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Casework in a veterans' hospital : an analytical study of referrals from doctors, Shaughnessy Hospital, 1953-4 Barsky, Anastasia Nellie


There is evidence that from the earliest days of recorded history man has been aware of a significant relationship between sound physical health and an harmonious social environment. Many physicians and hospital administrators today recognize that a complete program of medical care includes facilities for the treatment of patients' social and emotional problems. The Department of Veterans' Affairs has recently given recognition to this principle through the provision of medical social service as part of the Treatment Services program for veterans. In the present study the medical social service program at Shaughnessy Hospital is examined in an attempt to show how the doctors use the new service and with what results. At the same time, an attempt is made to point out other potential areas of development for medical social service in this hospital. The basic information for the study was obtained from an analysis of approximately four hundred social service records, representing new referrals by doctors to the department for the year 1953-54. In addition, approximately thirty doctors were asked, through the medium of a questionnaire and in personal interviews, how they were using social services to complement medical care, and what recommendations they might make for the fuller utilization of these services. The findings from these two procedures were consistent. They indicated that there is a growing demand for social services in this setting, and that the potential demand is even greater. The services most widely requested were for the purposes of enabling medical diagnosis and treatment, and assisting the patients in discharge planning. On the other hand, there is as yet, little recognition of social work as a method of treatment, complementary to the medical plan: this finding appears both in the classification of the services for which patients were referred to the Medical Social Service Department, and in the comments and suggestions made by medical personnel. While recognizing the very real limitation of staff shortage within the Social Service Department, this study is primarily concerned with the need for continuous interpretation of casework services. Much can be done through the refinement of everyday practices, such as closer co-operation with the medical staff, more effective use of casework recording, and continued self-evaluation. These practices, together with the favourable attitudes toward social-service already expressed by the medical staff, should enable the doctors to make the optimum use of the existing services available through the Medical Social Service Department, to the end of improving still further the overall program of care for the veteran patients.

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