other at an ever-increasing rate. The promotion of trafhc safety has evoIved into a concerted nationa effort on which hundreds of thousands of doIIars are spent a year. It has assumed the same national scope as the crusades against cancer, poIiomyeIitis, tubercuIosis and muscuIar dystrophies. EstabIished agencies have been compeIIed to contribute to the effort-industry, the professions, IegisIative and judicial bodies, school systems, police departments and others. The administration of the business of traffic safety has actuaIIy created new jobs within our economic structure, and these are jobs which have a disturbing way of demanding results. The proht in this business is measured in Iives saved. Great investments are made annuaIIy in time and money by the various agencies and organizations. The greatest of care must be exercised to achieve a balanced effort, in order that an adequate profit in lives saved wiI1 justify continuing effort on the part of each contributor. FACTORS

FIRST

BLAMED

FOR

TRAFFIC

THE

TROUBLE

At the beginning of the movement to increase traffic safety, there was a tendency to point many accusing fingers in many directions. The first viIIain accused was the alleged instrument of destruction itseIf, the automobile. A little later some of the more sophistiAmerican

Journal

of Surgery,

Volume

~8, October,

IQ_W

ROLE

OF THE

PHYSICIAN

The pathetic and too IittIe pubIicized resuIt of careIess driving is the injured and incapacitated victim of an accident. Over 150,000 traffic injuries yearIy result in some degree of permanent disabiIity, and these disabilities are not always the obvious physical cripphngs 450

What

Profit

in Driver

licensing. The legal profession finds that peopIe are stoic and even remorseful when facing the court on charges of causing bodily injury or death, but if the threat of removal of their license to drive is expressed, immediateIy thev become angry and even voIatiIe. They wiI1 vigorousiy carry an adverse decision through a11 appea1 courts, yet the doctor is reluctant to advise agencies to revoke even temporarilv his patient’s license to drive. This attitude may be onIy the reflection of facts as they are. In onIy four states in the Union is there a requirement that physicians make avaiIabIe to driver-licensing bureaus reports of such significant diseases as diabetes and epiIepsy. Of forty-two states having Governor’s Traffic Safety committees, only twenty-three have representation of the medical profession. In thirty-eight states there are no established channeIs of communication with which to inform motor vehicle administrators or driver training schooIs whether or not applicants for driving permits have any record of mental illness. It should become increasingly evident to both the driver and the physician that the Iicense to drive a motor vehicIe cannot be an inaIienabIe right but must be a priviIege that carries with it the grave responsibilities concomitant with such a privilege.

that cause invalidism. Sometimes they take the form of mental instability caused by unsightIy scarring and sometimes they become subtIe guiIt compIexes associated with actions taken that Ied to stark tragedy. Often the burden is economic too. Many a life’s savings has been drained to make financia1 amends for a moment’s careIessness. FamiIies have been broken up with children becoming the burdens of reIatives. Victims have entered nursing homes or have become charges of state-supported institutions and hospitaIs, a11 requiring eIaborate facilities and services. AI1 these pathetic resuIts become a daily probIem for the physician and surgeon along with his speciaIty consultants. The study of the injury and its method of automobiIe design and injury production, patterns, and accident frequency as it reIates to diseases and the use of drugs are as much the concern of the responsible surgeon as the lay investigator. ArticIes on these subjects shouId increase in quantity and quality. WHAT

ABOUT

DRIVER

Education?

EDUCATION?

The greatest weapon for good in a democracy is education. The greatest weapon in the campaign for safety on the highway is an informed driving public. The pubIic so desperately needing to be educated in safe driving habits falls roughIy into three groups: (I) the great mass of the driving public-some good, some bad, some with mereIy bad attitudes and some grossly unfit for medical reasons to drive at all, (2) teenagers who are quaIifying for Iicenses for the first time and (3) the geriatric group in whom hazards increase with age and who present special probIems of their own. What can be done in the way of education with the great mass of the driving pubIic is somewhat Iimited, for they are a group extremely diffrcuIt to reach except through the mass media. Physicians, however, are in a position of exercising some infhrence in at Ieast one area, that of the medica aspects of driver Iicensure. Physicians need to take more seriously the factors concerned in the granting of a license to drive. Because a physician deals in services, and the patient is his onIy as Iong as he renders a satisfactory physician-patient reIationship, he is often reluctant to face up to the probIem of physical disabiIities as they effect driver

DRIVER

EDUCATION

FOR TEENAGERS

ProbabIy the best Iong-range pIan for improving the over-ah quahty of drivers is good driver education training for teenagers, both in the cIassroom and behind the whee1. The more than 20,000 high schooIs in the United States have in them a tremendous captive audience of teenagers, 1.G miIIion of whom become eligible to drive an automobiIe each year. RegrettabIy, onIy about three of ten get training both in the classroom and in actual car operation. The cost of good drivertraining programs, particuIarIy when measured in terms of pupil-teacher ratios, is enormous. By its verb- nature, it is reaIIy private tutoring. The cost must be shared by community business organizations and voIunteer Iabor. -4 UNIT

SURVEY

The driver education program of the Flint public schooIs began in 1954. Since that time more than 7,000 students have been instructed in the skiIIs and attitudes of safe driving. (Fig. I.) To make such a program click in551

Woughter

FIG. I. The FIint driver training range has been described by nationa authorities as the best equipped in the nation. Over 7,000 students since 1955 have received training here. The building at Ieft contains classrooms, garages and special training devices.

valves a great many community businesses and organizations. The FIint AutomobiIe DeaIers Association has furnished nineteen automobiles through an auto assistance pIan. The Genera1 Motors Corporation encourages such civic support by its deaIers through a plan that awards $125 to any deaIer for each automobiIe Ioaned to the program. This is, in fact, a national policy. Genera1 Motors deaIers aIone provided 5, I 82 new cars to high schooIs around the country during the year 1957-1958. Ford, ChrysIer, Studebaker-Packard and others have done proportionateIy the same. In FIint, the IiabiIity insurance for the program is furnished by the Association of Fire and CasuaIty Underwriters, who beIieve they have scored heaviIy in keeping insurance rates low through this means of encouraging better driving among their insured. The Genesee County Traflic Safety Commission gives invaIuabIe aid to the Flint program with organizational know-how, instruction and timely assistance in a11 aspects of the program. The Iist of community agencies and organizations now participating in the program is exhaustive. Among them are: The FIint AutomobiIe CIub, The Manufacturers’ Association, The Parent-Teachers’ Association, The PoIice Department, The Recreation and Park Board, 552

The Michigan Inter-Industry Highway Safety Committee, The Mott Foundation Program and The Genesee County MedicaI Society. The contributions toward this program by the medica society are varied, but one unique experiment conducted may be of particuIar interest. In the spring of 1958 each high schoo1 in FIint heId an assembIy of a11 students who had compIeted the course in driver education. A doctor representing the IocaI medical society and the Trauma Committee of the American CoIIege of Surgeons presented an iIIustrated taIk on the medica aspects of traflic safety. The presentation emphasized the consequences of driving while under the inffuence of drugs and alcohol. It aIso deaIt with accidents caused by drivers with incapacitating diseases producing temporary crises, such as epiIepsy and diabetes. Graphic iIIustrations of accidents caused by careIessness, poor attitudes and violations of the Iaw were presented. The coIor sIides of these actua1 cases were sometimes too reaIistic for the young audience to withstand comfortab1 y. A questionnaire answered by the students after the presentations measured their reactions. In aI1, there were four assembIies. In three assembIies injury to the body from

What

Profit

in Driver

accidents was dramatically emphasized with the realistic sIides. In the fourth, the stress was placed on the effects of aIcoho1, drugs and debilitating diseases. The results are contained in TabIe I. It is interesting to note that the bodiIy injury approach apparently frightened quite a few students, whiIe the “drug and disease” approach gained quite a different response to the question, “Did the talk create fear or upset you?” THE

ROLE

OF THE

‘TABLE STUDF.NTS’

GERIATRIC

KEACTIUNS ON

INJURY

TO TWO

1 KINDS

FROM

OF PRESENTATIONS

ACCIDEKTS

Bodily Injury Approach

: Drug and Disease

’ Approach

_ Did the doctor’s talk have meaning to you?. fear or 2. Did the talk create upset you?. 3. Do you believe the talk was informative and that all students shouId have the opportunity to hear it?. 4. Do you believe the talk contributed heIpfu1 information to the driver education program?..................... 5. Do you think students shouId have an opportunity to see actuaI automobiIe injury, cases?. I.

COURT

In spite of all efforts to the contrary, there are those students who repeatedIy vioIate traffic Iaws and frequent the MunicipaI Court. In August 1958 a sort of “postgraduate” or refresher course was inaugurated for these apparent incorrigibIes. Twenty-four young aduIts reported at the request of the court to a series of four two-hour courses designed to teach them better driving habits, This was the first time, in Flint at Ieast, that this type of education was made a part of a court procedure to curb bad driving habits. Of the twenty-four students enrolled, seventeen compIeted the course satisfactority and the majority were attentive and interested during the duration of the course. THE

Education?

222

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(61

!

148 ( 81

I09 2

!

!

I2 1 hl0

I !

213

i /

/

accidents that occurred in Flint during the caIendar year 1957. Of sixteen traffic deaths in 1957, ten of the people killed were over the age of forty and six were over the age of sixtyI&e. During the same year, 3,548 drivers were invoIved in accidents, and of these 105 were sixty-five years of age or older. These figures wouId seem to indicate that perhaps the public is too conscious of driving frailties among our youth and not nearIy enough aware of the safety shortcomings of our oIder population.

GROUP

Serious thought has been given in FIint to encouraging peopIe over the age ,of sixty-five to take driver training. OIder peopIe are sometimes reIuctant to part with an old car for fear of not being abIe to react properIy to the new and automatic devices on Iater modeIs. With this thought in mind, the Mott Foundation Adult Education Program of the Board of Education took pains to make enroIIment in driver-training courses for oIder peopIe especiaIIy easy and attractive. The response was most encouraging; they took to behind-thewhee1 training with vigor. They aIso received we11 the cIassroom suggestions that they drive during the sIack hours of the business day, avoid unnecessary trips during bad weather and pIan most of their trips during the day. In one year, September 1956 to September 1957, there were ninety-one students over forty years of age attending part or all of the driver-training program. That this type of training is a significant thing for conscientious communities to consider is reflected in some figures on the fata

A REHABILITATION

PROGRAM

Another unique public service offered by the Flint Driver Education Program includes triaIs in reaction time, attitudes and abiIities offered near the end of rehabiIitation folIowing disabling accidents. This offers tria1 runs in cases in which some form of permanent disabiIity exists. In other cases it simply offers the bolstering of confidence after unpleasant experiences. RESULTS

Does such a program as Flint’s, invoIving considerable cost and recruiting the services of so many agencies, pay off in Iives saved? Records kept by the IocaI Traffic Safety Com353

Woughter BROWN, R. I. Americans don’t want traffc safety. Detroit Free Press, June 15, 1958. 3. Aetna CasuaIty and Surety Company. Toward a generation of safer drivers. Tbe Atlantic and Harper’s Magazine, February, 1956. 4. GIBBENS, M. E., SMITH, W. V. and STUDT, W. B. The doctor and the automobile accident. J. A. M. A., 163: 255-259, 1957. 5. GIBBENS, M. E. Prevention of automobiIe injuries. Exhibit, 26th Annual Meeting, American Academy of Orthopedic Surgeons, January 24-29, 1959. Chicago, IIIinois. 6. Editorial. New driver education range described as finest in country. Flint School Review, October,

mission show that during 1958, 93.5 per cent of those peopIe who had compIeted the Driver Education Program in FIint had a record of absohrtely no violations. In addition, not one graduate of the courses had been invoIved in a serious traffic accident. Safety On January I, 1959, the NationaI CounciI ranked FIint as second in the Nation in traffic safety among cities with a popuIation of 200,000 to 350,000. There were 1.1 deaths per 10,000 registered motor vehicles. During 1958 the city had a no-fataIity record for six of the tweIve months. Contrast this with the record just four years ago, 1955, when FIint held last pIace in traffic safety among cities its size. The odds for survival have certainIy improved.

2.

1958. 7. Editorials. Warn sick drivers, A. M. A. urges doctors. A. M. A. News, October 20, 1958. 8. Editorial. Looking forward. Nation’s Schools, January, 1959. communications. James J. Cohoon, 9. Personal Genesee County Traffic Executive Director, Safety Commission, December 29, 1958. IO. Personal communication. CorneIia MuIder, Coordinator of Health and Safety, FIint PubIic Schools, ApriI 15, 1958.

REFERENCES I. News items. Flint Journal, August 17, 1958, October 3, 1958, October 29, 1958, November 12, 1958, November 23, 1958, January 2, 1959.

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