Two, ensure that examiners are qualified and know what to look for.
To me, this seems like a no-brainer. But the Safety Board explains that “many commercial vehicle drivers whose serious medical conditions are known to their employers, health care providers, and others are never reported to the appropriate motor vehicle licensing authorities”. Perhaps there is room to lay some blame at the feet of these employers who would endanger the general public. At least, one should hope that not everyone involved is initiated into a code of silence.