You have described case management as it damn well ought to be practiced, but all too rarely is, at least in the U.S. Here, as you have likely heard, the term "case manager" usually refers to an employee of a managed care organization whose superordinate purpose is to keep claim costs down. Although in my work with case managers I have encountered some that are intelligent, decent and reasonably well-informed, there are . . . shall we say, others? These are the ones we call "case manglers," just as we call their corporate masters "mangled care organizations."