RE: Vol. 4, No. 4, "Sign of the Time: Field Case Management"

I have been an independent, field nurse case manager for 17 years for California Workers Compensation insurance carriers. The article renewed pride for my profession and acknowledgment of my skills. Field case managers require more than nursing skills and education. We use communication skills to relate to injured patients, stressed family members, employers with staffing concerns, obtaining the best physicians for the injured patient, and provide insurance carriers with timely information and documentation for appropriate authorizations. We require a great deal of patience for physician office wait times with injured and stressed patients. But we use that time to assess the patients' physical and mental health, as well as barriers to recovery. We research medical diagnoses that are uncommon within the Workers Compensation system, that is, coccidioidomycosis. We research uncommon requests for medical services.

I thank the authors for their insight and acknowledgment.

Deborah Hill, BSN, RN, PHN, CCM

Hill Medical Management