Well it sounds to me like all of you are talking about the type of case manager that makes the patients well being their chief priority. A patient advocate and coordinator.
The term Case Manager can be used for many other roles in the medical field however. And unfortunately some of the roles are definitely not making the patient their first priority.
Most hospital case managers are actually there to make sure costs are controlled and in the U.S. that often means they are reporting directly to the insurance companies. They don't work for one particular company but they are about controlling costs. I have also found out that they get paid incentives from the insurance companies for making the hospital stay as short as possible.
I have a rather poor opinion of these kind of case manager based on two personal family situations.
The most recent was when my adult son had an accident resulting in brain injury and was hospitalized.(he has subsequently recovered about 98% and is back fully functioning)
During his recovery in the hospital as he was transitioning from ICU to Acute care and beyond, the case manager had her clipboard at hand measuring his progress and reporting to back to her contacts in the hospital business office and the insurance companies. For every possible health situation they have what is considered "the normal" amount of progress a patient should be making. One example. My son was briefly in a coma. His brain was damaged and at first he couldn't do anything for himself. As he was progressing into routine things like walking the case manager was counting how many steps he could take before needing help etc. Every possible symptom and recovery was compared to the "norm"
When it came time to leave the hospital the head neurologist told us that the insurance company was questioning how long he had been in Intensive care and a couple of other aspects regarding length of care. The doctors had made every decision based on their vast experience dealing with my sons type of injury. Despite this when all the bills started pouring in the insurance company said he spent 2 days longer than they would cover in intensive care and 2 days longer in acute care plus a couple other "overages" We appealed and had medical records and letters from all his doctors saying he got the exact care he should have received. They modified their position by and allowed 2 of the 4 disputed days. We were stuck with the bill for the rest.
I guess this has been a long rant but believe me this is fairly normal in healthcare these days. (despite a downgrade of my prior excellent credit it will be a cold day in he.. when they get paid)
So if you hear someone talk about a case manager when you are in a hospital, proceed with caution before assuming they are the "good type" of case manager.
peace.
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