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Home Courses I teach Social Work Program Medical Social Work and Occupational Social Work Medical Social Work - The Health Care Continuum •Preventive Care • Primary care - community based models of care, clinics • Secondary care - Acute care hospitals • Tertiary Care - After Care Services, extended care facilities, rehab • Least restrictive setting principle Who pays for health care? •Fee for Service • Diagnostic Related Groupings - Prospective Payment • Managed Care - Capitation or contracting? • Health Care financing is a blending of public and private dollars • Medicare/Medicaid • Over 40 million uninsured • Results in cost shifting Roles in health care •Purchasers - patient and/or employer, federal or state government • Providers - professionals who provide care • Patients • Family and Caregivers Interdisciplinary Team •Physician - attending and consultants • Nurse • PT, OT and Speech • Dietician • Pharmacist • Casemanager • Social worker History of Medical Social Work • Tithes of the church used to care for poor and sick. • Third century monks provided rescue and health care services to avalanche victims - called hospice. • The Great St. Bernard Hospice still in existence in Switzerland • Term hospice came to be used for institutions that cared for sick, often in conjunction with almshouses •1500's monasteries seized by the Crown (Henry VIII/Anglican Church) and hospitals became public property • Lady almoners - women who assisted poor, 1895 London's Charity Organization Society stationed one at Royal Free Hospital to interview patients and determine eligibility for free care. Forerunner of contemporary medical social work. Modern day medical social work • Ida Cannon brought to Massachusetts General Hospital by Dr. Richard Cabot • Originally worked as a visiting nurse then graduated from the Boston School of Social Work. • Wrote "On the Social Frontier of Medicine: Pioneering in Medical Social Service".
•Specialized and general roles –renal – rehab – children – psychiatric – oncology •Coordination of care (discharge planning) and counseling Skills of medical social work •Assessment, Discharge planning and adjustment to illness counseling • Grief and loss • Community resources • Policy, insurance and financing knowledge Settings for medical social work •BSW in nursing homes with more than 100 beds • MSW in hospitals,hospice and home care • MSW in speciality clinics and areas What does the future look like? •Many unresolved problems in health care • Hospitals closing, merging • Managed care • Great variability in the traditional role of the social worker depending on the institution • Maybe less inpatient work, more work in community
Role of occupational social work •Typically done by MSW • Clinical role - maybe just crisis intervention, assessment and referral or extend to counseling employee • Often called Employee Assistance Counselor (EAP) Structure •MSW is paid employee of the company • MSW works for a company under contract with employer • MSW in private practice Problems seen • Usually referred to occupational social worker when problems interfere with ability to perform job • Substance Abuse, depression, domestic violence, family troubles • Disability and health concerns • Maybe involved in health and wellness programs to prevent problems Issues in occupational social work • Confidentiality - if employer is paying for services, how much does he/she need to know • Social worker often must be involved in disciplinary action with employee if problems are serious • One strength is that people can be motivated when job is in jeopardy • Growth field • Senior level practitioners • Can be lucrative • Need to move into more preventative kinds of programs |