What's in a name? That which we call a rose by any other name would smell as sweet.

-Shakespeare

It was early in the 1990s that I assisted a neighbor to get her GED. During that time, I was also working on my higher degrees and preparing to take one of the first CCM examinations. I was so proud of my new credential, so imagine my chagrin when, 4 months later, my neighbor showed me her new business card with the title of "Case Manager."

This scenario is decades old. Both newly minted GED staff and degreed professionals (bachelors, masters, and beyond) with hardearned credentials have been using the title of case manager. In today's healthcare arena, it is getting more complicated. The simple fact that various levels of professionals (or lack thereof) called themselves case managers has more currently been confounded by a plethora of names and titles for the work that case managers have been doing for years. Many new models have emerged (and this is positive progress); however, each model calls the "case manager" something different. Terms with variations of job descriptions have emerged: medical home coordinators, care coordinators, patient navigators, healthcare coaches, guided care nurses, and so forth.

If all these names were completely intuitive, this would not be a problem. But there are two audiences to consider when thinking about this predicament: professionals and consumers. If this has been a confounding concern for professionals, imagine the confusion in the minds of consumers. We have previously been rather unsuccessful in educating consumers about "case managers" and what we do. Imagine our challenge now!!

Names are important. And as some say, "words are things." But on a deeper level, words are symbols, as well. They capture entire concepts and sometimes they portray a "promise." For example, although many consumers are not clear what a "case manager" is and does, a case manager holds the promise of support and help during their experience in a complex, scary, and ever-changing healthcare environment.

How we describe that "help" is critical. Each case manager has a golden opportunity to calm the confusion by asking themselves how they initially present to a new patient/client? The 30-second "elevator" introduction is quite important. In a Phoenix Medical Management recent newsletter, the authors ask an important question: "What do you say after you say hello?" As the authors state, "The introduction is one of the most important elements of a hospital case manager (HCM) communication. "Most patients still don't understand the role the HCM plays in their care and misconceptions about HCMs still tend to be the rule, not the exception" (Phoenix Medical Management, 2010, p. 1). The solution will take "team thought" and will most certainly take some time: boiling down the complexities of case management into a simple, clear sound bite is a formidable task. This is as much about educating the consumer, as it is managing expectations of the consumer.

I only call attention to this evolving situation; I pose no real solutions, except to ask the readers to take this seriously and submit viable solutions so that I may disseminate them. One was suggested in this issue. Watson said in the "CCMC News and Views" column that perhaps the common denominator in the near future might have to be the distinct credentials behind a case manager's title.

Whichever title the organization has chosen for the task-at-hand and whichever credential(s) the professional has chosen, that credential points to one's specialized credibility, knowledge, proficiency, experience, and professionalism. It is as much about clear roles and accountabilities, as it is about case management professionalism.

Before I close this Editorial, I want to mention one more important stakeholder that must be absolutely clear about who we are and how we impact patient safety and improve the quality and efficiency of healthcare: those on Capitol Hill. They interpret the new acts and laws and determine, at least to some extent, who gets reimbursed and how that reimbursement is portioned out. Case management credentialing organizations and societies are doing what they can to separate this issue's wheat from the shaft. They have developed standards and definitions. But we must all participate to clarify the issue and decrease the variation: it is important to our future. Action item: What are your solutions? What solutions has your organization come up with? Brochures, scripts, and 30-second "elevator" introductions are welcome. Please write me at mailto:[email protected] and put "SOLUTION" on the subject line. I will share anything valuable in a future Editorial.