Once treatment has been completed, the recovery process has only begun. It is imperative for recovery to be monitored to help prevent a relapse or a return to old patterns of behavior.

The monitor plays a crucial role; this person is chosen for their ability to be firm yet supportive, their knowledge of the underlying problem and geographic proximity to the participant. Whenever possible, the monitor will be chosen from within the same medical group or from the same hospital staff. This allows the monitor to have his/her ear to the ground regarding patient complaints, erratic behavior and the consensus of the recovering person's colleagues. The monitor helps to oversee compliance with the signed Monitoring/Treatment Plan Contract:

1. The recovering physician/PA should be in contact with his monitor within one week of completing intensive treatment. It is the responsibility of the recovering person to contact his monitor, However, lack of contact or other major change can also alert the monitor to a potential problem. NCPHP will notify the monitor of the projected discharge date and return home.
2. The monitor should meet with the recovering physician/PA at least once a month. The monitor should explore how the recovering person is doing socially and professionally and address any areas that may put their recovery at risk.
3. The monitor will also be asked to look at the participant's AA/NA attendance sheet if a meeting log has been required. The monitor should look over the sheet to verify that the required number of meetings is being attended.
4. If the monitor is working with a chemically dependent physician/PA, it will generally be necessary to obtain drug screens as proof of sobriety. The NCPHP office will sometimes call the monitor and ask him/her to obtain a drug screen that day or within a specified time period. NCPHP, the volunteer monitor, or both will notify the participant to show up at the designated location that same day or within 8 hours of the call. Failure of the participant to show for the drug screen will be counted as a positive sample. The NCPHP monitor should also request a drug screen if the participant's behavior is erratic, if relapse is suspected or an untoward event at the hospital has occurred and the possibility of impairment will likely be raised.
5. If a monitor is also serving as therapist for a physician/PA with a non-substance related psychiatric diagnosis, NCPHP is only interested in the overall progress of the participant. At no time will the specific details of therapy be required. NCPHP should, however, be notified if the participant develops new or worsening symptoms that may lead to impairment.
6. Monitors submit quarterly written reports to the NCPHP office. These reports are mailed to each monitor several weeks before the end of each quarter. These reports will be used to verify that the participant is in compliance with his/her Monitoring/Treatment Plan Contract and serve as tools for advocacy on behalf of the participant. If a monitor suspects relapse at any time, the NCPHP office should be notified immediately as opposed to waiting to file the report.
7. Participants should be aware that monitors are serving in a volunteer capacity; it is the participant's responsibility to help the monitor do their job. If there are any questions about a particular case, monitors or participants are encouraged to call NCPHP.

Volunteer Monitor Training

Complete information on the proper procedures for monitoring program participants in recovery can be found in the NC Academy of Physician Assistants Health Committee’s training module. If you are a new monitor, or a question arises as to proper handling of a situation, this comprehensive reference can be immediately accessed by clicking on the link above. If further assistance or clarification is required, please contact Nicole Trail, NCPHP Case Management Coordinator.