Medical social work--a possibility for me?

Parent Cafe
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<p>Hi all,
As I have posted in the past, I'm really interested in going into some branch of healthcare but am having some problems negotiating the technical standards of many of the professionals. I have not totlly ruled out pharmacy yet (absolutely loved my summer shadowing ands will likely do it again this year, regardless ofr the outcome) but am worried that even if I could graduate, I'd be very, very limited in the types of jobs that I could get. I'm going to consult with a lawyer regarding the ADA and job requirements, i.e., to what extent can a requirment of lifting 25 pounds by accomodated?, and then make a final decision (same type of questions with med. school but to a greater degree, especially because I can't see myself making a career in academia or research). I really want to be in a field where I can thrive and be employed.</p>

<p>While I'm waiting on that, I'm looking into the possibility of medical social work, which would still allow me to be in healthcare buit not have to deal so much with physical issues or physical procedures. I actually think my disability could be an assest of sorts in some situations with this career and am intrigued by the ability to mix in mental health/psychopathology in (such as working in a psych hospital or floor), which I'm interested in but to a somewhat lesser degree than straight "health." I also like the flexibility of an MSW and the reduced school time and debt. However, some things do concern me about the field. Namely, I'm worried that a social worker wouldn't be part of an integrated medical "team," that they would just spend their time filling out discharge plans and resource lists and not having any interaction with the patient/families. I'm also worried about the relatively low pay. I don't necessarily want to be rich (don't desire a big house or fancy car), but I would like a condo with heat, electricity, running water, food, health insurance, and a little extra money for savings or occasional little spurgles. Basically, I want a liveabkle income, though nit a decadent one. I want to live/work in a rural or semirural area, possibly AK (dream locale), WY, WA, or MT.</p>

<p>If I want the social work route, I would get a BSW and BA in Psych (just for interest/background) with a minor in biology (I really like bio and think it would be good background for healthcare anyway. If I did pharmacy, I would go with a human bio degree and all the other miscellaneous courses some pharm. programs require. I'm trying to get a med. sw internship next semester (either way, I figure healthcare experience would be good to have) and plan to continue my biomedical research, regardless.</p>

<p>Any thoughts or info on pharm, medical sw, or anything else would be appreciated.</p>

<p>Thanks!</p>

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<p>There is a tremendous need for medical social workers in Washington. My wife is a hospice nurse (working mostly in rural areas), and there are medical social workers (and a chaplain) attached to the team. Most of the HMOs in the area also employ medical social workers (and child advocates). Lots of social workers graduated in the '70s and are closing in on retirement age, even as the demand for their services are increasing. Within state government, there is a shortage of social workers of all kinds.</p>

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<p>Wolfpiper, it's great to hear you are taking your interest in a healthcare career and modifying it to fit YOU, not a purely theoretical person who does not exist. Any physicial limitations you may have are part of your complete skill set. You are absolutely correct that your disability WILL BE an asset as a medical social worker. I think it can be a wonderful career. Hospice work comes immediately to mind for someone craving real patient interaction. When my mom was on the hospice program, she developed a wonderful & trusting relationship with her social worker. Frankly this shocked us all, given her private nature. My best friend heads a hospice & I have been her sounding board for her 25 year career & befriended many of her hospice nurses & social workers. They are a team in every sense of the word. I would not worrry about being merely a paper pusher in this field.</p>

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<p>It sounds like some job shadowing with medical social workers in several different job settings would be a good idea. Can your university help you set it up?</p>

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<p>Hi Wolfpiper..I am an MSW with most of my years of practice in mental health settings and medical settings, and I have some Hospice training. You can earn a living wage in the field, but you would want to get full credentials..all the way to getting your independent pracitioners license which requires a national exam and various years of supervised clinical practice, where your work is critiqued and modified by someone with experience. I think it helps a lot in this field to also have been a client at some point or another..in some transition in your life, you might consider a season of therapy so you can become very clear about your personality and issues vs those of clients. I guess that is a fancy way of saying self knowledge is crucial in this field, and when you are young, you are only beginning to "know thyself." I suppose it could be argued that this is a truism in every career path, but having good insight and good boundaries is certainly needed when you are sorting out the distress/crises of others. Medical social work is frankly in many jobs mainly intake work and discharge planning...as getting people "out" of expensive inpatient care is what you are often judged on. This means you would become a master of your community and be very attuned to every outpatient care team or long term care facility in your region and a great deal of what you can accomplish means you have to be good at networking. I was often the gateway person coming in and out of special care units, and an important member of an interdisciplinary care team which included RNs and sometimes pastoral care. Never underestimate the central role of nursing...I certainly don't anymore. They have tremendous power in medical care settings and are often the decision makers, although underappreciated. Nursing is a very physically demanding path, and they do appreciate when social workers understand their challenges and work hard to bring patients in and out of facilities with grace. I believe medical social work is a career path that could be an interesting option for you. You might start also with public policy courses. As soon as you are in the field, you will realize that lobbying for funding and for change is necessary.</p>

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<p>Thanks for the replies!</p>

<p>mini,
What has your wife's experience working with medical social workers beeen like?</p>

<p>Marian,
I'm looking into getting internship/volunteer experience next semester through my university.</p>

<p>Faline,
Much of what you say echoes what we've heard in intro to social welfare, so it's nice to hear the same things from an "outside" source. Having worked in both mental health and medical social work, what would you say was/is the main difference between to two in terms of client interaction? Did you find one more personally, professionally, and/or financially fulfilling? Is there much of a crossover between the two areas, and was it difficult to transition from one field to the other?</p>

<p>Thanks!</p>

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<p>An option for you that would definitely put bread on your table is a career as a CRA - clinical research associate. It is an office job, overseeing clinical trials of new drugs, so it is not physically demanding. People in this field tend to have nursing backgrounds, but not necessarily (for instance, one of CRAs in my company has a Masters in Public Health degree and went into this profession straight out of graduate school). However, it does not involve as much interaction with people as you'd probably desire, and another drawback for you is that companies employing CRAs tend to be located in the metropolitan areas with heavy biotech/pharma presence.</p>

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<p>There is more financial incentive in the private practice field, which is shared by other degrees..all of whom must be licensed and must undergo years of supervision. Requirememts alter from state to state and there is not always reciprocity. In my youth, social work was still more about "community organization" and grassroots change efforts, but today social workers are often in the same work force segment as private counselors who hang up a shingle. The insurance industry does not fund a great deal of private counseling hours for people with the masters credentials..insurance is geared more to medical degree provided services. Therefore, you would either have to charge a full rate or work for an agency that has funding like United Way that offers sliding scale rates to clients. Most of private practitioners are seasoned..and have worked in publically funded mental health outpatient or residential settings before being bold enough to consider private practice businesses. Social workers tend to be more concerned with poverty issues and can be found in more settings that address severe poverty problems, and the pay scale can be very low depending on where you live.
Clinical Psychologists are also often certified to do psychological and educational testing. I would ask that you look into this field as well. It takes an extra year and an extra hard exam to get credentialed but in metropolitan areas, there is a clear need for comprehensive plans for students with learning or psychiatric or dual issues in schools. Educational testing is a very interesting field and teachers today strive to individualize teaching plans for students with learning differences. And testing is sometimes needed simply to get more diagnostically clear and to make a treatment plan in psych settings. A good tester can make a good living and it is a satisfying field.
The Independent licensed social worker is able to treat a segment of the population seeking counseling, similar to that of masters in counseling or pastoral care. However, any responsible practitioner today must concede the large impact of biologically based symptoms. Therefore a professional, formalized relationship/association with a medical doctor of psychiatry is necessary, with excellent collaboration skills. Few psychiatrists can afford the time to engage in an hour of talk therapy but talk therapy and medication is clearly more likely to produce outcomes than talk therapy alone. Use of psychiatric meds are not as effective without talk therapy as a part of treatment...the most recent study on this was this week with headlines about teens who had suicidal ideation. Even though using antidepressants, talk therapy clearly helped them reduce any thoughts of suicide.<br>
Re mental health vs health care settings..health care settings are almost always about temporaray residence with the social worker doing intake and discharge. If you are part of a valuable team service, it can still be rewarding to do work with families at discharge. However, know that insurance reimbursement, not what is best for the patient rules this world and your role can be that of advocate.<br>
If you choose a masters or PhD path, you will have internships every year with supervision and you will be able to make these observations yourself.</p>

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<p>In my short time I've been on clinical rotations as a medical student, I promise you that social workers are indeed part of the medical team. Good ones are totally adored by the doctors I've worked with. Granted this has been at an academic medical center, with the corresponding patient population, but I think that there is certainly the potential for similar relationships everywhere.</p>