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Medical Social Work is a sub-discipline of social work. Medical social workers typically work in a hospital, skilled nursing facility or hospice, have a graduate degree in the field (Masters degree in social work (MSW or MSSW), and work with patients and their families in need of psychosocial help. Medical social workers assess the psychosocial functioning of patients and families and intervene as necessary. Interventions may include connecting patients and families to necessary resources and supports in the community; providing psychotherapy, supportive counseling, or grief counseling; or helping a patient to expand and strengthen their network of social supports. Medical social workers typically work on an interdisciplinary team with professionals of other disciplines (such as medicine, nursing, physical,occupational, speech and recreational therapy, etc.). Medical social workers are diligent in their positions and are dedicated to assisting the patients and families who are in need.
The medical social worker has a critical role in the area of discharge planning. It is the medical social worker's responsibility to ensure that the services the patient requires are in place in order to facilitate a timely discharge and prevent delays in discharge that can cost the hospital thousands of dollars per per day. For example, the medical doctor informs the medical social worker that a patient will soon be cleared for discharge (a term that means that the patient no longer requires hospitalization) and will need home care services. It is the medical social worker's job to arrange for the home care service to be in place so that the patient can be discharged. If the medical social worker fails to arrange for the home care service, the patient does not leave the hospital resulting in a delay in discharge. Although the treating physician is ultimately held responsible for the delay, the medical social worker often bears the brunt of the blame for the delay in discharge and his or her failure to perform often attracts the attention of management. As the medical social worker's caseload is often high and the worker has to meet tight dead-lines to avoid delays in discharge, medical social work is a highly demanding job and there is a high turnover rate. In addition, the medical social worker often is confronted with complex cases involving patients with multiple psycho-social issues, all of which can result in delays in discharge. For instance, in a major urban acute care medical center, it is not uncommon for the medical social worker to assess patients who are homeless, lack health insurance coverage, have multiple chronic medical and psychiatric conditions, are unemployed, have just been released from incarceration, and have substance abuse problems. These are just some of the problems that can impede timely discharge. Sometimes situations as mundane as the patient needing carfare or shoes can lead to delays in discharge, especially if these needs are not identified early. This is why a complete and timely assessment of the patient's psychosocial needs is critical. Other skills required of the medical social worker is an ability to work cooperatively with other health care staff as part of a multidisciplinary treatment team, good analytical and assessment skills, an ability to communicate clearly with both patients and staff, an ability to quickly initiate a therapeutic relationship with the patient, an ability to process paperwork, and a willingness to advocate for the patient, especially in situations where the medical social worker has identified a problem that may compromise the discharge and put the patient at risk in the community. For example, a frail elderly patient is deemed medically cleared for discharge and the plan is for the patient to be discharged to home with home care services. However, the medical social worker, after assessing the patient's psychosocial needs, has determined that the patient does not have the requisite ability to direct a home care worker and recommends that the discharge be deferred pending further assessment of this problem.
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- This page was last modified on 19 May 2008, at 18:33.
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