The case for a case manager

In an earlier post I argued that the crop diversity conservation and use system has a missing middle: someone whose job it is to get the whole way from an agricultural problem to a diversity-based solution.

That would address the perceived problem of “underuse” of genebanks collections better, I think, than making more data on collections available, or easier to search. I know we now have cheap genome sequencing and high-throughput phenotyping and powerful databases and AI on our phones, for pity’s sake. But we’ve been counting on the latest technological leap for quite a while now, and I figured it was time to look elsewhere for a solution.

I compared this missing role or function to that of an insurance broker.

I still think there’s a missing middle; but that was the wrong analogy. Insurance brokers navigate a liquid market of interchangeable, price-comparable products with a client who already knows they want insurance. That’s not like working with genebanks, if you think it through better than I originally did. I think I was seduced by the notion that crop diversity is a form of insurance.

There’s a better fit: medical case manager.

That’s the person who follows the patient through the maze of the health system. They don’t do the surgery or prescribe the drugs. They make sure the referrals happens, the test results gets chased, the specialists talk to each other, and nobody quietly drops the ball because, well, their particular bit of the system is working perfectly well.

Sound familiar?

A breeding programme can have a perfectly good reason for aiming for a particular combination of traits. A genebank can have exactly the right diversity to test. The accessions can be sequenced, well characterized, searchable through a beautifully designed database, and readily available. The breeders might be excellent breeders.

And still nothing might happen. Not because anyone screwed up necessarily, but because nobody owned the process as a whole, and thus put the entire package together.

That, I think, is the missing middle.

And this better analogy points to something else that the insurance-broker metaphor rather conveniently (for me) glossed over: independence.

Independence as a structural necessity. Someone sitting inside Genebank A, however well-intentioned, is going to have a harder time saying “actually, the stuff you need is in Genebank B,” because their salary, mandate and incentives all live inside Genebank A.

A case manager, on the other hand, is supposed to follow the patient, not defend the department.

The starting point should be the agricultural problem. The answer might be in a genebank. It might be in another genebank. It might be on a farm, in a community seed bank, in a breeding programme, or nowhere in the genetic-resources system at all. The case manager needs to be positioned so that they have no stake in which collection, programme or database ends up being the answer.

There is another useful thing about the case-manager analogy: it is not hypothetical. Health systems have been paying people to do this for decades. And they have had to work out some fairly prosaic questions that we tend to skip when talking about “unlocking” genebank diversity.

Who pays? What counts as success? How do you stop the navigator becoming a glorified administrator? What happens when whoever pays the salary starts deciding where the patients should go?

These are not trivial details. Getting them right is what turns a nice metaphor into an institution that might just work.

Start with the problem. Find the relevant expertise and diversity, wherever it happens to be. Get the handoffs made. Notice when things stall. Keep going until there is an outcome, including, if necessary, the conclusion that crop diversity wasn’t the answer.

We’ve gotten better at opening the door to genebanks over the years. We have lots of data, fancy databases and AI. What we’re still missing is the person who walks through that door with you, the user, and is knowledgeable and independent enough to help you figure out whether the answer lies inside, elsewhere in the system, or somewhere else altogether. Call it a broker or a case manager, or whatever else you like, but that’s what I believe we need.

Again, this is just me thinking out loud here. Maybe I’m the patient who has been sent home with a stack of test results, a list of specialists and a phone number for the hospital switchboard, and is trying to work out what to do next. Help me out.

Source: https://agro.biodiver.se/2026/09/the-case-for-a-case-manager/