WHO CAN BE AN MRO?
M.R.O. is defined by 49-CFR part 40 – Section 1.2 as: “A licensed physician responsible for receiving laboratory results generated by an agency’s drug testing program who has knowledge of substance abuse disorders and has appropriate medical training to interpret and evaluate an individual’s positive test result together with his or her medical history and all other relevant biomedical information.”
- An MRO must be a “licensed physician” (MD or DO) with qualifications listed above.
- May not have financial interest in the lab(s) involved!
Medical Review Officer Certification Council (MROCC)
MROCC is an independent, Physician-based Certification Council. Click here to reach the MROCC web page.
American Association of Medical Review Officers (AAMRO)
OTHER ORGANIZATIONS OFFER TRAINING BUT DO NOT CERTIFY:
American Society of Addiction Medicine (ASAM)
Click here to reach the ASAM Homepage
Click here to reach the ASAM course index
These organizations have co-operative arrangements with the certifying bodies. Certification exams are usually given on site immediately following the MRO training courses.
Governed by 40.29 (n) (6) — which says: “The laboratory shall not enter into any relationship with an employer’s MRO that may be construed as a potential conflict of interest or derive any financial benefit by having an employer use a specific MRO.”
WHAT GUIDANCE IS PUBLISHED FOR THE MRO?
In addition to a Medical Degree, MRO certification, and experience in primary care or psychiatry, the following are recommended:
- THE INITIAL CERTIFICATION COURSES (see above)
- MEDICAL REVIEW OFFICER’S MANUAL.
The Medical Review Officer’s Manual: MROCC’s Guide to Drug Testing, 4th edition.
This is edited by Robert Swotinsky and Donna Smith. The link to it (published by OEM Press) is http://www.oempress.com/product/386/1.
- The MRO Team Manual (authored by James Ferguson, DO) is a Guide for MRO Assistants and Staff. The link to this book (again, published by OEM Press) is http://www.oempress.com/product/354/1
- MRO ALERT MEDICAL REVIEW OFFICER HANDBOOK (9th edition) Published by AAMRO P.O. box 12873 RTP, NC 27709 Price $125.00 [Included in AAMRO course materials.]
Order by phone at 800-489-1839 FREE 800-489-1839
- The American College of Occupational and Environmental Medicine (ACOEM) publishes MRO Update. (Editor: Robert Swotinsky, M.D.)
www.mrocc.org to reach the MROCC web page.
- ALCOHOL AND DRUGS: The D.O.T. Compliance Manual 3-ring binder @ $175.00 Click here to order through J.J. Keller or to get more info.
- SEVERAL FORENSIC JOURNALS ARE WORTH MONITORING: The best summary is at http://www.gwu.edu/gelman/guides/sciences/forensics.html
- ONE EXCEPTIONAL JOURNAL ARTICLE: Green KB, Isenschmid DS: Medical Review Officer Interpretation of Urine Drug Test Results; Forensic Science Review 7:41:1995 (June 1995)
COMPETENCIES REQUIRED OF THE MRO:
Complete summary of competencies is posted at https://www.mrocc.org/examprep.cfm
THE FUNCTIONS OF THE MRO:
The MRO performs FOUR FUNCTIONS:
Lab reports from the laboratory (as governed by regulations.)
Lab reports for integrity, authenticity, false negatives, and false positives.
Lab results, including verification of lab positives.
Lab reports to employers (as defined by rules and regulations.)
Each of these functions is discussed in a separate section.
To reach a given section, click on its title above… or return to the MRO Index Page.