Medical Social Worker

Last Updated: September 9, 2020

Written by the Open Caregiving Team. Editorial review by Joyce O. Murphy RN, MSN.

What is a medical social worker?

A medical social worker is someone who serves and guides people through different stages of healthcare. Medical social workers are employed in many medical settings, from large hospitals to community health centers, long-term care facilities, and hospice agencies.

What does a medical social worker do for the patient?

The roles of the medical social worker may vary somewhat from one setting to another. In general, they:

  • Talk with a patient and family about their health decisions.
    • Convey the patient and family wishes to the rest of the healthcare team.
    • Advocate for the patient as necessary with family and health professionals.
  • Provide support when health concerns become emotionally charged.
    • They provide crisis intervention.
    • When needed, they make referrals for psychotherapy.
  • Assist clients with public and private health insurance applications and other documents.
    • This includes applying for Medicare and Medicaid.
    • The medical social worker is available to help a patient appeal an insurance denial.
  • Provide support in finding a care facility, such as when a person moves from the hospital to a skilled nursing facility (SNF).
  • Determine if a patient is in an abusive situation.
    • As a mandated reporter, the medical social worker reports suspected child or elder abuse.
    • This can involve determining if a person is a threat to their self or others.

What can a medical social worker do for the family?

Medical social workers work with families as they learn to navigate the complex healthcare system. They do so on behalf of the patient and the family unit.

They serve families with:

  • Adults of all ages in need of medical or surgical care.
  • Babies and children with physical health or have developmental needs.

Medical social workers provide families with a range of services that include:

Emotional and mental support:

  • These may be related to a family’s dynamics and interpersonal concerns.
  • The healthcare system is complex and often confusing. Families can feel intimidated and conflicted because of the information they get.
  • The medical social worker can help to make medical language and systems more clear.
  • The medical social worker advocates for the family’s choices with the patient’s healthcare team. This offers special relief when the patient is a dependent, such as a baby, child, or terminally ill loved one.

Helping families learn about payment details:

  • Explaining various insurance terms and how they apply in their loved one’s case.
  • Talking about options that will help with healthcare bills.
  • Working with a family on insurance documents, making sure they are complete and filed in a timely manner.
  • Guiding a family with payment options.

What are the types of medical social workers?

There are different types of medical social workers who specialize in serving various groups of people. These include:

  • Inpatient medical social workers employed in medical centers or small hospitals.
    • They may serve patients in one or more units.
    • They are part of care management for a person from admission to discharge.
      • They assess a person’s social, emotional, and mental needs on admission.
      • They participate in developing the inpatient plan of care, helping to assure outcomes are met.
      • They assist with discharging planning, placement, and follow up care.
  • Outpatient medical social workers are also employed in hospital and medical center settings. The people they serve may be those who are leaving the hospital or people cared for as outpatients.
    • They generally have a specific role, such as working with people who have just been discharged from the hospital. They’re available to help other outpatients, such as on weekends and evenings.
    • Their main role is making sure that a patient’s plan of care is being followed. They intervene with the family or healthcare team when needed.
    • They provide emotional support and encouragement for patients and families.
  • Medical social workers for specialized care clinics serve a specific group or groups of patients. Examples include patients receiving kidney dialysis care, or caring for people with degenerative diseases such as Multiple Sclerosis (MS). The role includes broad responsibilities such as:
    • Assisting clients with transportation, housing, financial, and legal matters.
    • Assuring that the plan of care is regularly updated with outcomes being met.
    • Encouraging the individual to stick with prescribed medications and care routines.
    • Providing emotional and mental health support when life and the disease process become overwhelming.
  • Medical social workers in Public Health fulfill roles that include educator and advocate as they:
    • Influence public policy and the development of community-wide programs.
    • Work in non-profit settings including those devoted to heart and lung health among others.
    • Educate the public, policy makers, and health influencers about the effects of individual and policy decisions on health.

Why are medical social workers important?

Medical social workers serve a vital role within healthcare at the individual and community levels as they:

  • Provide people with information and support for making critical decisions about care.
  • Advocate for patient and families wishes within the healthcare team.
  • Educate healthcare administrators and professionals about patient and family needs and concerns.

What degree does a medical social worker need?

A medical social worker typically needs an advanced degree such as a Master’s in Social Work that may include a clinical focus. It is suggested that those who are working with English as a second language communities have fluency in the primary language.

What is the difference between medical social worker and clinical social worker?

The medical social worker is prepared to serve patients in a variety of inpatient and outpatient settings with a primary focus on physical illnesses. The clinical social worker has a focus on mental health and may work in private practice, for the government, or in schools.

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