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27 Table 6. Physician's Health Programs Scope Most PHPs work with other healthcare professionals (dentists, veterinarians, pharmacists, etc.) Approach PHPs expect each physician participant to maintain lifelong abstinence from alcohol and drugs. Relapses are seen as temporary setbacks or learning experiences. e elements in PHP care management are part of an integrated long-sustained program. e level of cohesion and coordination that comes from such integration may contribute to the PHP's high long-term recovery rates. Monitoring e minimum period of monitoring for addiction is five years. e minimum period of monitoring for harmful substance use is 1 year and a maximum of 2 years assuming no additional concerns are raised during the monitoring period. A contractual component between PHPs and participants should include an agreement for abstinence and the requirement to immediately report any use of alcohol or mood- altering chemicals. A contractual component between PHPs and participants should include an agreement to submit to biological specimen monitoring without question. e monitoring function involves periodic interviews as well as random urine and hair testing. e average PHP participant receives weekly random drug testing for the first 6–12 months followed by once or twice per month for the remainder of the agreement. Testing is random, meaning that typically every day of the work week the physician participants call a phone number to see if that day they need to submit a sample for testing. If they had been tested the day before, they could be tested next. If problems emerge, frequency of random testing is substantially increased. Failing to attend required treatment and support groups may result in heightened testing frequency. Many physicians in recovery cite continued urine testing as a powerful deterrent to drug use, which greatly increases their motivation to remain abstinent. Drug Testing Protocol Commonly marketed drug panels such as "NIDA-5" and "CSAT-7" are not adequate for testing in this population. Most PHP programs routinely use ethyl glucuronide testing to better detect alcohol use. e panel most oen performed is a 20+ drug health professional drug panel. Witnessed collection is the gold standard. Deviation from this collection protocol for a specimen must be approved by the PHP.