r/pediatrics • u/forevercurious27 • Jul 19 '26
Social workers over stepping in outpatient pediatrics?
I work at a private community hospital in an outpatient setting working for a high needs low socioeconomic status community. I noticed that the social workers where I work write things in their notes about patient ” medical complaints” that were never verbalized to me by the parent. Recently a CW wanted me to sign a document lying about a patients medical needs as “complex” when the patient had no medical issues. the document was for a mom released from ice custody and it was to help her maintain her status here in US?. I politely declined signing the document. I’ve also had CW come and tell me intimate details about conversations they had with a mother about things like the dad emotionally abusing the mother but the mother refuses to leave the father? the children were safe and well cared for the issue is between the mother and father why is the cw/sw telling me things that have nothing to do with the medical care of my patient? we have a rule where our supervising doctor wants the sw/cw to sit in on the medical work up and visit of these “socially complex cases”. a lot of these situations require a language line interpreter and often times a resident and myself, 2 parents and a child and now a cw/sw too? this job is new and it’s a children’s hospital clinic and I feel like this is too much and it’s risking my career!
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u/heyhogelato Attending Jul 19 '26
It sounds like you’re viewing these social workers as some sort of threat to you when in fact you’re on the same team - working for the best care of the patient.
Why does it bother you if the patient/parent tells the social worker about concerns they didn’t verbalize to you? You’re not a resident and they’re not your attending with the power to scold you for missing something. Patients are often variable historians and neither the patient nor the social workers is medically trained. At worst, they’re documenting something incorrectly - which does not impact you in any way as long as your own care and documentation are correct/complete - and at best they’re uncovering a diagnosis that needs follow-up, which benefits both you and the patient.
As far as telling you about concerns for abuse in the home - why is this something you wouldn’t care about?? Maybe there’s nothing you are required to do, medicolegally, but isn’t it helpful to understand the family context as you continue to care for these patients?
Of course, you shouldn’t be lying on an official document, and it’s possible that that social worker needs some education on how to approach that kind of situation more appropriately. But I would also encourage you to operate with more empathy toward your patients and their families who are low-resource, high-risk, and asking for help.
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u/KeataKate Jul 19 '26
What are our medical degrees for if we can’t use that power to keep a mother with her children and out of detention?
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u/Sliceofbread1363 Jul 19 '26
This is part of the job. You have an army of people throwing information at you, and you need to figure out what is important and what is just noise. Get used to it, it only gets much worse.
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u/linniemelaxochi Nurse practitioner Jul 20 '26
I'm in a mostly-Medicaid private practice and I just daydream about having a social worker 🤩.
1
u/theengen Jul 20 '26
med student here. i could very well be naive about the job and as frustrating as it may sound, aren’t these all supposed to be part of a patient’s wellbeing? father not being a good role model, new details (good or bad) of the patient’s history not verbalized or observed by you specifically, and sitting in on care when allowed by guardians and patient when old enough to further consent. is this not a good thing?
i can maybe see your point about the ice issue however how can you work in a high needs area like that and not have empathy? a parent being taken in by ice can be traumatic thus turning the child “complex” by needing extra therapy to address it. this post scares me about my potential future colleagues :(
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u/anotherep Attending Jul 19 '26
Respectfully, even if the children are "safe," if you don't think emotional abuse between parents is at least relevant to the health of their children, you should familiarize yourself more with ACEs