Medical Social Workers and Interprofessional Care Teams: Examining Roles, Team Based Interactions, and Interventions

Background. Chronic diseases such as cardiovascular illness, cancer, and diabetes account for 7 out of 10 deaths and generate trillions of dollars of costs in the United States (Raghupathi & Raghupathi, 2018). Chronic diseases are often complex including both biological and psychosocial factors (Hill-Briggs et al., 2021; Stoop et al., 2019; Walker et al., 2014). Interprofessional care teams emerged to better address complexities associated with chronic disease (Hermann et al., 2016; Norful et al., 2022). Interprofessional care teams acknowledge that health is complex, and therefore include multiple disciplines on health teams (Morgan et al., 2015). Social workers are one of the most common professions included within interprofessional healthcare teams, yet there is limited research examining their roles on interprofessional teams. The current study addresses this research need by examining the roles, communication dynamics, and workflows of social workers within medical settings.

Methods. Semi structured interviews were conducted with 55 medical social workers across the United States. A qualitative thematic analysis was performed to analyze the roles, communication dynamics, and workflows of social workers working on interprofessional teams. Kigler and Varpio's (2020) stepwise process for thematic analysis was utilized to 1) familiarize researchers with data, 2) generate initial codes, 3) search for themes, 4) review themes, 5) define and name themes, and 6) produce results. The primary author generated initial codes and categorized initial themes within the data. The coauthor then reviewed all themes with the primary author and collaborated to define and name the themes.

Results. Participants worked in hospitals, skilled nursing facilities, dialysis centers, primary care, and other outpatient settings. Interprofessional roles varied based on medical setting, education, self-perception of social work scope of practice, and team dynamics. Social workers with a macro-orientation emphasized case management, care coordination, and policy intervention while those with a clinical orientation emphasized psychosocial assessment, therapy intervention, and health behavior interventions. Interprofessional communication varied based on setting, team composition, and the patient population. Social workers more confident in their role engaged in more interprofessional collaboration while those who viewed social work as an ancillary service limited interactions with other professionals. Workflows often included census review, interprofessional rounds, and review of electronic communications with other team members. There were variations in how proactive social workers were in identifying patient needs. Medical social workers often cited lack of education within their formal social work training and made recommendations to train next generations of medical social workers.

Conclusion. Medical social workers engage in myriad settings, and their roles vary based on their views of social workers, the needs of the setting, and the expectations of the team. Social workers also have wide variability in how they view and define medical social work leading to nuances in how social workers operate on interprofessional teams. Future research may assess these themes more broadly while identifying educational opportunities to prepare social workers for interprofessional care.