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Table 6. Physician's Health Programs (cont'd)
A forensic laboratory facility qualified to perform and confirm a state of the art
healthcare testing profile must be used.
Level of detection testing rather than using predetermined cut-off should be employed
in analysis and reporting.
A toxicologist must be available for consultation in test interpretation.
Adulteration testing must include at a minimum specific gravity and creatinine and
other tests for adulterants as recommended by the laboratory.
Responding to a Positive Result
Adjustment of treatment/continuing care/monitoring is undertaken based upon on-
going evaluation of the monitored health condition.
Detailed relapse statistics for chemically addicted individuals will facilitate an analysis
of monitoring efficacy. Information should be recorded about the relapse (i.e., relapse
severity, substance type, content/setting, temporal relationship to patient care, whether
impairment was suspected, etc.).
All positive screening results must be confirmed prior to reporting.
Alcohol positive results should be reflexed to test for glucose and yeast.
Voluntary withdrawal from practice pending evaluation and/or treatment is usually
indicated when inappropriate toxicolog y results are received.
Each relapse should be evaluated clinically with a graduated response tailoring
treatment intensification to relapse severity.
Part 6: Special Populations
