The Role of Social Work Values in Innovative Primary Care Practices

Background and Purpose:The Patient Centered Medical Home (PCMH) is a model for healthcare restructuring guided by the Institute of Medicine’s aims for improved quality and lowered cost of patient care. Primary care PCMH exemplars provide insight on fostering innovative practice. This presentation describes the ways in which representatives of ten exemplary primary care practices describe their approach to patient-centered care, which reflects social work values codified in the National Association of Social Workers (NASW) Code of Ethics. 

Methods:In April 2014 representatives from ten exemplary primary care practices gathered to discuss the ways in which their practices innovated in two substantive areas: 1) healthcare neighborhood integration and 2) creative use of technology. Practice participants were identified from a study that generated a national sample of especially innovative practices using snowball interviews of researchers and primary care experts. The three-day “working conference,” funded by the Agency for Healthcare Research and Quality (AHRQ), included a series of fishbowl and small group discussions and one-on-one interviews with practice representatives. Group discussions and interviews were digitally recorded and transcribed.  The lead author immersed herself in the data and regularly met with the co-authors to identify patterns. Social work values emerged as a key component of innovative approaches to patient care.

Findings:The emergence of social work values in group discussions and one-on-one interviews with primary care representatives were not articulated or acknowledged as such. Yet they provide insight on ways that social work values inform patient-centered care in practice and medical education. The conference participants talked about their approach and attitudinal stance toward patients by placing patient self-determination at the center. Furthermore, they couched patients with a sense of the whole person and recognized the importance of the social context of the whole person. 

Conclusion and Implications: Innovative primary care practices are using many core values of social work. Given they seem to be used unknowingly, practices are not taking full advantage of the theoretical and practice foundations that social work could offer in medical education. This is particularly important as primary care practice transform into PCMHs and need to embrace new mental models of collaborative care and patient-centeredness.