"Put the UR Report Aside and Be a Real Case Manager"

I don't want to sound preachy, but isn't time that case managers starting behaving like, well, case managers?

I am well aware of the history of our profession and how case management has its roots in insurance, claims management and cost containment. However, did you become a case manager to push paper or scroll from screen to screen on your computer? Let's agree that with every profession, there is an amount of paperwork, documentation and administrative tasks that must be performed, but my observation is that the pendulum has swung too far too the left when it comes to case management.

Where is the patient relationship in all this? When was the last time your case 

management focused on the patient and not the paperwork? You did not become a case manager to care for utilization reports and insurance claims. You became a case manager to care for patients. It seems we've lost this focus in our era of skyrocketing healthcare costs and declining insurance company profits.

Over the course of my career as a case manager, there has been more than one occasion when my direct involvement with a patient made all the difference in the world. Getting out from under all of the reports and in the real world with our patients is what the case manager's mission should be. Sometimes I think this is lost on so many employers of case managers who unfortunately are over tasked with the goal of saving money. Of course, saving dollars, particularly considering the already too high costs of healthcare, is an important goal. In no way do I want to diminish that objective, but there must be a balance and lives must prevail over dollars. It is that simple.

What can we do to bring the pendulum back to the center? We can start by educating employers about how we as case managers believe case management should be performed. We can start by having open, forthright exchanges between key decision makers, case management department supervisors and case managers.

 Too often the voice of case managers is not heard. The blame for this lies with management's failure to understand and value case management, as well as case managers' failure to advocate for their profession. I have been saying this for years, but seriously, it's time for case managers to develop a strong voice and use it. Do it for yourself, future case managers, and most importantly, your patients. They deserve better than what our nation's healthcare system is currently providing them.

Here's my charge to all case management supervisors: Schedule a meeting as soon as possible with your case managers. Ask them how they would change the way your department currently functions in order to place the emphasis on patient care? Ask them for specific recommendations. Then, take the best of those recommendations to your organization's management - the individuals who oversee decisions relating to case management policies and procedures - and make a strong case for why changes need to be made. When doing so, remember to strike a balance between better patient care and meeting the organization's fiscal and operational requirements. I have to believe if even one or two changes were made, your case managers could better serve as real case managers and give life to our core belief which is that, within every case manager, there is a caring heart.