MRO - About the MRO
 
Important information regarding MRO's

~~ ABOUT THE MRO ~~

WHO CAN BE AN MRO?

M.R.O. "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....

  • AND May not have financial interest in the lab(s) involved!
CERTIFICATION:  
    THERE ARE TWO CERTIFYING BODIES: (Both offer training courses as well as certifiction.)
     
      Medical Review Officer Certification Council  (MROCC)
        This is a "sub council" of ACOEM. (American College of Occupational & Environmental Medicine
        MROCC has over 5,000 graduates
        MROCC publishes MRO Update.  (Editor: Robert Swotinsky, M.D.)
        Click here to reach the MROCC web page.
      American Association of Medical Review Officers  (AAMRO)
        AAMRO has about 2,500 graduates
        AAMRO publishes MRO Alert  (Editors: Ted Shults, J.D. & Steven St.Clair, M.D.)
        Click here to reach the AAMRO web page.
         
    TWO OTHER ORGANIZATIONS OFFER TRAINING ~~ but do not certify **
      American Society of Addiction Medicine  (ASAM) ** Western Institute for MRO Training **
        Call 509-926-2202 for info.
        Publishes MRO Practice.  (Editor: Ron Springel, M.D.)
    ** NOTE:
    • These organizations have co-operative arrangements with the certifying bodies
    • Certification exams are usually given on-site immediately following the MRO training courses.

      •  

MRO/LABORATORY RELATIONSHIPS

    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 MANUAL FOR FEDERAL WORKPLACE DRUG TESTING PROGRAMS
    • Published and distributed by Center For Substance Abuse Prevention  (A division of SAMHSA)
    • Copies available through CSAP "hotline" at 800-843-4971  or  FHWA @  800-852-5660 or (202) 366 DRUG.

      •  
  • MEDICAL REVIEW OFFICER'S MANUAL
    • Published by ACOEM press.  Eds.: Robert Swotinsky, M.D. and Donna R. Smith, Ph.D.
    • Available May 1999
     
  • GUIDELINES FOR IMPLEMENTING THE FHWA ANTI-DRUG PROGRAM
    • (Office of Motor Carriers Publication No FHWA-MC-91-014, March 1992)
    • Order from: [try F.H.W.A. @ 1-800-852-5660] or (202) 366-DRUG,
      • Office of the Secretary of Transportation,
      • 400 Seventh St., S.W.,
      • Washington, D.C. 220590
     
  • MRO ALERT MEDICAL REVIEW OFFICER HANDBOOK (Sixth edition)
    • Published by AAMRO   P.O. box 12873   RTP, NC  27709
    • Price $75.  [Included in AAMRO course materials.]
    • Order by phone at  800-489-1839

      •  
  • THE MEDICAL REVIEW OFFICER'S GUIDE TO DRUG TESTING
    • Robert Swotinsky, M.D., M.P.H.  editor
    • Wonderful Reference for Serious MRO!
    • Order from Van Nostrand Reinhold  800-544-0550  (Will take phone orders per credit card)
     
  • 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:
    •  
  • 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)

      • We are seeking permission to post this article (which is worth a trip to the library!)
       

COMPETENCIES REQUIRED OF THE MRO:

Complete summary of competencies is posted at  http://www.mrocc.com/pageexam.htm" 

THE FUNCTIONS OF THE MRO:

The MRO performs FOUR FUNCTIONS:
    RECEIVE lab reports from the laboratory (as governed by regulations.)
      REVIEW   lab reports for integrity, authenticity, false negatives, and false positives.
        INTERPRET lab results, including verification of lab positives.
          REPORT 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.