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SHORT COMMUNICATION
Year : 2014  |  Volume : 2  |  Issue : 2  |  Page : 130-131

Medical social worker: Strengthening linkages between the hospital and the community


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, India

Date of Web Publication18-Aug-2014

Correspondence Address:
Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-9019.139074

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  Abstract 

The concept of medical social work had emerged towards the end of the eighteenth century, and has gradually become an integral element in the practice of medicine. It is executed with the help of Medical Social Worker (MSW) - a paramedical worker who has been trained in the social case work and art of interviewing. The aim of this manuscript is to describe the role of MSW in establishing a linkage between the healthcare system and the members of the community. The MSW is a pivotal member of the health team for any public health initiative whose success is based on community engagement and participation. Recognizing the importance of medical social worker in healthcare system, they are now considered as an essential part of the health care along with doctors and other allied health professionals in the analysis and correction of the social and emotional factors, eventually leading to ill health. They are also increasingly being relied upon for supplying information that is of fundamental importance in reaching the correct diagnosis and management of the patients' health. To conclude, the MSW plays a decisive role in helping sick people - individual-by- individual, both through the best use of the patient's capabilities and community resources and thus eventually assists in the strengthening of the healthcare delivery system of the entire nation.

Keywords: Health team, hospital, medical social worker, quality of life


How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Medical social worker: Strengthening linkages between the hospital and the community. Int J Health Syst Disaster Manage 2014;2:130-1

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Medical social worker: Strengthening linkages between the hospital and the community. Int J Health Syst Disaster Manage [serial online] 2014 [cited 2019 Mar 26];2:130-1. Available from: http://www.ijhsdm.org/text.asp?2014/2/2/130/139074


  Introduction Top


Medical social work and medical social workers

The medical social work had emerged towards the end of the eighteenth century and had gradually become an integral element in the practice of medicine. [1] The medical social work essentially utilizes "case work" as its main technique is to assess the social background of a disease, which directly assists the treating physician by arriving at a holistic diagnosis, and in estimating the prognosis of the disease. [2] It is executed with the help of Medical Social Worker (MSW) - a paramedical worker who has been trained in social case work and the art of interviewing people. The MSW develops a strong link between the institution, where he/she is employed, and the community. [3] Different settings such as hospitals, tuberculosis clinics, family planning clinics, cancer societies, mental health institutes, maternal and child welfare centers, and school and university, have been identified where MSW can be employed for the betterment of the healthcare delivery. [1],[2] Thus, MSW in current medical practice is an indispensable element and has a key role in improving the therapeutic management and overall rehabilitation of the patients. [1],[2]

Roles and responsibilities assigned to the medical social worker

The principal work of the MSW is to perform home visits and to explore the personal, economic and social causes of illness with a view to supplement the medical history. [1] MSW has been identified as the key link to establish a rapport between the patients and the clinicians, especially in sensitive conditions like sexually transmitted diseases or leprosy, which are usually associated with social stigma and ostracism. [3],[4] This linkage has gained further importance, owing to the poor communication skills of the medical students (both under-graduate and post-graduate), who are not trained specifically in communication skills during the course of their medical education. [5] From the therapeutic point of view, MSW assists the treating physician in giving customized recommendations applicable to the socio-cultural milieu (viz. customs, habits, values and behavior) of the patients, so as to expedite the process of disease control in a comprehensive manner. [1],[3] Being trained in social work, with some medical knowledge, they have an extra edge in contrast to the physician who generally communicates only on the intellectual plane, especially the specialized and sub-specialized clinicians. [2] This approach alleviates the need for re-admission to the wards, and facilitates the self-management of illness at home after the discharge from the hospital. [1] Their role is especially useful in the health promotion activities like facilitation of exclusive breastfeeding or immunization services and in minimizing the incidence of malnutrition or social problems. [2],[6]

Medical social worker: A crucial member of the health team

The MSW is a pivotal member of the health team for any public health initiative, whose success is based on the parameters like social mobilization and community participation. [1] Studies have shown a significant role of MSWs in different individual and public health indicators, such as improvement in the quality of life of patients suffering from advanced cancer or terminal stages of the disease; [7] in decreasing the suicide rates in patients with substance abuse; [8] in guiding the patients and the family members to co-ordinate a multifaceted healthcare regimen at both hospital and home; [9] and in facilitating the research work and testing of newer initiatives. [3],[4],[6],[10]

Identified gaps in the health care

Despite the increase in observed incidence and prevalence of different infectious diseases/lifestyle disorders/malnutrition, it has been observed that multiple sanctioned posts still remain vacant. [11] In fact, even the enrolled MSWs have to face multiple challenges ranging from no sensitization sessions at the time of induction; no provision of organizing sessions for upgrading their knowledge/skills during their tenure; minimal level of co-operation from hospital or healthcare establishments of administrative staff; limited assistance from the doctors; and no monetary incentives or pay hike. [12],[13]

Recommended strategies to enhance the output of the medical social worker

Realizing the scope of the medical social worker in healthcare delivery, a range of strategic interventions has been proposed to enhance the output from the MSW and to negate the influence of bureaucratic, professional and clinical barriers existing within the hospital environment. [12] These measures include strategies to conduct sensitization sessions at the time of enrollment to orient them to the concerned medical setting; creation of an enabling environment in the hospitals to encourage their involvement and active participation; organizing training sessions to aid the MSW in targeting the families; and to facilitate evidence-based practice. [9],[12],[13],[14] These measures should be planned and implemented in all the healthcare establishments, once the hospital administrators have been sensitized. Furthermore, all the sanctioned posts should be filled at the earliest and all the MSW should be given adequate and timely remuneration. [11]


  Conclusion Top


To conclude, the MSW plays a decisive role in helping sick people - individual by individual, both through the best use of the patient's capabilities and community resources and thus eventually assists in the strengthening of the healthcare delivery system of the entire nation.

 
  References Top

1.Nottingham C, Dougall R. A close and practical association with the medical profession: Scottish medical social workers and social medicine, 1940-1975. Med Hist 2007;51:309-36.  Back to cited text no. 1
    
2.Park K. Medicine and social sciences. In: Park K, editor. Textbook of Preventive and Social Medicine. 20 th ed. Jabalpur: Banarsidas Bhanot; 2009. p. 605-6.  Back to cited text no. 2
    
3.Shrivastava PS, Shrivastava SR. Post burn avenues in rehabilitation of female burn victims. J Med Soc 2013;27:25-30.  Back to cited text no. 3
  Medknow Journal  
4.Bobhate PS, Shrivastava SR. A cross sectional study of knowledge and practices about reproductive health among female adolescents in an urban slum of Mumbai. Int J Public Health Res 2013;3:307-311.  Back to cited text no. 4
    
5.Jagosh J, Donald Boudreau J, Steinert Y, Macdonald ME, Ingram L. The importance of physician listening from the patients′ perspective: Enhancing diagnosis, healing, and the doctor-patient relationship. Patient Educ Couns 2011;85:369-74.  Back to cited text no. 5
    
6.Shrivastava SR, Shrivastava PS. HIV-tuberculosis interface: A comparison of collateral prevalence of HIV and tuberculosis in an urban health centre. Ann Trop Med Public Health 2013;6:290-6.  Back to cited text no. 6
  Medknow Journal  
7.Miller JJ, Frost MH, Rummans TA, Huschka M, Atherton P, Brown P, et al. Role of a medical social worker in improving quality of life for patients with advanced cancer with a structured multidisciplinary intervention. J Psychosoc Oncol 2007;25:105-19.  Back to cited text no. 7
    
8.Hamada M, Miyata M, Uegaki F, Yamashita T, Yagi M, Iwano A, et al. The medical team approach to the suicide-attempted patients by taking drugs or chemicals-participation of the medical social workers. Chudoku Kenkyu 2001;14:119-25.  Back to cited text no. 8
    
9.Dubus N. Who cares for the caregivers? Why medical social workers belong on end-of-life care teams. Soc Work Health Care 2010;49:603-17.  Back to cited text no. 9
[PUBMED]    
10.Chan CL, Suen M. Validation of the Chinese version of the modified caregivers strain index among Hong Kong caregivers: An initiative of medical social workers. Health Soc Work 2013;38:214-21.  Back to cited text no. 10
    
11.Shrivastava SR, Shrivastava PS, Ramasamy J. Implementation of public health practices in tribal populations of India -Challenges and remedies. Healthc Low Resour Settings 2013;1:e3.  Back to cited text no. 11
    
12.Rabin B, Lehmann S, Kedar D, Hegar A, Dori N. An off-site orientation program for medical social workers. Soc Work Health Care 1998;27:43-55.  Back to cited text no. 12
    
13.Jansson BS, Dodd SJ. Ethical activism: Strategies for empowering medical social workers. Soc Work Health Care 2002;36:11-28.  Back to cited text no. 13
    
14.Heiwe S, Nilsson-Kajermo K, Olsson M, Gafvels C, Larsson K, Wengstrom Y. Evidence-based practice among Swedish medical social workers. Soc Work Health Care 2013;52:947-58.  Back to cited text no. 14
    




 

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