If you’ve been diagnosed with cancer, you will interact with a number of different members of the health care team at various times during treatment. When you walk into a doctor’s office, hospital, or cancer center, you may encounter nurses, physician assistants, social workers, doctors—the list goes on. In the Spotlight On series, we talk with some of these health care professionals to learn more about their jobs and the role they play in providing high-quality cancer care.
A cancer diagnosis can be overwhelming. All the information about treatments and insurance benefits can be hard to navigate, and patients may not know what support is available to them or which ones best suit their needs and situation.
This is where the role of the case manager comes in. Case managers are educators and advocates for the person with cancer. They help people identify and choose resources based on their availability and what best suits the patient’s financial and personal needs.
There are many kinds of case managers. Some case managers work in hospitals and help people manage inpatient care. Others help people with cancer navigate outpatient care. And yet others work for insurance companies and specialize in helping people understand their insurance benefits and coverage.
To better illustrate the role a case manager plays in the cancer experience, Ann Brady, RN, OCN, described her role as a case manager at Beth Israel Deaconess Medical Center in Boston, Massachusetts.
What is your role as a case manager?
Ann Brady (AB): I handle home care for patients in the hematology/oncology areas. I work with patients and doctors to discuss visiting nurse care, palliative care, and hospice care. I meet with patients and educate them on what home care agencies are available to them. In addition, I make referrals to visiting nurses. I also help by ordering durable medical equipment (DME), like hospital beds or wheelchairs, for their home care.
Do case managers work directly with patients? Or is most of the work done behind the scenes?
AB: I work directly with patients to make sure that the proper type of home care is available to the them. I also help manage the conversation and expectations between doctors and patients on the topic of home care.
Is more of your contact with patients done in person or over the phone?
AB: I really prefer to speak to patients face to face. If someone has a scheduled clinic appointment with their medical team, I will seek them out, so I can speak with them in person. However, this is not always an option. If a doctor decides a patient needs something after they have left the clinic, then I will touch base with the patient over the phone. For example, when I am lining up a visiting nurse to see a patient after chemotherapy, I will talk to the patient over the phone before they start chemotherapy because I know the visiting nurse will have the face-to-face interaction later on.
When do case managers begin working with a patient?
AB: This depends on the case manager’s specific role and the patient’s wants and needs. For my role in handling home care, there are times when people decide that they want to look into options for hospice care. At that time, I would sit down and have a conversation with them. So, it depends on the type of case manager, the patient, and the situation. An insurance case manager, for example, would be involved in a person’s cancer care before they would come to me.
Do case managers also communicate with caregivers, family, and friends?
AB: This depends on the patient. If a patient wants me to communicate with them and gives me permission to contact their caregiver, family, or friends, then I will reach out to them. For example, if a patient tells me that they do not want to handle the details about home care and would rather have a family member arrange that for them, then I will reach out to their family member.
Can a patient have more than 1 case manager?
AB: Yes. Case managers can work for hospitals, insurance companies, and even primary care physician offices. People can have different case managers, depending on their situation and their needs. Sometimes, patients may not even be aware of how many case managers they have. I ask my patients if they have other case managers, because if they do, I can contact those other case managers to coordinate care.
What backgrounds do most case managers have?
AB: In my experience, most case managers have a background in nursing. This background is extremely helpful in working as a case manager because so much of what I do has to do with patient care. A clinical background can really help case managers understand someone’s medical needs.
How would someone go about finding a case manager?
AB: Most times, it will be the case manager who contacts the patient. However, there are many ways a patient can find a case manager. You may want to hire a private case manager or work with one provided by a hospital or insurance company. It all starts by asking a member of the health care team or calling the insurance company to ask whether case managers are available to help. You could even contact your primary care physician’s office to ask for a case manager referral. Case managers are there to help patients with their needs.