Case Managers

I wish the Canadian medical system had case managers. 

This need has presented itself many times in my experience with the medical system.  I'm currently trying to get through a logistics issue so that I can get an MRI done on my head.  I got a call from the hospital informing me in cannot be done until confirmation is received explaining if my aneurysm clips are MRI-safe.  Simple, right?  No.  Now I'm stuck trying to project manage four different care-providers: my brain surgeon (knows about the clips), my neurologist (ordered the MRI, needs to send the info the St. Joes), my family doc (supposed to request all my information from Ottawa, gets C- on the task so far) and St. Joes (doing the test).  The problem is that none of the four talk to each other.  McDreamy's office doesn't answer my phone calls (seriously - they have answered one of thirty calls and have never once returned a call of mine).  Any issues with logistics fall to.....the girl they are checking for brain damage.  How does that makes sense?  Okay, perhaps that's putting it a bit dramatically.

This sort of project management can be just fine, at least when you feel fine or don't have a lot wrong with you.  It sucks when it's complicated.  I've been making phone calls, follow-ups and more phone calls for three week now and I've gotten nowhere. 

In theory, a family doctor could be a case manager.  It just doesn't work that way when a case gets too complicated.  I had a family doctor in Calgary for years who I would recommend to anyone.  I have one now that I think might be an idiot (at least some of the time).  Neither of them could really case-manage for me.  They address specific complaints and send you too specialist it's out of their scope.  If I make an appointment and present a problem, even logistic, they might be able to help.  You had better know the exact problem first.

It's certainly not just this one brain-clip question.  It's insurance paperwork, finding doctors or other health services and scheduling (again, easy when you feel fine).

I'm influenced by my past experience as well.  When I got sick with thyroid cancer, a mistake where my surgeon and endocrinologist each thought the other was doing a task left me much more sick than I needed to be, and for longer.  A case manager would have caught that.

A case manager could be a health professional, if not a doctor or nurse (?).  They would help complicated patients navigate the medical system and make sure nothing gets missed.

Does this exist?  Can anyone in the health field comment?  All I have to go on regarding the operations of the medical system is person experience.  I think this strengthens my case as to a need for case managers that know how to navigate the system.