Tuesday, May 01, 2007

Don't You All Wish You Were Me?

In the never-ending glamorous swirl of back pain, sinus infections and pus-filled boils that fills my work day, an edict has come:

"Thou shalt go and fulfill thy requirements to become an MRO!!!" came the voice from on high.

"You want me to become a Medical Review Officer?" I queried.

"Yea, verily. Yesterday would not be too soon." the Powers That Be thundered.

"Okie dokie."

In this new career plot to make-over this mild mannered internist into an occupational medicine doc, this is the latest step.

Ah. And what the hell is a MRO?

Very good question, mon ami.

The MRO is the physician (although in Iowa, I believe, it can be a nurse practitioner or a physician's assistant and in Maine and Kentucky they've taken to using moderately trained monkeys) who reviews the results of work-related drug screens, investigates any mitigating circumstances that might make a positive screen due to something other than what you scored from that guy down on the corner, and then notifies the boss/potential boss/never-to-be-future-boss of the results.

Sort of makes me a toady for The Man.

I've given it some mulling over the past few months between being given the edict and now, a few days away from hopping a plane to go take the hopefully enlightening class (because the 2 inch thick syllabus was beyond confusing). I am torn in my feelings about drug testing. Is it a necessary safety measure? Is it a horrific violation of our civil liberties?

I've come to a few personal conclusions.

First, that drug testing will not remove drug use from the work place, but may decrease it. Second, that there are, for me, some jobs that should never be undertaken with so much as a pediatric cold pill in the system, let alone other judgement altering substances. Jobs like driving a 100 ton truck down the freeway. Jobs like operating a train or a plane. Jobs like practicing medicine.

Do I have a problem with someone in a non-life-or-death occupation using something recreationally on the weekend?

As this is a public blog, I don't think I should answer that.

Does the employer of someone who does not have a life-or-death job have the right to test their employees for drug use?

I have a bit more trouble with this. I guess, as drug testing is so very ubiquitous now days, I'd wonder if someone who used recreationally might be in need of some help if they couldn't abstain while job hunting, in the almost certain event that a pre-employment drug test was required. (Either that or they had such poor judgement that, as an employer, I'd question their ability to staple papers or use a copy machine without doing damage to themselves or others.) Random drug testing of employees without suspect behavior in non-life-or-death jobs? I think that's a different issue as well.

Finally, I've become comfortable with my role in this, as there ARE extenuating circumstances for positive tests and, if it were me, I'd want someone with compassion and an open mind talking to me to see if there were any other valid explanation for my positive test, rather than dismissing me as a druggie out of hand.

There. Rationalization complete. So much better for that.

And where am I off to? Whither the wild blue in my yonder? Well, that would be South. I'm heading South to New Orleans. I'm a bit nervous as I've arranged the whole damn thing on my own and have this feeling that I've forgotten something, or gotten the dates wrong or what-have-you and I'll end up arriving on the last day of class, in my underwear with (inexplicably) spiky green hair and everyone will stare and laugh as they hand me a 100 page test that I have to finish in 30 minutes.

Oh! and look! I have no #2 pencil.

I have that kind of 'something's wrong' feeling.

I've also not flown since all the new restrictions on luggage (What? I can't bring anything with paper on a plane? But the 2" thick syllabus! I need it! Oh. What if someone lights my syllabus on fire as an attack? Ok.) and the new check-in systems. I am someone who is comfortable with what I know and can control (gosh, what a shocker). I am trying to treat this as some great adventure, but really, it's a pain in the ass, as it's 2 days of travel to sit for 2 days in a hotel conference room and study for 3 nights in a hotel room.

Did I mention the 400 page textbook that must be ingested, digested and regurgitated, along with the 2" syllabus on Monday, when I take the test?

Did I mention the primal fear that I not pass this employer decreed hoop and have to tell them that, gosh, you just spent $2000 on me for squat.

No, no. Not good. So, despite having always wanted to see New Orleans, ever since reading Interview With a Vampire, and seeing The Big Easy, if you want to know, I will not be partaking in this fascinating city outside of a walk after class and before dinner each evening.

So that you can sing along with me, when I head off in 2 days, I leave you with the following excerpt from the reading:

"As a BAT or STT, or employer, you must cancel and alcohol test if any of the following problems occur, unless they are corrected. These are "correctable flaws." These problems are:

(a) The BAT or STT does not sigh the ATF (see 40.247 (a) (1) and 40 255 (a) (1).

(b) The BAT or STT fails to note on the "Remarks" line of the ATF that the employee has not signed the ATF after the result is obtained (see 40.255 (a) (2)).

(c) The BAT or STT uses a non-DOT form for the test (see 40.225 (a)).

--from the Dept of Transportation CFR part 40

And so on, and so on, and so mind-stunningly, horrifyingly, brain-curdling, sobbingly on.

Suddenly I question if my overwhelming desire to avoid all on-call responsibilities is really worth this.



Blogger CarpeDM said...

Oh dear. That is quite horrifying indeed. I have no idea what to say to you other than "Oh my God! You can't read on a plane? How stupid is that?" Very glad we're not flying anywhere, I would go insane.

Here's a question. If someone stole your sylabus to start a fire, couldn't you, oh, throw some water on them? Or is water forbidden as well? And, since you can't bring matches or lighters on board, how are they making the fire? Rubbing sticks together?

I will have extra fun for you. I promise.

12:18 PM  
Blogger Voyager said...

Pre employment drug testing? Does that really happen? I've never heard of it, maybe I'm hopelessly naive.

12:22 PM  
Blogger Dumdad said...

I think they should drug-test the person who wrote that Dept of Transportation excerpt!

Good luck with your trip - I'm sure it'll go well.

12:58 PM  
Blogger Diana said...

Dana- No, no. I was kidding. (At least as far as I know, you can bring paper freely on the plane.) Sticks may be a problem, though...

Voyager- Hah! I was just reading in my handy-dandy Medical Review Officer's Manual that in Canada, pre-employment drug testing is not allowed. That is the opposite of what it is here, in the States, where it is pretty much ubiquitous, even in such jobs as making cheese or running a cash register or packing boxes with orders for sausages and chocolates.

Dumdad- You know, if the whole bunch of them were on drugs, that would explain quite a lot. Suddenly it all becomes clear.

2:07 PM  
Blogger listmaker said...

Sounds awful! Good luck with the test.

5:15 PM  
Blogger Stepping Over the Junk said...

this makes me giggle since you grew up going to a CS church!

7:16 PM  
Anonymous Christie said...


Piffle's working for 'Da Man!!!! WOOHOOO!!!!!!!!!

And good luck to ya sister, sounds like my own private hell....

8:21 PM  
Blogger Teri said...

I am tempted to respond to your random garbledygook with the garbledygook that I've been reading, but I will not.

I have not flown since the liquid rules were put into effect - but I found having to remove my shoes, well, icky. Ugh. Foot fingus central at the x-ray machines.... the floor was so dirty. I would never have noticed if I hadn't been made to take of my shoes.

12:10 AM  
Blogger Teri said...

sigh. fungus. can't. type. right.

12:11 AM  
Blogger moegirl said...

No paper on airplanes? weird. Well, I know you will have at least a few interesting blog entries about your trip/training. So, UA's? Does this mean more cloudy urine haikus?!

12:44 AM  
Blogger Lauren said...

So so so very love Interview with a Vampire. I also have never been to New Orleans. I hope you get to see some of the city. As for your jargon.... well, I will just say good luck. Have fun. And I will pray you don't fall asleep. That is what I would do if I were in your shoes.

8:12 AM  
Blogger Diana said...

Listie- Thanks. I'll need it. That and lots of coffee...

Stepping- Oh, yeah. I wonder what Mary Baker Eddy would have to say about drug testing?

Christie- Ah. Wish you were there to share the misery (and then my quest for beignets).

Teri- I'm certainly not going sockless, that's for sure. We could have dueling random garbledygook.

Stace- No, no, no. That was just a bad joke. Paper fine. I should have a few pee tales.

8:28 AM  
Blogger Diana said...

Lauren- I find it difficult to keep my attention focused on more than 1/2 day of lecturing. I'm hoping the course will involve some practical bits and not just sitting and being yammered at.

10:28 AM  
Blogger Jocelyn said...

First, good job with the rationalization. I must say I'd rather have you reading my drug-screens that most anyone else. (that's a compliment, right?)

Secondly, I'm sorry you won't be able to get out and see the horror that is New Orleans at this historic juncture in its history. We have a little Third World country within our borders, so getting a taste of that might be the best thing you'd ingest on your trip.

Good luck on that test. Man.

1:43 PM  
Blogger Mother of Invention said...

Wow! You have a lot ti digest and spit out! Dry bedtime reading! I hope you get this if that's what you truly want. I'm assuming it's a kind of promotion or at least means better working conditions for you since there's no on-call that will interrupt your family time. I think I'd miss my regular patients and the connection you develop through them. Will you? It's the same as I'd miss being with your own class if I were to change from the classroom to a principal. I kinda like being in the trenches.

6:40 PM  
Anonymous Ariella said...

Sadly, I, too, have been reading the CFR and DOT regulations. Blah, can't really talk about work on your BLOG, but at least this is in the context of a nice gory accident.

Have a good time in the Big Easy!

6:44 PM  
Blogger Rozanne said...

Good luck on the test--it sounds brain-curdling, blood-curdling, and soul curdling all at once.

I like your rationale, BTW, and think you arrived at the right conclusion.

I'm wondering what it will be like to be in New Orleans? I'm sure you won't be (won't be allowed to) venture far from your hotel, but be careful. All I keep hearing about is how dangerous it is. I wonder if that's true or an exaggeration by the media?

7:43 PM  
Blogger brooksba said...

The company that provides my paycheck doesn't do drug testing (although there are times I wish we did), but to be the conservative (which is rare for me), I actually like the concept. Being a manager who has to try and get work out of someone who is consistently in another mental state is not a fun experience. I also figure people know what they're doing and they're making a choice. Employment is at-will and employers can choose not to provide a paycheck for an individual who they don't want to have employed.

And now I'll hop off the soapbox - I'm not really that passionate about this topic but I've had a ton of caffeine and my fingers keep typing. I hope that you don't get bored on the plane, get through the airport easily, and do get to see at least some of New Orleans. You'll have to bring back pictures for us all to see. I've always wanted to visit New Orleans.

Since DM is going on vacation, can I come with you?

Have fun, learn lots. I guess I'm a dork because I love learning - doesn't matter the topic. So if you're like me, you'll enjoy the class.

4:25 AM  
Anonymous Leigh-Ann said...

Learning new things is good! I hope you'll have a fun and exciting trip, and will eat lots of good food that you will tell us about.

4:56 AM  
Blogger Diana said...

Jocelyn- Thank you. I'd be honored to review your pee. I am wishing I had some days after this (and someone with me) to poke around, see the good and the horrible. Thanks. Man.

Ruth- Actually, I made the leap back in 2000, when we made the trek out here from the West Coast. I'm currently working as the overflow doc, meaning I see patients who can't get in to see their primary providers or patients who don't yet have a primary. I thought I'd miss the continuity, but I find that I sleep much better and fret less this way. I don't take call, do no hospital or nursing home work. My hours are set and when I leave, I leave it there. I don't have the scads of paperwork I used to have, either. It's a wonderful job for me, but I'd be silly to think that something this good will last forever.

Ariella- EW! Poor you. At least there's some horror to keep you awake.

Rozanne- What is that line from The Big Chill that states that rationalizations are more important than sex? Charles is not thrilled about all the reports of crime and murder. Where I'll be staying is in the French Quarter and I've promised to not go out after sundown and will be staying where the crouds are, so the most likely evil would be a picked pocket. Won't get to do much, anyway as I must study, study, study. Damn.

Beth- I can certainly see it from the employer's side, but I still have issues. Oh, well. I'll do things to the best of my ability. Honestly, from where I stand, the MRO is on the side of the testee, trying to see if there's anything that could account for the non-negative test before passing on the bad news. How fun would it be if you were here with me??? You'd probably even like the lectures and I could make snide remarks to you, which always makes such things easier for me.

Leigh-Ann- Am bringing my camera and my appetite! See you on the other end.

8:52 AM  
Blogger Stepping Over the Junk said...

I'm glad I just paint for a living!!! Have a good trip!

12:55 PM  
Blogger Babs said...

I'm here to make you laugh. Do you know what I got yesterday??

Sweatjacket. From Down South.

It's summertime.


5:37 PM  
Blogger Diana said...

Babs- The definition of tragi-comic! Herself outdoes Herself. The tears of mirth roll down, babe.

9:43 PM  
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