CMs are gatekeepers of their own conduct
They are accountable, regardless of area of practice
By Carole Stolte Upman, RN, MA, CCM, CRC, CDMS,CPC Chair,
Committee on Ethics and Professional Conduct
Commission for Case Manager Certification
Case managers today work in a broader range of venues than ever before. Professionals from a variety of backgrounds are finding that they, too, are practicing in the case management field.
These two powerful forces of change are intersecting at a critical point: The need for all case managers and those who practice in the field to become the gatekeepers of their own professional conduct.
This means that no matter what other affiliations a professional may have, anyone practicing in the case management field also must be accountable to the Code of Professional Conduct for Case Managers. For example, a case manager might specialize in workers’ compensation, social work, group health, or an area such as hospice.
Whatever the segment of the field, the individual must practice within the parameters of his or her professional designation and also must comply with the Code of Professional Conduct for Case Managers.
In recognition of the changes in the case management, the Commission for Case Manager Certification (CCMC) is revising its Code of Professional Conduct. The purpose of the revision is to ensure that the code reflects all aspects of case management and the multiple areas in which it is practiced. A draft document has been posted on the CCMC web site (www.ccmcertification.org), and feedback is being sought from all case managers — including certified and noncertified individuals. (All feedback must be received by Oct. 31.)
Given the complexity of the case management field, it’s easy to see how ethical questions could arise. In my particular areas of specialty with seniors and catastrophically injured workers, there can be instances in which an inexperienced case manager could inadvertently cross the line of ethical behavior.
Let’s take a hypothetical example: A new case manager working in the field has a high degree of autonomy. The case manager has a discussion with an insurance company adjuster regarding a seriously injured worker, whom we’ll call "Mr. Smith."
The insurance adjuster tells the case manager, "You had better write a letter to Mr. Smith and tell him that if he doesn’t cooperate with the case management process, we’re going to discontinue his benefits."
If the case manager follows that directive, however, he or she is threatening Mr. Smith — even if such action is completely inadvertent. The case manager could be well intentioned in notifying the injured individual. Nonetheless, such an action would be outside the realm of professional practice.
No one wants to be called accountable by peers and/or the justice system as to why he or she did not practice in compliance with the Code of Professional Conduct for Case Managers. Ignorance of the code or how it applies is not a reasonable defense. Furthermore, as a standard of ethical behavior for the field, the Code of Professional Conduct for Case Managers can be applied to all case managers — those who are certified and those who are not — in litigation. (The CCMC, however, can only use its code in handling complaints against individuals who have the CCM certification. CCMC has no authority over case managers who are not certified and violate the code.)
Case managers must hold themselves accountable in full awareness of what is expected of them. Here are a few tips to help case managers ensure that they are complying with the highest standards of ethical standards:
• Review the Code of Professional Conduct for Case Managers and other professional codes on a regular basis. For example, each time you apply for continuing education credits from a particular organization (such as the CCMC), review the code or ethical standards of that group. What standards are you being asked to live by? Are there any areas of conflict for you? Do you need clarification about a particular matter?
• Understand what other professional or ethical guidelines you also are expected to follow. If you are also a nurse, for example, you must be aware of the implications of the Nurse Practice Act. The dual nature of your professional role — as both a nurse and a case manager — means that you have to practice according to the standards of two professional codes.
• Develop a "red-flag" system. For some people, it comes with experience. But most of us have some degree of an innate sense that serves as a kind of warning when something doesn’t "feel right." If a particular circumstance raises that kind of red flag, pay attention! If you are being ask to do or say something that raises that red flag, make sure that it is in accordance with the Code of Professional Conduct for Case Managers as well as any other applicable professional codes or standards.
The heightened awareness of ethical and professional conduct issues should not be viewed as a burden on case managers. Rather, the Code of Professional Conduct for Case Managers helps to distinguish you as a professional who adheres to the highest standards to the benefit of the clients you serve and the rights of those whom you must protect.
In future columns, the CCMC will explore ethical issues for various areas of the case management field. We welcome your questions and feedback, by contacting us at [email protected].
Editor’s note: Carole Stolte Upman is Immediate Past Chair of the CCMC and Chair of its Committee on Ethics and Professional Conduct. In addition, she is founder and president of Chesapeake Disability Management Inc., and director of Maturity Concepts: Care Management & Consulting, both of Towson, MD. For more information or to obtain an application for the CCM, contact the CCMC at (847) 818-0292 or see the web site at www.ccmcertification.org.
Case managers today work in a broader range of venues than ever before. Professionals from a variety of backgrounds are finding that they, too, are practicing in the case management field.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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