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What is a Medical Review Officer?

Tuesday 21st July 2009

The Medical Review Officer (MRO) is a critical person in any workplace drug testing process. S/he is usually a physician who has specialized in occupational medicine, but may be a nurse or other appropriately trained and experienced medical professional. The MRO may be involved in the company’s drug testing programme or may be provided independently by the testing laboratory. In either case, s/he provides expert independent advice and is a critical safeguard for both employees and employers in any drug testing programme.

The medical review process protects both the individual and the company from the risk of wrongful accusations, which can result in job loss and adverse publicity. The MRO may also represent the first formal challenge that an individual faces over their life-style choice. The MRO therefore requires in-depth knowledge of the workplace drug testing protocol, the collection procedure and the laboratory analyses, and must be able to interpret laboratory findings as well as being familiar with all potential pitfalls.

If a sample tests positive, it is first reviewed by the laboratory toxicologist who considers the level of drug found, its kinetics and the potential interference of any medication or medical condition reported by the donor, to assess the significance of the result. The Medical Review Officer then reviews all positive laboratory results and may communicate with the employee. For example, an employee may currently have taken prescribed or over the counter medication that may be responsible for the positive result. It may be necessary for the MRO to contact and speak directly with the donor to discuss the results and to verify any medication the donor has taken. This may be done over the telephone or in a face-to-face medical consultation. The employer will not be notified if this occurs and will only be notified when a test result is finalized.

At the end of this process, the MRO is able to make a black/white PASS/FAIL decision with respect to the particular substance misuse policy that applies to that employee’s workplace.

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