This chapter explores the impact of care management on social workers. Social workers were required to become aware of the cost of services and purchase the lowest cost service possible from a range of sources to meet service user's needs. The factors associated with the introduction of care management are consistent with the concept of McDonaldization in that Fordist management techniques have been applied to the service sector to increase post-Fordist choice. Social workers who worked as care managers in SSD care-management teams were not usually called social workers. Managerialism concerns the ideology that managers should exercise their freedom to manage and has been central to the political commitment to introduce markets to public services and to creating post-Fordist mixed economy of care. Care managers experienced stress and conflict as a result of their attempts to negotiate the competing demands represented by managerialism and professionalism.