4 Reasons Why Leadership in Social Work is Under Attack Part 2: Social Work in Health Care

By: Mindy Barnes


Medical social workers are vital members of the health care profession. These social workers are often the only health care professionals able to assess and address all of the client’s biopsychosocial needs. Unfortunately, few social workers hold leadership positions within health care settings. Before are four reasons why:


#1. Reengineering of the 1990s was a major threat to medical social work leadership, as decentralization took supervisory positions away from social workers. And according to Judd and Sheffield, “[a]s social work leadership began to evaporate and free standing departments were absorbed into case management units, hospital social workers were placed into a position of competing for roles they had historically filled” (2010, p. 858). Today more than ever, patients are in need of social workers, and social workers are gaining back their valued positions within health care settings. However, social workers are still missing from prominent leadership roles. 

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#2. Social work leadership is overlooked by professionals at all levels. DiNitto and McNeece say that, “[s]ocial workers are taught to place a high value on collaboration, whereas physicians are generally taught to assume leadership roles in interdisciplinary groups (Mizrahi & Abramson, 1985)” (2008, p. 206). Interdisciplinary collaboration is certainly an important aspect of social work, but perhaps social workers could also learn to incorporate leadership styles into their practice within health care settings. Also, “[a]s in other important areas of social welfare policy, social workers have generally not been at the table when government or proprietary health-care organizations have made important policy changes in health-care programs. Social work’s multilevel perspective provides an important point of view that should be considered in any major policy shift” (DiNitto & McNeece, 2008, p. 214).


#3. According to Liechty, “[d]espite the extensive knowledge and skills that social workers can bring to bear to assist patients with low health literacy, the concept of health literacy is underused in social work scholarship. This gap reflects missed opportunities for social workers to contribute their expertise to the evolving field of health literacy and to strategically align their work with organizational and national priorities” (2011, p. 99). The disconnect between health care providers and patients with low health literacy often leads to patients being referred to social workers, as social workers are highly equipped to deal with this vulnerable population. Unfortunately, health literacy terminology is rarely used within social work literature, which can hinder social workers’ ability to become leaders and advocates in health care settings (Liechty, 2011).

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#4. DiNitto and McNeece point out that, “[s]ome of the struggles social workers experience in the medical field can be attributed to the various ideas other medical professionals have concerning what constitutes medical social work” (2008, p. 194). The fact that medical social work encompasses a variety of roles is beneficial in that it allows social workers to assist and advocate for patients in many different areas within the medical field. However, because medical professionals differ in their ideas of what a medical social worker’s purpose should be, social workers could lose out on important leadership positions within medical settings.

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Ida Cannon, the first identified medical social worker, said that medical social work, “strives to bring to the institutionalized care of the sick such personal and individual attention to the patient’s social condition that his recovery may be hastened and safeguarded” (DiNitto & McNeece, 2008, p. 193). Cannon’s words still hold true today. The patient’s health and well-being is the sole concern of medical social workers. So, it only makes sense that patients and medical professionals at all levels would benefit from having social workers fulfill leadership roles. To accomplish this, social work programs could promote the integration of leadership skills with interdisciplinary collaboration, and they could acknowledge the importance of addressing health literacy and evidence-based approaches within the academic literature. Also, all health care organizations should recognize the necessary work and specific knowledge provided by medical social workers, as well as the potential benefits of having social work leaders within their facilities.



DiNitto, D., & McNeece, C. (2008). Social work: Issues and opportunities in a challenging profession (3rd ed.). Chicago, IL: Lyceum Books.

Judd, R., & Sheffield, S. (2010). Hospital Social Work: Contemporary Roles and Professional Activities. Social Work in Health Care, 49(9), 856-871. doi:10.1080/00981389.2010.499825

Liechty, J. (2011). Health Literacy: Critical Opportunities for Social Work Leadership in Health Care and Research. Health & Social Work, 99-107.

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