The Desire for Professional Engagement: Why Some People Are in and Why Many Are Out!


You are likely reading this article because you have already made some level of commitment to engaging in your professional development as a case manager. You have probably paid your membership to CMSA and are somewhat tapped into what is going on in the organization. However, the majority of individuals in the case management field are not, so what is the difference between those who engage and those who do not?

In the last 2 years, the news media have reported on the Great Resignation, popularly known as the mass exodus when tens of millions of Americans left their jobs during the pandemic (Richter, F., 2022). The departure highlighted many reasons why people left, but clearly, the traditional thought of building a sense of community with your employer was no longer seen as of value. The historic perspective of an employer treating employees as if they were expendable has created a vacuum of disengaged employees who have built connections outside of employment through interests with outside relationships such as family, friends, sports, clubs, etc. Although many spend a significant amount of time at work, ambitions are no longer tied to the expectation of leaving a legacy of accomplishments as older generations once strived to achieve. The traditional stigma of switching jobs no longer applies, as many people are now OK moving from one job to the next to meet their needs (De Smet, A., Bowling, B., Magayar-Baldoochi, M., & Schaninger, B., 2022). Today’s workforce is at a baseline expecting to be valued, which is demonstrated by higher compensation, work setting or schedule flexibility and an inclusive culture with a new sense of community.

To build an engaged sense of community and develop the next generation of case managers committed to their profession, we must understand what brings people in and discern that those drivers are not the same for all people. Thus, similar to any employer or professional organization, there exists a lack of interest in further development. For example, a hospital I worked with recently had a manager position open for over a year. When I asked the staff why no one internally would apply, they gave the following reason: “Why would I ever do that to myself…it is not worth it.” Diving deeper, I understood more clearly, the pay is not significant enough; sometimes, it is even lower because you lose your differential benefits, the work goes beyond office hours with expectations to be “on-call,” there is regular staff turnover that you must deal with and there is little opportunity to advance beyond the manager role in the organization. When I looked at the explanation they laid out, they were right; who would ever want that position? To analyze the reasons listed for not taking the manager position, I hear about lack of financial compensation for the hours devoted away from family or outside my employer, lack of engaged workforce, fear that turnover will be the sole responsibility of the manager and, finally, lack of professional development and advancement opportunities.

This group of employees liked each other and always had lunch together, but their sense of commitment was outside of work and not devoted to the hospital anymore. They could not see how volunteering any more of their time would provide them with any personal benefit. Not one of these employees belonged to a professional case management organization, despite holding a state professional license, which required ongoing education and being employed full-time as case managers. I think this example is not uncommon to the workforce we see today.

In review of why many have entered the profession of case management, it is likely because of the initial desire to help and advocate for the clients and community with which we serve. Harvard Business Review released an article, “To Retain Employees, Give Them a Sense of Purpose and Community,” which expands on key areas that were found with employers who were able to maintain employees during the pandemic (Carucci, R., 2021). What they found was that aside from all other factors, employees felt an internal sense of purpose and community to their profession and their employer. The article identifies key areas that can also be applied to the case management profession as we assess our own employers and our sense of commitment to advance the profession of case management.


A culture of solidarity surrounds the concepts of assessing if you and/or coworkers see value in the work you provide and whether or not this provides a sense of purpose. Case managers are often oriented in the skills and tasks of what they need to complete each day, but it is not uncommon to find out that they lack an understanding for why they are completing these tasks. The case management department may lack a programmatic mission with a true understanding of the goals the program is trying to achieve. If the staff do not understand the value they bring, what incentive would they have to reach out to volunteer or participate in their professional organization?

  • Does your employer recognize your value and contributions?


As a leader, setting time aside with your employees to discuss and build support around their professional and personal aspirations takes discipline. In times of crisis and when feeling overwhelmed, this is likely one of those items there is never time to do. One can see how a leader who does not actively support one’s professional and personal aspirations would lead any employee to seek outside community support and thus reinforce a lack of solidarity to their profession. In contrast, a leader who is genuinely interested in the aspirations of their employees fosters a culture of kindness and support among peers.

  • When was the last time you discussed your professional and personal ambitions with your one-up?

Successful organizations include employees/colleagues in the everyday experience from policies to the workplace environment. Granted, there are some barriers around how things must occur related to compliance and regulatory guidelines; however, the details in the middle should allow for a say from professionals who engage in the everyday work. Engaging in an approach that values the contributions of the staff in the decisions of the organization builds internal leadership and a sense of collective responsibility for the community the team members have designed.

  • Do you have a voice in your workplace experience? How does this impact your feelings with your employer and thus your profession?

Fostering a connection with any professional organization means connecting back with our colleagues and peers in our everyday work to demonstrate one’s value and belongingness to the profession of case management. Then we can see how certification and membership demonstrates our commitment to the field. As an active and engaged member in our professional organizations, we must remember to engage and reach out to our colleagues to help build a continued sense of community. This starts in our everyday work.


De Smet, A., Bowling, B., Mugayar- Baldocchi, M., and Bill Schaninger (March 2022). Gone for now, or gone for good? How to play the new talent game and win back workers. McKinsey Quarterly. Retrieved from

Richter, F., (November 2022) The Great Resignation is (slowly) losing steam. World Economic Forum. Retrieved from

Carucci, R., (October, 2021) To Retain Employees, Give Them a Sense of Purpose and Community. Harvard Business Review. Retrieved from

tiffany ferguson

Tiffany Ferguson is CEO of Phoenix Medical Management, Inc., the case management company. Tiffany serves as an adjunct professor at Northern Arizona University, Department of Social Work and on the American College of Physician Advisors (ACPA) Observation Subcommittee. Tiffany is a regular contributor to RACmonitor, Case Management Monthly, serves on the editorial board for CMSA Today and is commentator for Finally Friday. She is a weekly correspondent on SDoH for the news podcast Monitor Monday. After practicing as a hospital social worker, she went on to serve as director of case management and quickly assumed responsibilities in system level leadership roles in health & care management, which include CM, UR, CDI, HIM and coding. She has held C-level responsibility for a large employed medical group, which included value-based arrangements, PCMH and outpatient care management. Tiffany is a graduate of Northern Arizona University and received her MSW at UCLA. She is a licensed social worker, ACM and CMAC certified.



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