Rural hospital social work: views of physicians and social workers

Psychosocial problems among patients in neighborhood health centers: perspectives from health care providers

Little is known about how health care professionals perceive and understand the psychosocial problems of individuals receiving services in neighborhood health centers (NHCs). We conducted interviews with health care professionals in NHCs in New York City. The respondents identified seven problems, including a lack of financial resources, unsafe housing, and emotional distress/depression as affecting large portions of their patient populations. Respondents reported that they are presently meeting many of the psychosocial needs of their clients, but they were pessimistic about their ability to continue to do so due to a lack of funding streams to support their provision of comprehensive health care that includes psychosocial services. The findings suggest that while NHCs may be "holding their own" in providing quality services to their clients, this will be harder to sustain in the future if the numbers of the uninsured served continues to increase, and the revenues generated continue to decrease.

Hospital social work: are we conducting the right type of research?

Given the current financial state of health care in the United States, intervention- or outcome-based research is essential for the survival of hospital social workers. The purpose of the current study was to systematically review the current literature on hospital social work to assess the effectiveness of hospital social work in implementing intervention- based research and to make recommendations for the future direction of research among hospital social workers. Over the 10-year period (1991-2001), a total of 44 peer-reviewed journal articles were identified for inclusion in the present study: 19 were qualitative articles and 25 were quantitative articles. Of these studies, only 5 studies were intervention based research. Possible strategies for increasing intervention research among hospital social workers were discussed.

Understanding collaboration between social workers and physicians: application of a typology

This article builds on prior analyses of data collected from a qualitative study of 50 pairs of social worker-physician collaborators in. This article presents the elements of a typology of collaborators from both professions developed from those analyses. The typology was also applied to the entire sample and each respondent characterized according to type (traditional, transitional or transformational). Further analysis was done to evaluate the relationships between type and collaborative perspectives. The sample was primarily transitional (56%-58%) and there were more traditional social workers (22%) and transformational doctors (24%) than anticipated. Social workers, as a group, were much less satisfied with the doctors than the doctors were with them although both groups of traditional respondents were the most dissatisfied. Both groups were least transformational in relation to control over decision making.

Physicians' perceptions and responses to patient emotion: implications for social work practice in health care

Physicians serve a pivotal role in today's health systems, as they are often the first professional patients must contact for emotion problems. This study surveyed 225 practicing physicians to understand how they perceive patient emotion and the actions they would then take in response to these perceived emotions. In reply to nondescript "emotion complaints" from a patient vignette, these physicians perceived the patient as experiencing anxiety, followed by fear, anger and sadness. Physicians had distinct preferences for psychosocial oriented responses (e.g., explore, reassure, and rationalize) and were least likely to avoid, distract, and ignore. Overall, anxiety and fear generated the greatest number of possible responses from physicians, anger and sadness the fewest.

Collaboration between social workers and physicians: perspectives on a shared case

As health care is being restructured, health care institutions are recognizing that interdisciplinary collaboration is an essential element of both effective patient care and organizational survival. This paper analyzes self-reported views of actual collaborative activities between 50 pairs of social workers and physicians on a specific shared case in an acute care hospital setting. Through examining the degree of congruence in perspectives of each pair of collaborators, we compare the two professions' views of the collaborative process and outcome. Additionally, each profession's outlook on its own and the other profession's roles and responsibilities in the case is examined. Our findings indicate that many social work and physician collaborators share similar perspectives about many aspects of their joint patient care endeavors. Where there was disagreement within a pair, almost always, it was a social worker selecting or discussing a variable when her physician counterpart did not. Physicians were less likely than their social work counterparts to identify patient/family problems related to adjustment to illness and problems connected to hospital and community resources as well. Social workers were much less satisfied with the collaboration, saw many more things that they or their collaborator could have done differently and even perceived more disagreement about the approach to the case than did their physician collaborators. It is important to understand, empirically, the dynamics of successful collaboration and to assist social workers in becoming influential and effective collaborators with other health professionals.