A Complete Guide to Medical Social Work

Table of Contents

A mother has just discovered her child has a potentially life-threatening illness. A million thoughts race through her mind: What’s going to happen to my daughter? How serious is this illness? How can my family afford treatment? What do I tell her?

In confusing and overwhelming times, it’s important for families to have somebody knowledgeable to lean on who can help them manage their emotions and navigate the complex medical system. That’s where medical social workers can step in as advocates for patients and families.

What Is Medical Social Work?

Medical social work primarily focuses on supporting patients and their families in hospitals, community clinics and other health care settings by coordinating patients’ care with the larger medical team. According to occupational profile created by the National Association of Social Workers (PDF, 2.8 MB), social workers in this field play an essential role in many of the non-medical aspects of patient care, including helping patients and their families navigate the medical system, assessing and monitoring patients’ and family members’ mental and emotional health, providing short term counseling and therapy, and communicating patient needs and concerns to the larger medical team.

Medical social workers work closely with patients and family members who are experiencing mental, emotional, family and/or financial stress due to their or their loved one’s medical condition. Because of the types of challenges they encounter and the fast pace of medical settings, medical social workers may find this field to be stressful and demanding. However, many medical social workers refer to the relationships they build with patients, families and the medical team, combined with the knowledge that they are helping individuals, as reasons they entered and have stayed in the field.

Due to the demands of the profession, becoming a medical social worker typically requires that individuals earn a Master’s in Social Work (MSW) degree from a CSWE-accredited institution. Medical social workers typically combine a strong understanding of clinical social work practices and modalities (such as psychosocial assessments, crisis interventions and psychotherapy) with knowledge of medical environments and protocols.

Job Description of a Medical Social Worker

Medical social workers’ primary job functions are to provide patient care by:

  • Educating patients and families about illnesses and treatment plans
  • Conducting psychosocial assessments to identify mental or emotional distress
  • Counseling those in crisis or experiencing distress
  • Connecting patients and their families with necessary resources

(Back to Top)

How to Become a Medical Social Worker

Medical social workers recommend a combination of solid academic preparation and internships or professional experience in a medical setting for individuals interested in entering this field. The steps to become a medical social worker are:

  1. Complete a bachelor’s degree in social work (BSW) or related field
  2. Pursue a master’s degree in social work (MSW)
  3. Complete fieldwork hour requirements
  4. Become licensed
  5. Maintain licensure

Let’s look at each step in detail.

1. Complete a Bachelor’s Degree in Social Work or Related Field

Earning a bachelor’s degree in social work or a related field such as psychology or sociology can help aspiring medical social workers get their foot in the door with entry level positions. These positions are rare and may be limited in scope of duties. Many hospitals and other medical settings require a master’s degree with a clinical focus.

However, a BSW is typically a requirement to apply for advanced standing in a master’s program. Unlike traditional MSW applicants who are being exposed to the field for the first time, students in advanced standing programs build on knowledge they have acquired from their bachelor’s degree and can move through the program at a quicker pace.

2. Pursue a Master’s Degree in Social Work (MSW)

Most medical social worker positions require that candidates are prepared at the master’s level, due to the intense nature of the work and the expertise required to navigate complex patient situations. Individuals interested in entering this field of social work should research MSW programs that are CSWE-accredited and that provide classes on subjects that are relevant to medical environments.

Classes that prospective medical social workers should consider taking include but are not limited to courses on clinical social work methods and therapeutic modalities, such as motivational interviewing, strengths-based therapy, problem solving therapy, and substance abuse counseling, and courses on specific issues that medical social workers encounter on the job, such as death and dying, grief and bereavement counseling, crisis interventions, child abuse and neglect and family dynamics.

While some MSW programs provide concentrations in health care or medical social work, students do not necessarily need to concentrate in medical social work during their MSW program to qualify for roles in health care settings.

At the University of California, Berkeley, “we have a ‘health’ division within the social work school, and this is where many people go to pursue medical social work,” explained Carrie Allen, LCSW, who works at John Muir Medical Center in Walnut Creek, California, where she supports patients in the emergency room and the surgical trauma and orthopedic floors. “But there are many other students in children and families and mental health concentrations who end up with a second-year hospital internship, and then get hired on at a hospital.”

Take the Next Step in Your Social Work Career. Earn an MSW From Simmons in as Little as 15 Months. Discover more by requesting information directly from SocialWork@Simmons.

Sponsored Online MSW Program

3. Complete Fieldwork Hour Requirements

Sometimes referred to as internships or practicum, fieldwork provides MSW applicants with hands-on experience by requiring students to apply what they have learned in the classroom to work at a field site currently employing social workers. This is an opportunity to better understand the populations and communities that students may work with as a social worker.

Fieldwork requirements for traditional MSW programs may include 16-20 hours of field placement for about two days a week for the first year and three days a week during the second year, although specific times may vary. Students with advanced standing placement can expect to complete 450 to 1000 hours of field work.

Field Placement in a Hospital

MSW students who are interested in medical social work should strongly consider completing at least one of their internships in a hospital.

“I know firsthand that it is very difficult to get hired with no hospital experience,” Ms. Allen said

Jenn Toledo, MSW, works as a medical social worker for Satellite Healthcare, a dialysis unit in Menlo Park, California, that treats patients afflicted with end-stage renal disease. Toledo also recommended that students actively seek field placements in medical settings.

“I definitely recommend getting a field placement in a hospital or clinic because otherwise you will not have the experience that is practically necessary to get a job as many health care settings will require at least a year of experience in health care,” she said. “I also recommend volunteering with organizations related to the medical field.”

If social workers or students are unable to complete their field practicums in a medical environment, they should try to find professional or volunteer opportunities in these settings, even if they are not related specifically to social work. Ms. Allen told OnlineMSWPrograms.com how important it is to be familiar with medical terms and workflows.

“[T]he more medical experience the better,” she said. “Because it’s not just the medical social work job a person has to learn, but they also have to learn how a hospital works, medical terminology, and how to belong on a medical team. Like when you sit down for rounds and the information says Doe, John, 36M, fx L femur, TBI, SDH. Hx: DMII, HTN. You better know that they are saying, ‘John Doe is a 36-year-old male with a fractured left femur, traumatic brain injury, and subdural hematoma. He has a history of Type 2 diabetes and hypertension.”

4. Become Licensed

Social work licensure varies by state. Candidates typically must pass exams administered by the Association of Social Work Boards (ASWB). However, individual states may require their own licensure examinations or additional exams, underscoring the importance of reviewing each state’s requirements. After passing the exams, applicants can apply to the State Board of Social Work.

To earn a clinical level of licensing, which is the highest level of licensing and is typically required for medical social workers, candidates who earn an MSW must pass the ASWB exam and work two to three years under the supervision of a licensed clinician, who will consult on subjects such as clinical practices and ethics before making a recommendation for licensure. Once they have received a recommendation, candidates can sit for the ASWB clinical examination.

5. Maintain Licensure

To maintain licensure, licensed social workers must complete continuing education requirements that vary by jurisdiction. It is not the responsibility of the licensing board or the professional association to provide continuing coursework; individual social workers are responsible for understanding the number of hours and types of courses that are required and ensuring that their continuing education plans meet their board’s requirements.

Get to Know Yourself First

The medical social workers we interviewed emphasized how individuals considering this field should work to build self-awareness and strong and supportive relationships before, during and after their graduate social work program.

“My advice is to get out in the world and practice this kind of work before you really commit to it as a career. It is very taxing,” said Jessica Beitch, LCSW, who works in the pediatric bone marrow transplant service at UCSF Benioff Children’s Hospital. “Get to know yourself and your triggers and vulnerabilities before engaging in intense relationships where people’s emotions and lives are at stake. In terms of sustainability, I’ve learned that even more important than the population I work ‘for’ is the team that I work with. My colleagues are the ones who will support me day in and day out, year after year. I trust in them completely and feel so fortunate to be on a team with them. Therapy and supervision have been so completely necessary for me emotionally and professionally. And my friends from social work school are my saviors.”

The knowledge, expertise and commitment that medical social workers bring to their work with patients and their families help health care facilities deliver high quality, compassionate health care to people in need. Through sound academic preparation, internship and volunteer experiences, a strong support network, and consistent self-evaluation and self-care, medical social workers can maintain resilience and energy when tackling the daily challenges of this deeply necessary field of work.

(Back to Top)

What Do Medical Social Workers Do?

While their precise responsibilities vary depending on their work setting, medical social workers typically fulfill a number of key tasks, as explained in NASW’s occupational profile:

  • Evaluate mental and emotional health
  • Assess social, family and/or financial circumstances
  • Communicate patient information to stakeholders on a patient’s health team
  • Provide counseling or psychotherapy to patients and families
  • Maintain confidential patient records
  • Connect patients and families with outside medical and non-medical resources
  • Coordinate patient care in collaboration with health team stakeholders

Psychosocial Assessments

Medical social workers typically conduct psychosocial assessments of patients (and sometimes their family members) to determine their needs and to identify any mental or emotional distress that could exacerbate their condition. A psychosocial assessment is defined as an evaluation of a patient’s psychological and physical health, as well as any external conditions (financial hardship, family conflicts, cultural considerations, etc.) that the medical team should factor into the care of a patient.

Upon completing this assessment, medical social workers communicate the information they have gathered to the larger medical team, which helps other team members (i.e. physicians, nurses, medical assistants, etc.) provide more effective care.

“Core responsibilities include completing an interview with our patients with a full psychosocial assessment as needed,” Ms. Allen said. “We are responsible for developing and implementing a plan of treatment to assist patients while they are in the hospital with many different psychosocial factors, such as social, emotional, financial and environmental. We are an integral part of the treatment team, and we assess and provide treatment based on biopsychosocial information.”

The psychosocial assessments are not just essential in the development of a treatment plan; they are also important in ensuring patients receive the insurance coverage they need for certain services.

“I conduct psychosocial evaluations of every patient and family that gets admitted to the service, and insurance companies often utilize these evaluations as part of the transplant authorization. In line with general social work practice, I am constantly assessing for safety and risk, access to resources, mental health, financial concerns and available support networks.”

Patient and Family Education, Counseling, and Therapy

Patient education is one of the most important responsibilities that medical social workers have in health care settings. Grappling with a disease, injury or other medical condition can be confusing and deeply stressful for patients and their loved ones. Medical social workers explain to patients the causes, effects and progression of their illness. After receiving information about patients’ treatment options from the medical team, medical social workers also communicate and discuss these options with patients and their families. They also provide updates to patients and their families regarding any changes in their treatment plan.

In describing her work with pediatric bone marrow transplant patients, Ms. Beitch said she helps “explain to the patients with age-appropriate language the reason they are in the hospital and getting this type of treatment, and I also support the siblings. With my child life specialist colleagues, we prepare patients for certain procedures and teach them strategies to reduce anxiety, depression and stress. I help the medical team understand a family’s cultural perspective and help a family understand the medical team’s recommendations and treatment plan.”

Medical social workers also provide emotional support and psychotherapy if needed to patients and family members who are experiencing emotional distress as a result of the diagnosis. This can include supportive psychotherapy, cognitive behavioral therapy, mindfulness-based stress reduction, and problem-solving therapy.

“In my clinical work, I utilize the techniques and spirit of motivational interviewing,” Ms. Beitch said. “My goal is to stay very patient-focused and draw on the person-in-environment model. If anxiety becomes a problem for a patient, I introduce stress-reduction techniques such as deep breathing and visualization. With parents, I encourage self-care and mindfulness activities to help with the stress and strain of hospital life. Mostly, I engage in active listening, provide emotional support and validation, and bear witness to the challenges and triumphs of our families.”

Medical social workers may also work with populations that are faced with mental health disorders and/or substance abuse. In talking about her work in the trauma unit at John Muir Medical Center, Ms. Allen noted: “Statistics show that many trauma patients who arrive do test positive for alcohol or drugs, and so the social worker does a lot of substance use counseling while the patient is admitted.” Substance abuse counseling and therapy may include harm reduction techniques, cognitive behavioral therapy, dialectical behavioral therapy and motivational interviewing.

For more information about these and other therapeutic modalities, please see our Guide to Clinical Social Work.

Resource Connections and Navigation Services

Medical social workers help patients and their families understand the resources that are available to them within the hospital setting as well as in the community. In her interview with OnlineMSWPrograms.com, Ms. Toledo elaborated on her work in connecting clients to the resources and services they need within and outside of Satellite Healthcare.

“I help with assuring they have the resources necessary to get to/from treatment, transportation, helping them assure their insurance is in order, applying for our financial assistance programs if they cannot afford payment of their treatments, referring them to Medicare (as ESRD patients, they qualify for Medicare regardless of age). I help with coordinating with primary care physicians in getting referrals to physical therapy or home health safety evaluations, referring them to CalFresh food stamps, food banks, homeless shelters, low-income housing, mental health providers, vocational rehabilitation programs, and kidney transplant wait lists and evaluations.”

Alexa Silva, MSW, works for the Alameda County Public Health Department’s Asthma Start Program as an asthma coordinator. Through her work with the Asthma Start Program, she connects asthmatic children and their families to the supplies and medication they need during her home evaluations and follow-ups. “I assess any need for supplies such as dust mite-proof mattress covers or a vacuum and bring them to my next visit,” she said.

Ms. Allen also elaborated on how medical social workers connect their clients with a variety of resources according to their needs. “[Social workers] provide counseling for adjustment to illness, and also help patients navigate the system so they can sign up for insurance and receive medical care once they are discharged,” she said.

As she often works with patients in the trauma unit, Ms. Allen must frequently connect them to resources to help them transition upon their discharge from the hospital.

“Some of our trauma patients are elderly and suffer from falls, and then they become very sick and the social worker can help transition them to hospice if that is their wish to do so. Many trauma patients are gang-affiliated, and the social worker works with those patients to help the patient plan for a safe discharge, connect them to victim of violence resources, and connect them to our Beyond Violence program, which is an outpatient program that works with our patients to stop the cycle of violence.”

Crisis Intervention

Medical social workers also implement crisis interventions when necessary, helping patients and their families cope with tragedy, emergency situations and acute stress. For patients and families who are coping with a terminal illness, medical social workers provide grief counseling, therapy and referrals to additional mental health support.

DeEtta Barnhardt, LCSW, works as an inpatient social worker at Lucile Packard Children’s Hospital at Stanford (LPCHS).

“Many families are in crisis mode and I provide crisis intervention services which would include general support, resources, referrals to appropriate agencies or services within the hospital, specific steps to follow (like homework), suicide assessments, and even walking parents to the ED for mental health assessments if needed. At times it is important to discuss death, dying, grief and bereavement,” she said.

In some medical settings, such as the emergency room or the trauma unit of a hospital, patients may struggle with substance abuse, severe mental health issues, conflicts with family, or domestic/sexual abuse upon their admittance to a hospital or other medical setting. Medical social workers help patients resolve or manage these issues.

“In talking about the ER, it’s difficult to write about all the different things they need us for in the ER, but here are some of things we most normally do: grief support for death, adult and child abuse, rape/sexual assault, substance use, homelessness, hospice patients, patients who are unsafe at home (frequent falls), suicidal patients, patients with mental health issues, and uninsured patients who need help with follow-up. In the ER, the main difference is that everything is crisis oriented, so you just have to focus on what needs to be done now, and what is the plan,” Ms. Barnhardt said.

Care Coordination

All of the responsibilities described above fall under care coordination, which is defined as the effective organization and delivery of medical care to patients. By bringing patients’ mental, emotional, familial and social concerns into their treatment plan, medical social workers ensure that patients receive more holistic, compassionate and efficient care that improves health outcomes. Medical social workers are an integral part of the care coordination team in many medical environments. Other care coordination duties that medical social workers fulfill include serving as a point of contact between different teams within the health care setting, ensuring that facilities adequately serve patients’ needs, and coordinating patients’ movement from different units or from one medical setting to another (ex. hospital discharges or transfers to a different ward).

(Back to Top)

Sponsored Programs That May Help You Become a Medical Social Worker

Sponsored Online Social Work Programs
School Description
University of Denver Earn your Master of Social Work online from the top-20 ranked Graduate School of Social Work at the University of Denver. No GRE Required.
Fordham University Earn your Master of Social Work online from the top-ranked Fordham Graduate School of Social Service. Bachelor's required.
Simmons University Simmons University's online Master of Social Work program can be completed in as few as 16 months, and GRE scores are not required.
Case Western Reserve University The CSWE-accredited Master of Science in Social Administration from CWRU is an online program for social work leaders.
University of Southern California (USC) Apply to USC's innovative MSW program to take the next step in your social work career. No GRE required.
Baylor University Complete Baylor's Master of Social Work program online in as few as 12-16 months and start serving vulnerable populations in need.

(Back to Top)

Types of Medical Social Workers

Medical social workers are employed in a wide range of medical settings, such as hospitals and medical centers, specialized medical clinics and public health departments.

Inpatient Medical Social Workers

Social workers who are employed at hospitals and medical centers, providing specialized social services to patients suffering from chronic and/or acute health conditions that require hospitalization, are known as inpatient medical social workers. While some inpatient medical social workers stay within one medical unit or department, many spread their time across several units.

In an interview with OnlineMSWPrograms.com, Ms. Allen explained how social workers work throughout the John Muir Medical Center:

“At John Muir our social workers are assigned to different floors, we have nine different social workers per day and the assignments are as follows: trauma intensive care (ICU)/(overflow) intensive care, neuro intensive care/progressive care unit, emergency room, acute rehab (physical rehab)/neuro progressive care, pediatric intensive care unit/mothers on labor and delivery/pediatrics, neonatal intensive care unit and mothers of these neonates, trauma med-surg/ortho med-surg (my floors), oncology med-surg/oncology surgeries, renal med-surg/general surgeries.”

Ms. Allen also said though medical social workers at John Muir Medical Center tend to focus on certain units, they also have a strong understanding of the needs of the hospital as a whole.

“On the weekends there are only two social workers, and then we are also on-call for PICU (pediatric intensive care unit) and NICU (neonatal intensive care unit) to meet California Children’s Services (CCS) criteria, so though we all specialize in our floors, we all have to know how to do everything because on the weekends and on call we have to know how to do everything.”

Depending on their academic training and professional experiences, some inpatient medical social workers may specialize in a given area within the hospital, such as geriatrics, pediatrics, or psychiatric and intensive care; these medical social workers may also work in multiple units that serve similar populations. In an interview with OnlineMSWPrograms.com, Ms. Beitch described how she worked in several areas of pediatric intensive care at the University of California, San Francisco (UCSF) before transitioning to her role at UCSF Benioff Children’s Hospital. “I worked on the pediatric oncology service, neuro-oncology and neurosurgery service, general pediatrics ward, pediatric ICU, outpatient hematology, and was hired as an employee to the bone marrow transplant service,” she said.

Medical social workers for inpatient settings collaborate on a daily basis with many different teams and staff members.

“As a medical social worker on the bone marrow transplant unit at a teaching hospital,” Ms. Beitch said, “I work with a robust team that includes attending physicians, fellows, residents, nurse practitioners, nurses, nurse coordinators, nurse administrators, patient-care advocates, dieticians, food service attendants, child life specialists, art therapists, music therapists, physical therapists, occupational therapists, speech therapists, lab techs, pharmacists, administrative assistants, medical assistants, medical interpreters, financial representatives, descendent affairs staff, national foundations, community organizations, and other social workers (I’m probably forgetting a few people!)."

The Role of a Social Worker in a Hospital Setting

NASW highlights the range of functions social workers perform to help patients and their families navigate the medical system, including:

  • – Assessing new patients as they are admitted
  • – Providing emotional support or counseling
  • – Developing and implementing a patient’s plan of care
  • – Working with agencies or insurance companies to cover costs of treatment and medication
  • – Arranging outpatient treatments
  • – Developing a discharge plan
  • – Conducting trainings for staff to help better meet patients’ needs
  • – Developing health care policy and advocating for patients’ rights

Outpatient Medical Social Workers

Outpatient medical social workers work with patients who either do not need hospitalization but still require medical care and guidance, or who are transitioning from hospital care to outpatient care or their home. Often, these patients grapple with challenges similar to those faced by hospitalized patients, and require similar services – such as resource navigation guidance, counseling and care coordination.

Outpatient medical social workers can work at hospitals, medical centers and specialty clinics.

“We have outpatient social workers as well [at LPCHS],” Ms. Barnhardt said. “I may assist a patient/family on outpatient needs if they have recently discharged but I will usually sign out any ongoing outpatient needs to the assigned outpatient social worker.” Ms. Barnhardt also worked as an outpatient social worker at Gillette Children’s Specialty Healthcare in St. Paul, Minnesota, and explained to OnlineMSWPrograms.com how her duties were in some ways quite like those of her current role in inpatient pediatrics:

“When I worked at Gillette Children’s Specialty Healthcare, I was an outpatient social worker. At times I would cover inpatient if we were short-staffed, but my primary role was outpatient. I worked with one other outpatient social worker and we covered all the outpatient clinics,” she recalled, “Part of our role was social work-related, including support and referrals to resources. However, the other part was care coordination (case management) such as ordering wheelchairs, hospital beds and enteral supplies. It was similar to my current role at LPCHS as I had to prioritize my day, never knew what each day would hold, and there was a general quickness needed to accomplish the tasks necessary each day. … I would be paged to assess a situation, would complete an evaluation, provide appropriate resources and support, make referrals as needed and would continue to work with the patient/family on an outpatient basis.”

Ms. Barnhardt said medical social workers’ responsibilities may span both inpatient and outpatient responsibilities. Furthermore, some medical social work roles involve fulfilling or coordinating both inpatient and outpatient services on a regular basis. For example, in her role in the pediatric bone marrow transplant unit at UCSF, Ms. Beitch “[covers] both the inpatient service and outpatient clinics,” and noted to OnlineMSWPrograms.com, “This is a great fit for me. I enjoy the integration of acute illness with the opportunity to establish long-term relationships with patients and their families.”

Medical Social Workers in Specialized Clinics

In addition to working in hospital settings, medical social workers can also work for specialized clinics that serve populations suffering from very specific conditions or diseases. These clinics differ from hospital settings in that they are serve individuals solely on an outpatient basis. Ms. Toledo explained to OnlineMSWPrograms.com the distinction between hospital settings and specialized clinics such as Satellite Healthcare. “Working at a dialysis clinic is different from working at the hospital because the patients at a dialysis clinic are all patients with the same chronic illness–ESRD,” she said, “Patients can require anywhere from twice a week treatment, to five times a week treatment, with each treatment running from 2-4 hours on average.” Specialized clinics such as Satellite Healthcare often receive patients through referrals hospitals and medical centers.

Medical social workers in specialized outpatient clinics often fulfill as wide a range of responsibilities as their peers who work in larger hospital settings. Ms. Toledo explained to OnlineMSWPrograms.com how she supports patients at Satellite Healthcare through a combination of resource navigation services, emotional support, guidance in logistical matters such as housing and insurance, and any other issues that affect patients’ mental, emotional, and physical well-being.

“I assist patients with adjusting to their illness, assisting in arranging dialysis while they travel, referrals to community resources, insurance support, kidney transplant referrals, transportation issues, housing and legal issues, behavior issues, complaints, encouragement of adherence to treatment regimen, and the list goes on and on. My day never looks the same as the previous day.”

Public Health Educators and Advocates

Medical social workers can also work for public health programs that provide education, guidance, advocacy, and resources to patients suffering from chronic conditions. In Ms. Silva’s role as an Asthma Coordinator for the Alameda County Public Health Department’s Asthma Start Program, she provides education to children who have asthma and their families regarding how to detect, medicate, and manage this condition. She also conducts home visits to assess for environmental asthma triggers.

In an interview with OnlineMSWPrograms.com, Ms. Silva explained,

“[M]y responsibilities include education to families around asthma including signs and symptoms such as coughing, shortness of breath, and retractions. […] I educate families about all the medications they are using, how they work, why they are important, and how to use them properly. I always have the child demonstrate to me how they use their medications and correct them if necessary. Finally, I do a home assessment in which I address any possible triggers in the home such as mold, dust, and pests (i.e. roaches).”

Ms. Silva explained how she and her fellow social workers on the Asthma Start Program team incorporate social services into their delivery of health care services to disadvantaged asthmatic youth and their families.

“Most of our families live on one income and receive governmental support such as Medi-Cal and food stamps. Some of the issues my clients face are lack of health insurance, a medical home (by which we mean a primary clinic and doctor to manage their care), and/or poor living environments. We try to address any social issues when we go out to the home such as screening for domestic violence to issues directly affecting the asthma such as mold and working with the landlords to correct any potential deficiencies.”

Medical social workers who work for public health departments focus much more on preventative care, relative to social workers in hospital settings. “Our job is very different from that of Medical Social Workers who are in a hospital because we do not deal with emergency situations,” Ms. Silva explained, “We focus more on prevention and education. We are [also] very specialized.”

(Back to Top)

Challenges that Medical Social Workers Face

Medical social work is a challenging field, as social workers must balance the needs of many patients and also manage the demands of stakeholders on the larger medical team. Ms. Barnhardt noted how one challenge of her role at LPCHS is feeling pulled in many different directions at once.

“Communication is challenging because I am working with interns, residents, fellows and attending physicians from multiple teams each day. At times it is difficult to know and understand what each team is doing and what the plan of care for the patient is. It is important to attend rounds when able, arrange care conferences as needed and seek out the medical teams for updates and information when appropriate. It is also very important that I communicate any psychosocial concerns or issues with the medical team as these issues can affect the discharge plan.”

Witnessing and helping patients work through physical, mental and emotional trauma and hardship can also be deeply stressful, as the stakes for the patient, the family, and the medical team are high. Particularly in acute care medical settings, the work can be emotionally taxing. “Some of the most challenging aspects of my job include communication, meeting expectations, meeting administrative demands, and for me, when a patient dies,” Ms. Barnhardt noted.

Frustration with administrative and systematic barriers to patient care is also a challenge that some social workers voiced.

"[A] big challenge that we face is in dealing with landlords that do not want to take the time or spend the money on repairs that are needed in the home to make it a healthy home for people with asthma,” said Ms. Silva, who works with the Asthma Start program. “In this case we are forced to turn to the city for further intervention. … I would say to those looking to go into the public health department that they need to learn how to be an advocate for their clients and not be intimidated by those in power.”

The stress that medical social workers feel can also have an effect on their physical well-being.

“The most challenging aspect of the job is the stress of the job,” Ms. Allen said. “Stress brings on lots of headaches, backaches, and just overall exhaustion at the end of the day. Sometimes I just have to lay down and take an hour nap when I get home before I begin with my evening because I am just so emotionally and physically exhausted. I feel as if there is no real preparation for this, and I am still honestly trying to find my own way of coping with the stress of the job.”

Many medical social workers recommend a consistent self-care plan. “It is important when working in a pediatric hospital setting to know yourself. Look into yourself and acknowledge what might produce countertransference or open old wounds,” Ms Barnhardt said. “Remind yourself how you handle stress and determine a plan of how you would relieve stress after a challenging day. Try to remember why you wanted to be a pediatric social worker in the hospital setting.”

(Back to Top)

Why People Become Medical Social Workers

Medical social work, while demanding, gives individuals a unique opportunity to connect with people in deeply meaningful and at times unforgettable ways. “The rewarding aspects of my job are that I am able to follow patients and families through their experience, from diagnosis to sometimes death,” Ms. Barnhardt said of her work as a pediatric social worker, for which she won a Gold Rose Award granted to people in helping professions for excellence in service.

“I am able to support them through the ‘roller coaster’ that is pediatric illness. I sometimes watch patients improve and go home, never to return again. Other times I see patients during each admission as they transition from being ‘intensive care’ to being ‘acute’ and then going home, only to return again in the future. And then there are the other times, where I have developed a wonderful working relationship with a family, having seen them through many obstacles, only to be at a place that is the end. This is a very difficult time, but it means so much, to be there with a family through the last steps of hope, through the grief, the loss, and the time of bereavement, knowing that I made a difference, just from being there with them during that time.”

The concrete and, at times, dramatically positive impact that medical social workers can have on their patients’ health outcomes can also be rewarding and highly motivating.

“When I first heard about this position, I was excited to learn more about asthma and to work in a public health setting,” Ms. Silva said. “One of the rewarding experiences I have had at this job includes having success with getting my clients a medical home and health insurance so they remain healthy. … Our program has reduced ER visits and hospitalizations by more than 50 percent. This makes me proud and happy to be doing what I do. I intend on staying with the program for years to come.”

After working in the hospital since age 16 and as an EMT in the emergency room for several years, Allen decided to become a medical social worker after meeting a mother and her child who needed medication for a seizure disorder.

“I knew that I wanted to help patients in a tangible way,” she said, “I wanted to fight with insurance companies, advocate for patients, and try to go to any length to help that mother get that seizure medication.”

Some medical social workers have very personal motivations for entering the field.

“I decided to become a medical social worker because at 16 I was diagnosed with leukemia and I had a great social worker assigned to me at UCSF,” Ms. Toledo said. “My 2.5 years of treatment she followed my case and that is where I discovered what social work was for the first time. The types of things she assisted with all appealed to my strengths and what I enjoy doing – helping people and working with kids. That is when I decided to pursue medical social work as a career, and I have a very specific goal of one day working in the pediatric oncology department of a hospital because I will be able to speak the same language as my patients and have a deeper understanding of what they are going through.”

Note: In addition to this guide, OnlineMSWPrograms.com has published guides for specialized areas within medical social work, including Pediatric Social Work and Psychiatric Social Work.