With the recent emergence of large-scale health care companies, advocacy's role within the system has been reduced. Already occupying only a minor role in case management (itself partly subsumed into the system), advocacy efforts to help individuals and to make structural changes at the system level run against the driving forces of managed care–cost containment and profit making. Practitioners within the managed-care system may be able to carry out some case-and-cause advocacy within the limits of company requirements and possible job jeopardy. Greater efforts will have to come from outside groups focusing on broad issues, including patients' rights; standards of care; consumer empowerment; outside evaluations; maldistribution of physicians and other personnel; protection against lowering of quantity, type, and quality of services; and training of managed care personnel.
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References
1.
AustinC. D. (1990). Case management: Myths and realities. Families in Society, 71, 398–405.
2.
AustinC. D. (1993). Case management: A systems perspective. Families in Society, 74, 451–458.
3.
AustinC. D., & McClellandR. W. (Eds.). (1996). Perspectives on case management practice.Milwaukee, WI: Families International.
4.
BergerC. S. (1996). Case management in health care. In AustinC., & McClellandR. (Eds.), Perspectives on case management practice (pp. 145–174). Milwaukee, WI: Families International.
5.
BlazykC., & WimberleyE. T. (1987). The ombudsman and the case manager. Social Work, 32, 451–453.
6.
DublerN. (1992). Individual advocacy as a governing principle. Journal of Case Management, 1, 82–86
7.
EricksonA. G., MoynihanF. M., & WilliamsB. L. (1991). A family practice model for the 1990s. Families in Society, 72, 286–293.
8.
EzellM. (1994). Advocacy practice of social workers. Families in Society, 75, 36–46.
9.
FieneJ. I., & TaylorP. A. (1991). Serving rural families of developmentally disabled children: A case management model. Social Work, 36, 323–327.
10.
GinsburgC. (1996, November 18). The patient as profit center: Hospital, Inc., comes to town. The Nation, 263, 18–22.
11.
HagenJ. L. (1994). JOBS and case management: Developments in 10 states. Social Work, 39, 197–205.
12.
JacksonV. H. (Ed.). (1995). Managed care resource guide for social workers in agency settings.Washington, DC: National Association of Social Workers.
13.
McClellandR. W. (1996). Managed care. In AustinC., & McClellandR. (Eds.), Perspectives on case management practice (pp. 203–218). Milwaukee, WI: Families International.
14.
McGowanB. G. (1987). Advocacy. In Encyclopedia of social work (18th ed., pp. 89–95). Silver Spring, MD: National Association of Social Workers.
15.
MooreS. (1990). A social work practice model of case management: The case management grid. Social work35, 444–448.
16.
MooreS. (1992). Case management and the integration of services: How service delivery systems shape case management. Social Work, 37, 418–123.
17.
National Association of Social Workers. (1992). NASW standards for social work case management.Washington, DC: Author.
18.
NettingF. (1992). Case management: Service or symptom?Social Work, 37, 160–164.
19.
O'ConnorG. (1988). Case management systems and practice. Social Casework, 69, 97–106.
20.
PattiR.J. (1974). Limitations and prospects of internal advocacy. Social Casework, 55, 537–545.
21.
PhillipsK. (1990). The politics of rich and poor.New York: Random House.
22.
RappD. A., & KisthardtW. (1996). Case management with people with severe and persistent mental illness. In AustinC., & McClellandR., Perspectives on case management practice (pp. 17–45). Milwaukee, WI: Families International.
23.
ReischM. (1986). From cause to case and back again: The reemergence of advocacy in social work. Urban and Social Change Review19, 20–24.
24.
Roberts-DeGennaroM. (1987). Developing case management as a practice model. Social Casework, 68, 466–170.
25.
RoseS. R. (Ed.). (1992). Case management and social work practice.White Plains, NY: Longman.
26.
RothmanJ. (1991). A model of case management: Toward empirically based practice. Social Work, 36, 570–578.
27.
SamantraiK. (1991). Clinical social work in public child welfare practice. Social Work, 36, 359–361.
28.
ShapiroJ. (1995). The downside of managed mental health care. Clinical Social Work Journal, 23, 441–151.
29.
ShechterR. A. (1994). Managed care and psychoanalytically oriented psychotherapy: The influence of professional culture-clash on transference. Journal of analytic social work, 2. 47–59.
30.
SherrillR. (1995, January 9). The madness of the market. The Nation, 261, 45–72.
31.
SullivanW. P., HartmannD. J., DillonD., & WolkJ. L. (1994). Implementing case management in alcohol and drug treatment. Families in Society;75, 67–73.
32.
SunleyR. M. (1983). Advocating today: A human service practitioner's handbook.New York: Family Service America.
33.
SurlesR., BlanchA., ShernD., & DonahueS. (1992). Case management as a strategy for systems change. Health Affairs, 2, 150–163.
34.
VoslerN. R. (1990). Assessing family access to basic resources: An essential component of social work practice. Social Work, 35, 434–143.
35.
WolkJ. L., SullivanW. P., & HartmanD. J. (1994). The managerial nature of case management. Social Work, 39, 152–159.
