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One Deadly Sin Every Case Manager Must Avoid

There is a RIGHT way and a WRONG way to achieve our case management goals.  Unfortunately, some RN Case Managers have gone the wrong route all to try and steer treatment and medical opinions in the direction that would make their customer happy.  They committed the one deadly sin that I teach our JMS RNs to never commit...arguing with the treating physician.

Now don't get me wrong, we MUST ask for clarifications of opinions, recommendations, etc., but you just don't argue with a  physician.  WHY?  because: 
  1. It won't do anything but make him/her mad - doubtful it will change their mind
  2. You will make it much more difficult for that physician to appropriately manage your patient.
  3. If it doesn't get you thrown out of and banned from the clinic, you will certainly have heck to pay the next time you need to work with that physician again.  And trust me, if you intend to stay in the case management field, you WILL have need to see that physician again.

The higher road I require of our Case Managers is to do our best to assure all the important facts and information are presented to the physician, and then respectfully address our informational needs.  If the answer is not within anticipated treatment guidelines, or is not objective to separate the work injury from other considerations, we may recommend to the carrier another opinion is obtained.  

Kelli had an appointment with a hot-headed physician this week.  He was not fond of addressing WComp issues.  By using our JMS approach, by the end of the visit she obtained exactly what she needed for documentation, and the MD's temperature had cooled significantly.  Also this week, Rebecca had a client scheduled with a MD known to not care for dealing with Case Managers.  Nevertheless, going in with a respectful attitude, she saw her client got the appropriate treatment.   

The key is mutual respect for each other's domain.  If a physician doesn't return the respect, we will still see that our client receives the treatment they need.   Blockhead or not!
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