I have met and developed great relationships with several social workers through this business. From the start I was amazed by how much they do and what they are responsible for. I wanted to write a piece about them, particularly the ones who work in a hospital or skilled nursing facility. I know there are other types of social workers, but these are the ones that I have come to know. Through this piece, I hope at least one additional person develops a newfound respect for the profession and for the people who dedicate their lives to helping others.

A social worker is someone who helps people adapt to society, which could be orchestrating medications, medical devices, or services for a proper and safe discharge from an establishment. A social worker’s job is intense. They are often managing cases where a patient’s lifestyle has changed such that the appropriate plan is not appealing to the patient or is hard to achieve because the patient lacks resources or family support. The latter of these two issues is far too common, which means social workers are constantly having to create solutions with very little resources—multiply that by 60 and that is why this profession is one of the most intense I can imagine. Social workers routinely look out for people who don’t have a support system to look out for themselves. This is also why I call them “The Guardians of Society.”

Patient, compassionate people tend to excel at the profession. In my opinion, that’s because they have to win their patients’ trust in order to suggest a plan. As a result, social workers are tasked with remaining patient and compassionate in the midst of chaos and deadlines. Here’s an example of a typical problem they may face: an insurance company ceases payments to a facility because the patient no longer meets a certain level of care to justify his or her stay. As the patient remains at the facility, his or her costs may exceed tens of thousands of dollars a month. The facility will have to pay for the costs itself. The facility administration will look to the social worker to create a plan to get the patient out of the facility as quickly as possible without compromising the safety of the patient, because if that patient is readmitted into a hospital, then the “system,” particularly CMS, will penalize that facility in the form of reduced future payments. The social worker must balance the safety of the patient and the economic impacts on the facility—this can create a very stressful situation.

You may share the opinion that social workers are the hidden centerpiece of today’s health care system. So much relies on them. And to do their jobs well, they must have a breadth of skill sets including business acumen, knowledge of medical terminology, legal knowledge, communication skills, and relentless work ethics. A social worker must combine the intel from the doctors, in-house counsel, family, patient, and administration to make a plan for the patient. What a task!

It’s amazing with the caseload that social workers have that they are so successful at what they do. In the US, approximately 15% of all patients admitted to the hospital were readmitted within 30 days during 2019 1. Considering the typical case load at any given hospital or skilled nursing facility, that number is outstanding. And it’s as low as it is because we have a system in which social workers help coordinate all the different stakeholders at play. As that 15% number decreases, tax dollars can be allocated elsewhere, insurance premiums may go down, and individual patient outcomes will improve. For the reasons that social workers help patients and, bigger picture, help our society function, I think it’s appropriate to deem them America’s Guardians.

March was Social Work Appreciation Month, but there is no time like the present to thank social workers for all that they do, particularly now as their case loads begin to build and as they stand on the front lines of this battle against the invisible enemy.


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