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Case management, the latest buzzword in managed care, is a process that has been with us for a long time. The Commission for Case Manager Certification, the leading agency for credentialing case managers, defines case management as "a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs, using communication and available resources to promote quality, costeffective outcomes." 1 As such, there are strong parallels between the interests and skills of case managers and those of family physicians. Both disciplines are person-focused. Both address the needs of the individual across a variety of care settings. Both see their role as advocates, facilitators, problem solvers, and educators.2 Both are trained in and comfortable working in multidisciplinary settings. Both are accustomed to environments where resources to maximize care are limited or absent. This is not to say that the skills of each discipline are the same or that family physicians can effectively serve as case managers by themselves. A case manager might be involved in any or all of the following activities for a given patient: facilitating communications and coordination in medical matters, establishing and negotiating the patient's health care benefits within their health plan, negotiating directly with hospitals and physicians for less costly rates to maximize the patient's financial resources, and recommending medically appropriate and less costly alternatives to care. Note that case management does not involve direct patient care. It is the close oversight and coordination of care, frequently performed by telephone, that is the defining attribute of case management. In their interactions, family physicians and case managers can quickly recognize

Case Management in Family Practice: Assuring Cost-Effective Care for High-Risk Patients