chalp'ter-vi medical social. workers as...

CHAlP'TER-VI

• . ... - - - .

MEDICAL SOCIAL. WORKERS AS !£MEERS OF A PROFESSIONAL DISCIPLINE

I. • WHAT IS A PROFESSION? .'

• II. JOB EFFECTIVENESS

• • III. MEDICAL SOCIAL WORK RECORDS

IV. J<EElPI m IN TOUCH WITH NEW DEVELOPMENTS

V. INTERACTION AMONG MEDICAL SOCIAL WORKERS

VI. MBMBERSHIlP' IN PROFESSIONAL ORGANISATIONS

VII. PROFESSIONAL GROWTH OF l'1EDICAL SOCIAL vIORKERS • • • • •

VIII. KNOV1LEDGE ABOUT VARIOUS GOVERNME1Nl' COMMITTEES AND THEIR RElP'ORTS

279

• WHAT IS A PROFESSION?

, . •

Professionals are characterised by the • . '

pq~session of a t~eoretical body of knowledge,

.technical competence acquired through a'protracted

period of formal training, a s,trong ,service

orientation and a high degree of personal involvement. . '

Social control is exerted in a professional ~

community . through formal associations, and legitimacy is gained

through both clientele and cOl\lllluni ty sanctions. The . . .

central function of the professional role lies 'in its •

rationality, functional specialization, and •

universalism. The professional acquires his social

identity from his profession and·derives considerable

prestige and satisfaction in its practice'.', Each

profession,develops its own sub-culture with a strong . . " II

social and moral solidarity among the members (Theodore, "

1971: 2) • •

'In the United-States of Anierica, Medicare, • ,

Medicaid, Maternal and Child Health legisiation; •

national health insurancedproposals, a joint.commission

'" on Hospital Accreditation standards, Department.of Health, •

Education and Wel£are licensing and certification

studies, ani Public Law 92-6030£ 1972, the social

security amendment that established the professional

standard review organisation have emphasized social

work accountability (Meites, 1976) •

. . To examine one's accountability, one has to

constantly evaluate one's work. Constant efforts

to identify the scope of improvement in application

of knowledge and information can help one grow

professionally. In other words, professional growth

means achievement through efforts by the professionals

to keep themselves in touch with new developments and

constantly to redefine their own role and practice.

, . The respondents ~ere asked about efforts made

by them to measure job effectiveness, the type of

records they maintained, their reading habits, their

membership in professional organisations and •

participation in the same. The respondents were also

asked about their participation in conferences and

seminars, and participation in programmes of higher

studies.

280

28'

JOB EFFECTlVENElSS

There is job effectiveness when the activities

performed by the professionals produce worthwhile

results.

Respondents were asked about the methods used

to find out the effectiveness of their various

activities. Out of the tQial.respondents, 65.3 per

. cent stated that they did not see the need to resort .' to methods for assessing job effectiveness and 34.7

• per cent of respondents said that they saw the need to • adopt appropriate methods for assessing job effective-

ness. However, according to them, oral feedback from

the patients and increase in registration of patients

were sufficient indicators of a proven job effectiveness.

Both these methods are not adequate for the purpose of

measuring job effectiveness because the respondents •

were dealing with the clients who were suffering from •

problems caused by extreme economic deprivation and

these clients-did not by themselves, specifically

request help from the social workers. Consumers, • meaning patients, reporting to the doctors for treatment

of their phySical ailment, were aware of the doctors'

role. However, they did not have a clear idea about

the role of medical social workers in the matter of

282

their treatment. In the absence of knowledge about the

role of the professional social worker on the part of

the consumers, the consumers' feedback regarding

appreciation of social services cannot be considered,

as a scientific way of evaluating the work. Secondly,

an increase in the number of patients cannot be

considered as the decisive method of evaluating job

effectiveness. This increase in number of patients

can be attributed to the increasing population living

in slums. The increase in the number of patients who

come to the social service department does not prove

that the increase is because of a 'snow ball' effect.

There is a need to develop various methods of evaluating

social work services. There is a need for standardized

methods for measuring one's job effectiveness. To

measure one's effectiveness, one has to constantly

evaluate one's job: To help the practitioners in this

evaluation process, schools of social work should have , short-term training programmes from time to time. Lack • of standardization in evaluation of services is one of

the reasons, as to why respondents have not been able

to recommend the desirable ratio of medical social workers.

to the patients in hospitals.

283

MEDICAL SOCIAL WORK RECORDS

A record is an important tool for reviewing

practice and professional growth. It provides a

channel of communication among different professional

social workers and also provides opportunity to share

their work with other professional colleagues. The

purpo.se of recording social work practice is often

misunderstood and its importance is not recognized.

Systematic and well maintained records can provide

useful material about the patients' physical

surroundings, and attitudes towards the illness and

social situation. They help to provide the continuity .-~'!".:.<

~f- services, and their value for the purpose of research

and administration also cannot be undervalued. The

majority of the medical settings have a department

which looks after medical records but these settings

have not insisted on a standardization of social

service records. The researcher's observation has beer:

that the method of record-keeping was determined by the

individual respondents and not by the group nor by the .~

setting. A good record should throw light on:

1. Pertinent patient-data

2. Reasons for social work intervention

.,

"

3. Evidence of collaboration with other health

professionals

4. Problems to be worked on

5. Proposed actions

6. Actions taken

7. Outcome for every action

8. Follow-up activities.

Out of the total respondents, 6.3 per cent

respondents classified their records as adequate,

54.9 per cen~ respondents classified their records

as inadequate, 34.7 per cent respondents classified

as haphazard, while 4.2 per cent respondents did not

comment on the quality of their records. Those

respondents who classified their records as adequate,

stated "The records are adequate for us".

As regards not maintaining adequate records,

there were many reasons pertaining to a lack of some

thing or the other. In brief, the inadequacy as

regards the maintenance of records was due to a lack

of time, habit, skill or standardization of records.

Lack of time was reported by 56 per cent of the sample,

lack of habit by 42.9 per cent, and lack of

standardization by 48.6 per'cent of the sample.

Respondents saw the need to maintain records

but at the same time they were apathetic towards

concrete. steps to be taken, such as developing a

form for maintaining records. Some settings had

developed intake forms, but no system was evolved

for maintaining the on-going records. In one of the

settings, a fairly good system of record maintenance

was evolved ~nd practised. The respondents working

285

in the said setting rarely participated in professional

organizations, nor did they have any meaningful

interactions with the other social workers including

the other respondents of this study. Specimens of

two forms are given in appendix-VII and VIII.

The record is an important tool for a professional

to review one's own practice, and can be used to achieve

professional growth. This is an area in which the

professionals working in the medical settings and

professional organisations need to look into, with

concern.

. . XEElPING. IN TOUCH WITK THE. mw DEVELOlP'MENI'S AND EXPANDI N} BODY OF KNOWLEDGK

"Reading maketh a full man,

Conference a ready man,

and wri ting an exact man".

Francis Bacon

•

286

Reading is another important tool of stimulation

for the professionals. By and large, the respondents

were found to be indifferent towards reading. Reading

was as~ociated with opportunities for upward mobility.

This is well illustrated by the following examples.

In one of the medical settings, the respondents had

opportunities for promotion. After a period of five

or seven years, they appeared for an interview held

for promotion. Prior to the int~rview, the respondents

visited the library of an institution teaching social

work and went through some of the books. In the same

setting, the Head Medical Social Worker had developed

a library for the department. This group met once a

month regularly for case presentation and discussions.

The respondents working in this setting referred to

journals and books occasionally.

•

287

As against this, in another setting which had

a fairly good library, the librarian was not even

familiar with the respondents. Her remark was "I have

never seen a single social worker visiting the

library". The teaching medical settings had good

libraries. These settings did allocate certain funds

for the social service sections. It was possible that

funds were not always sufficient'for the books but

generally medical journals carry articles relevant to

non-medical intervention in related fields. In spite

of the facilities, respondents did not make use of

these journals. The respondents were familiar with

the journal 1Social Welfare' and 1Indian Journal of

Social Work', though they did not necessarily read

these journals. The reasons for not developing reading

habits can be attributed to various factors which are

mentioned below •

Respondents were involved in direct services

which contained mostly referral work and in mobilizing

the resources. This always did not require indepth

, probing and therefore, the respondents were able to

handle the situation without additional knowledge and

on a level of common sense. Professionals who do not

288

cultivate habit of reading professional literature

have difficulty in articulation and are.unable to use

precise expressions. The medical setting calls for

precision in verbal expressions and writings. Medical

social workers have to be precise in both speaking and

writing. One of the complaints about social workers is

that they are vague and ambiguous in their communica

tion. Therefore, reading is necessary to develop

articulation and precision. Opportunities for upward

mobility serve as an incentive for improvement of

professional practice through reading and other ways.

Since these opportunities are lacking for medical social

workers, they are apathetic as regards taking steps for

professional growth. As a result they are satisfied,

operating at the minimum level of their profeSSional

abilities and possibilities.

The medical setting generally provides a variety

of target groups such as children, adolescents, men,

• women, and old people with a variety of problems. It

is for the respondents to exploit the settings and

create opportunities for themselves for involvement.

Medical settings operate on a medical science approach

exclusive of social science orientations, with the

result that deficiencies and aberrations of the

soci~l structures and social and emotional factors

(that affect the patients and that are detrimental

289

to tne patients' condition of ill-health) are ignored

by tne administrators. Unless hospitals and other

medical settings add a social science orientation to

the ~edical science approach, social work intervention

will not be considered as important by administrators.

INTERACTIONS AMONG MEDICAL SDCIAL WORKERS

Sharing knowledge, skills and experience is an

impo~tant activity for professionals for their

professional growth. Purposeful interaction among the

professional social workers within the organisation

and outside the organisation facilitates the process

of p~ofessional sharing. The frequency of interaction

within the organisation is shown by the following

table.

Table

Distribution of Respondents According to their Interaction within the Organisation

Interaction of the No. of Percentage respondents within the organisation

Respondents

1 • Never 38 26.4

2. Whenever required 41 28.5

3. Once in a year 2 1.4

4. Once in six months 1 0.7

5. Once in three months 12 8.3

6. Once in a month 37 25.7

7. Once in a fortnight 6 4.2

8. Once in a week 7 4.9

144

290

Table 6.2

Reasons for the Respondents' Interaction Within the Organisation

(Multi-response Table)

Reasons Yes

iP'rofessional 80 (56.O"fo)

Social 33 (23.0%)

Administrati ve matters 49 (34.0%)

INTERACTION AMONGST'lRE RESPONDENTS OUTSIDE THE ORGANISATION

No

64 (44.0%)

111 (77.0%)

95 (66.0%)

291

Total

144 (100.0%)

144 (100.0%)

144 (100.0%)

One hundred and five respondents, that is

72.9 per cent, had ~n opportunity to interact with the

other respondents working in the other settings. But

31.7 per cent of the respondents had no interaction

outside the organisation.

•

Table 6.3

Respondents' Reasons for Interaction Outside the Organisation

(Multi-response)

Reasons Yes. No Total

Professional 92 52 144 (63.89}6) (36.11%) (100.0%)

Administrative 18 126 144 (12.5%) (87.5%) (100.0%)

Recreational 3 141 144 ( 2.0$) (97.92%) (100.0%)

292

From the table it may appear that the respondents

of this sample met professionally quite frequently but

deeper inquiry revealed. that they met generally to

discuss a case or to explore the availability of

resources. The respondents' meeting with other

respondents was related to specific cases of patients

or to seeking information on resources. There was no

contact as regards professional matters in general.

The. fact tha t respondents dld not come together

for any issue can be illustrated from the following

example. The Bombay Municipal Corporation introduced

293

a resolution to charge the patients for hospitalization.

The respondents working in psychiatric departments were

very disturbed about the resolution. They said that

they made tremendous efforts to motivate the patients

to take the treatment. By and large, relatives of

the patients were not quite interested in the treatment.

Hence, if the families of these patients had to pay for

the treatment, they would be least interested in

initiating the treatment of the patients. One of the

respondents said that she had ~o collect funds to buy

the drugs and keep them in the department and this

amounted to the additional responsibilities of raising

funds. At no time, however, did the respondents come

together to discuss the issue, nor did they think of

making a representation to the higher authorities. In

the absence of meaningful interaction among the

professionals, there is no professional sharing.

Assessing the quality of interaction was further

carried out specially in the case of those respondents,

who met once a week, once a fortnight and once a month.

For those respondents who met once a week or once a

fortnight, the meetings amounted to a mere formality.

These meetings under the instructions of the higher

•

authorities led to an act of reporting rather than

sharing. Those meetings of respondents who met once

a month, were generally headed by the Head M.S.W.

The meetings were structured and provided scope for

professional sharing. There is a need for a formal

leader in the form of a head and if the head has

useful ideas pertaining to the profeSSional growth

and development of the group, the members of the

group are benefitted by the ideas.

The need for profeSSional sharing is further

illustrated by the following situations:

In one of the areas of Bombay, there are

teaching and non-teaching medical settings under the

same management. One non-teaching medical setting is

a specialized setting, providing services for people

suffering from infectious diseases. The teaching

hospital under the control of the administrative

organisation, had a well established social service

department and a number of respondents of the study

were working in that setting. In the specialized

setting, there were two respondents who had training

outside Bombay. Both the respondents had considerable

time on hand. They were desirous. of making efforts

in working for their patients, but they could not

decide on the direction of work. They did not know

from whom and where to seek help. There was nothing

~9S

in the system which provided an opportunity for the

respondents to interact with others. If there had

been some models of service developed by medical

social workers, they could follow the models. But no

authority is invested in the senior people to develop

a model for services. Structured mechanisms designed

for professional sharing should facilitate interaction

among the professionals employed by the same organisa

tion but working in different settings.

To cite another example, there were three

medical social workers working in the field of sexually

transmitted disease from two medical settings. The

respondents from these two settings rarely met to share

ideas, experiences, or strategies. The same is true . of the respondents working in the areas of tuberculosis

and leprosy. These respondents are employed by

different organisations such as government, municipal

or VOluntary organisations, but these different

organisations also did not see the need to bring

296

together various respondents working in the same areas

in order to develop common strategies.

MEMBERSHIP OF PROFESSIONAL ORGANIZATIONS

Professional organisations are important bodies

through which members individually or collectively

express their views. The profession of social work

is of recent origin. Medical social workers have not

developed strong professional boards like those of the

medical and law professions. The professional

organisations of social workers present a rather dim

picture. Respondents' indifference towards professional

organisations emerged very clearly when the respondents

were interviewed by the researcher. Out of the total

respondents, 113 respondents (78.5 per cent of the

sample) were not members of any professional organisa

tion, 31 (21.5 per cent) respondents were members of

professional organisations, ou"t of which 11 (7.6 per

cent) respondents were interested in activities of the

professional organisations. The respondents who were

educated outside Bombay did not know about the

existence of any professional organisation. They saw

the special need for such organizations. These

respondents were of the opinion that professional

organization should facilitate the process of

socialization for social workers coming to Bombay

from other places.

Professional organizations oreate solidarity

among professionals; There is no solidarity among

social workers. The medical social workers in the

hospital have remained divided. First of all, the

traditional boundary between physical medicine and •

297

psychiatry has resulted in the bifurcation of hospital

social workers into medical social workers and

psychiatric social workers. In teaching hospitals,

there is a further division between hospital social

workers and community social workers. In the medical

settings because of the specialization in medicine, the

medicql social workers are assigned to different units

or departments. Identification with the assigned unit

is highly desirable, as it gives the social worker an

opportunity to work as colleagues with the members of

other disciplines. Social workers attached to such

units had developed stronger feelings of identifica

tion with the units than with the social work

4departments of " the same medical settings. The

298'

respondents in the field of Wsychiatry and Blood Bank

participated in the activities of the Bombay Psychiatric

Society and Federation of Blood Bank respectively.

Respondents working in the field of Psychiatry or Blood

Bank got an opportunity to express their professional

views through these organisations. ,These respondents

did not see the need to identify with the professional

organisations of social workers, and as a result there

was no common platform for social workers to meet or

exchange their views. •

The lack of a strong professional organisation

indicated that there was no platform for the professionals

to come together and raise issues or agree on • professional standards. Absence of strong professional

organisations has led to absence of solidarity among

the respondents working in the same setti~ and different

settings. This is aptly illustrated from the following

examples.

In one of the teaching medical settings, a number

of posts for medical workers existed. The medical

social workers were attached ~o different departments.

-There was a social worker in the pOSition of a lecturer,

but she was attached to the Gynaecology department.

Being a lecturer, she belonged to grade II in the

government, while the rest of the medical social

workers belonged to Grade III.

Therefore, when medical soci~l workers met to

discuss their administrative issues, they preferred

299

to keep the respondent with designation of 'lecturer'

out of the meeting. They felt, the respondent, being . a grade II employee, did not face the problems of the

group# Nor did tbis respondent take any initiative

to convey the message that regardless of her status

.of grade II, she would like to see that others also

acquired the same status.

There was no unity among the respondents working

in different settings which were administered by the

same organisation. For example, respondents employed \

by the municipal corporation came together several

times tofo:nn a union or association. Till today,

they have not been able to form a union or association.

Similarly, in case of the respondents employed by the

state government, one of the.senior respondents made

efforts to bring all the respondents togetber to make

800

a representation to the government to look into the

issues, connected with their status and salaries.

These efforts were so time-consuming and frustrating

that she ended up asking "Am I dOing this for the

profession or for personal benefit!" All the

respondents who \\I'ere working with the state government

were unhappy about their status as they belonged to

clasv III. Yet, when it came to taking action, they

were not willing to join the movement for united

action. In three teaching hospitals managed by the

municipal corporation, there "las no uniform policy

about the status of medical social workers. In two

of t~e teaching hospitals, these respondents were

work~ng under social service departments and in the

case of the third setting, they were working in the

department of preventive and social medicine. In the

year 1977, to bring about uniformity in all the

%.'l.'t\ .... c i.';)a1. b..Q'S. ';)1. ta1.'S. '> a ';)Q'S. t Qf. 1.~ <:. t'3:O;:~"l: i.'t\ %.~<ii.<:.-o.1..

sociel work in the Department of Preventive Social

Medicine was created in every municipal teaching

hospital. The lecturer was to work under the professor

of Preventive and Social Medicine. She also had the •

responsibility of superviSing medical social workers.

The $enior-most medical social worker was appointed

301

as lecturer in medical social work. This created

a very peculiar and unusual situation~ The respondent

had considerable freedom in planning her work till

her appointment as a lecturer, but as a lecturer, she

had to plan her activities in consultation with the

professor of Preventive and Social Medicine. At that

time, the municipal hospitals had quite a few medical

social workers who had been in employment for more

than ten years. Some of the medical social workers

saw the need to have a separate department "'ith a

social worker as its head. Hence, a representation

was made to the Municipal Commissioner through the

Indian Association of Trained Social Workers. At this

stage the medical social workers were divided among

themselves. There were three groups. One group

preferred to work under different departments, another

group preferred to work under the department of

preventive and social medicine. The third group

preferred to have a social worker as the head of the

department. Ultimately, after many discussions and

deliberations, the senior-most social workers were

given the choice to opt for either a lecturer's post

in the department of Preventive and Social Medicine

or the position as the Head of Medical Social Service

Department. In two of the teaching hospitals, two

respondents opted for the position as Head of the

department, while in the third medical setting, the

respondent preferred to be a lecturer but she wanted

to isolate herself from others as she felt that she

had no support from her own professional colleagues.

All this has led to the bifurcation of medical social

workers into a group belonging to the hospital and

another group of medical social workers belonging to

the medical college. In one of the teaching hospitals,

this bifurcation affected the grqup of professionals

to such an extent that there was no meaningful

communication among the two groups. In another setting,

where the senior-most respondent opted to be a lecturer,

the hospital social workers had decided to be under the

department of Preventive and Social Medicine for

administrative purposes. It is evident that there was

no unity among the social workers of the three hospitals.

Therefore, decisions of long term effect in the social

work profession were made on an adhoc basis, depending

more on personal considerations than on professional

interests. In the first place, the municipal corporation

ought not to have left it to the choice of individuals.

The corporation could have adopted other strategies for

303

, an objective discussion of the issue, to derive thereby

impersonal decisions geared to professional interests.

FTofessional organizations, besides creating

feelings of solidarity and security among the members

strengthen one's sense of identification with the

profession and professional goals. Under the umbrella . . of the organisation, opportunities for learning from

each other and for supporting each other are provided.

Furthermore, the organisation serves as a channel for

social control which is often exercised indirectly and

unobtrusively by groups of,fellow professionals.

. .

PROFESSIONAL GROWTH OF MEDICAL SOCIAL WORKERS

Professional growth cannot be measured easily.

In this study the professional growth was measured in

terms of their responses; on job effectiveness. the

type of records they kept, and their reading habits.

Their participation in conferences, seminars, work-

shops and important meetings was also measured. Their

membership and participation in professional organisa

tions, and whether they had gone for higher stUdies

was also taken into consideration.

304

to professional growth were scored. It is represented

in the following table. I

Table 6.4

Distribution of the Respondents' according to their Professional Growth

Low

41 (28.5%)

Medium

65 (45.1%)

High

38

(26.4%)

Total

144 (100.0%)

. . •

The maximum number of respc;mdents were in the • medium category, followed by those in,1ow category,

followed by those in high category.

Relationship between their professional growth

and sex, experience, field of specialization, job

title, and type of setting was examined.

Table 6.5

Relationship between Sex and lP'ro'fessional Gro\'rth

Sex

Male

Female

Total

_ Low

11 ~42.3%~ 26.8%

30 F5.4%~ 73.2%

41 (28.5%)

(100.0%)

Medium

11 ~42.3%~ 16.916

54 ~45.8%5 83.1%

65 (45.1%)

(100.0%)

High

4 p5.4%~ 10.5%

• 34

F8.8%~ 89.5%

38 (26.496)

(100.0%)

Total

26 (1 00 .O%~ ( 18.1%

118 ~100.0%~

81.916

144 (100.0%) (100.0%)

Chi square = 3.6455; with D.F. = 2; P = 0.159928;

p > .05 .'. difference is not significant.

It was seen in previous chapters that female

respondents of this study were more involved in direct

service tasks, they made use of social work methods

and case work theoretical models more than male

305

respondents. Despite these earlier findings one does

not find here any difference as regards the professional

growth between male and female respondents, One can

infer that for the professional growth, one has to

go beyond the routine activities.

Table 6.6

Relationship between Years of Experience and ~ofessional Growth

Years of Low Experi-ence

1 - 10 years 25 .

~27.8%~ 61.0% 17.4%

11 - 20 years 9 ~28.1%~ 22.0% ( 6.3%

21 - 30 years 7 (31.8%~ f17 .'1%

4.9%

Total 41 _ (28.5%)

Medium

44

~48.9%~ 67.7% 30.6%

13

~40.6%~ 20.0% 9.0%

8 (36.4%~ ~12.3%

5.6%

65 (45.1%)

High Total

21 90 ~23.3%~ 55.3% 14.6%

~100.0%~ 62.5%

10 32 ~31.3%~ (100.0%~ 26.3% ( 22.2%

6.9% -

7 22

~31.8%~ 18.4% 4.9%

(100.0%~ ( 15.3%

38 144 (26.4%) (100.0%)

Chi square = 1.7540; D.F. = 4; P = 0.783309;

i' > • 05 • • • difference is not significant •

This finding should be of concern to , professional social workers, If experience did not

lead to professional gro\rlh then it can lead to

status quo. This situation is of concern for the

professionals,

Table 6.7

Relationship between Field of Specialization and lProfessional Growth

Field of • f.1ean No. of Specialization Respondents

Medical and Psychiatric Social Work (MfSW)

19.79 38

Specialization other 19.71 24 than MiPSW (Non-M!FSvl)

Generic (GEN.) 19.92 74 •

Untrained (UNT.) 19.75 8

19.84 144

Group (1) and Group (2)

t value = 0.1349; D.F. = 60; P = 0.833361;

p > .05 .'. difference is not significant.

-,

Group (i) and Group (3)

• , t value = 0,2419; D.F. = 94; P = 0.787076;

P > .05 .'. difference is not significant • •


t value = 0.0404; D,.F. = 44; iP> = 0.833536;

P .). ,05. '. difference is not significant.


t value = 0.3759; D.F. = 60; P = 0.706982;

P > .05. '. difference is not significant.


t value = 0.0441; D.F. = 30; P = 0.835391;

P ) ,05 • . , difference is not significant •

• Group (3) and Group (4)

t value = 0.1466; D.F. = 80; P = 0,829655;

P ~ ,05 .'. difference is not significant.

There was no significant difference between

MfSW, Non-MfSW, GEN., UNT. respondents as regards

professional growth.

308

•

Table 6.8 • •

R~lationship between Job Title and ~fessional Growth

•

S.No • Job Title Number

1. Head Medical Social Worker 6

2. Lecturer in Medical Social Work 3

3. Medical Social Worker 97

4. Social Worker 7

5. Psychiatric Social Worker 14

6. Assistant Medical Social Worker 5

7. Social Guide 2

8. Intake worker 1

9. Rehabilitation .Officer or 9 Research Assistant

Total

Mean

22.33

21.67

19.71

19.71

21.07

17.20

16.00

18.00

19.67

Respondents designated as Head Medical Social

Worker, Lecturer in Medical Social Work and

309

Psychiatric Social Workers made efforts, for professional

growth, Job title made the difference for the

professional growth.

Table 6.9

Relationshi, between Medical Settings and rofessional Growth

Type of Setting

Teaching

Non-teaching


•

Me.an

20.07

19.63

Number of Respondents

68

76

19.84 144

t value = 0.9730; D.F. = 141; P =0.665595;

P > • 05 • • • difference is not significant •

310

311

Table 6.10

Relationship between specialized/General Settings •

and Professional Growth

Type of Setting Mean Number of Respondents

Specialized 19.48 31

General 19.94 113

19.84 144


t value = 0.6218; D.F. = 36; P = 0.544830;

P > • .'05 ... difference :is not significant.

Table 6.11

Relationship between Private and Public

Settings and Professional Growth.

Type of Setting Mean Number of

312

Respondents

Private 20.50 26

Public 1·9.69 118

19.84 144

Group (~) and Grou~ (2)

t value = 1.0822; D.F. = 31; P ~ 0.287503;

P > • .05 .' ~ difference is not significant.

There was no relationship between different

medical settings and professional growth.

The findings as regards the respondents' involvement

in professional growth can be summarised as follows:

Sex, experience, field of specialization and

settings made no difference for professional growth.

Job title indicated differences in professional growth.'

•

The findings of this chapter raises an

important question: why were) the respondents once

trained from schools of social work, indifferent

towards professional gI"lloth?

3&3

This issue needs a close examination by the

schools of social work. Socialization of the students •

entering the schools of social work should be such

that it helps the students to identify with the

professional organization. For the desired professional

growth, socialization has to be an ongoing process,

Without identification with the social work organisations,

professional growth could not take place.

KNOWlEDGE ABOUT VARIOUS GOVERNMENT COMMITTEES AND THEIR REPORTS

Knowledge about the national development in the

area of health is necessary. India became independent

in 1947. After independence the Bhore Committee,

Mudaliar Committe e, Jugamlalla Committee, Kartarsingh

Committee, Mukherjee Committee, Shreevastava Committee

and the latest p. Ramalingaswami's report on •

'Health For All', were appointed by the government of

India to review health services available to people •

•

With every committee's recommendation, the focus of

health policy has been changing. The focus changed

from communicable disease to rna ternal and child • welfare services, family planning, rural health

services. Initially, the focus was'on training of the

professionals. The focus has shifted from doctors and

nurses to multipurpose workers and community health

workers. With the changing focus of health policy,

people associated with the health field have to change

the focus of their work. The respondents were asked

about their knowledge of the various committees. Sixty

eight per cent of the respondents had little knowledge;

thirty one per cent knew about various committees.

Since many respondents did not know about various

committees, the respondents did not view their work

in the light of the new perspectives.

The respondents' responses regarding various

committees were scored. Their relationship with sex,

experience, field of specialization, job title, and

the medical setting was examined.

Table 6.12

Relationship between Knowledge about the various Commi ttees and their Repor.ts and the Sex of the

Respondents •

Sex

Male

Female

Total

Low

23

t8.5%~ 23,296 16.096

76

(76.8% (64.4%~ (52.8%

99 (68.8%)

High

3

~11 ~5%~ 6.7% 2.196

42

~35.6%~ 93.3% 29.2%

45 (31.396)

Total

26 ~100.0%~

18.196

118 (100.0%~ ( 81.9%

144 (100.0%)

Chi square = 5.7382; D.F. = 1; P = 0.015929;

P < .05 .'. difference is significant.

Female respondents had more knowledge about various

committees.

316

Table 6.13 - - . -

Relationship between .the Experience of' Res1ondentsand Knowledge about the Committees and the r Reports

Experience Low High

1 - 10 years 63 27 FO'O%~ pO.O%~ 63.6% 60.0% (43.8%) (18.8%)

11 - 20 years 22 10

~68.8%~ ~31 .3%~ 22.2% 22.2% 15.3% 6.9%

21 - 30 years 14 8 ~63.6%~ (36.4%~ 14.1% (17.8%

9.7% ( 5.6%

Total 99 - (68.8%)

.Chi square = 0.3332; D.F. = 2; P = 0.842353;

lP' > .05.·. difference is not significant.

Total

90 ~100.0%~ 62.5%

32 ~100.0%~

22.2%

22 ~100.0%~

15.3%

144 (100.0%)

Experience did not make any difference as regards

knowledge on the committees.

Table 6.14

Relationship between Field of Specialization and Knowledgeabout the Committees

Field of Specialization Mean No. of Respondents

1 • Medical and Psychiatric Social Work (MfSW)

0.50 38

2._ Specializations other than 0,42 24 Medical and Psychiatric Social Work (Non-MFSW)

3, Generic (GEN. ) 0.44 74

4. Untrained (UNT.) 0.12 8

M.V. = 0,44 Total 144


t value = 0.4155; D.F. = 61; P = 0.681015;

P > .05 .'. difference is not significant,


t value = 0,2711; D.F. = 110; P = 0.770938;

P > .05 • differenc e is not significant. • • •

Group (1 ) and Group (4)

t valj.le = 1.9230 ; D.F. •

= 34; P = 0.059820;

lP - .05 • difference is signifi cant. _. • •

•

3'7

•


t value = 0.1629; D.F. = 65; P = 0.823865;

lP ) .• 05 .'. diffe;ence is not significant.


t value = 1.1958; D.F. = 30; P = 0.239573;

lP > .05 .'. difference is not significant.


t value = 1.8494; D.F. = 28; 1P' = 0.071730;

lP )-. 05 .'. difference is not significant.

There was no significant difference between

(1) MlPSW am Non-MlPSW, (2) M1P5W and GEN.,

(3) Non-MfSW and GRN., (4) Non-MlPSvl and UNT.,

(5) GEN. and UNT. respondents,

There was significant difference between

MfSW and UNT. respondents •

•

31S

•

'.

Table 6.15

Relationship between Job .Title and Knov/ledge about Various Committees and their Reports

1. Head Medical Social Worker

2. Lecturer in Medical Social Work •

3. Medical Social Worker •

4. Social Worker

5. Psychiatric Social Worker

6, Assistant Medical Social Worker

7. Social Guide

8. Intake worker

9. Rehabilitation Officer or Jr. Research Assistant •

Mean

1.67

1.00

0.37

0.57

0.36

0.20

0.00

0:00

0,'44

No. of Respondents

6

3

97

7

14

5

2

1

9

M.V. = 0.44 144

Head Mifdlcal social worker and lecturer in ... ., .;

Medical Social Work had fairly good knowledge about

various committees, indicating that respondents

319

having higher job positions kept themselves up-to-date

with the knowledge.

• •

Table 6.16

Relationships Between Different Settings And Knowledge About Various Committees

And Thei.r Reports

Setting •

Teaching

Non-teaching

Mean

0.43

0.45

No. of Respondents

68

76 --------------------------------------------

M.V. 0.44 Total 144


t value = 2.321; D.F. = 111; P = 0.834107;

P > .05 difference is not significant.

320

Setting

Specialised

General

Table 6.17

Mean No. of Respondents

0.52 31

0.42 113

321

--------------------------------------------------------0.44 144


t value = 0.7216; D.F. =.88; P = 0.520634; •

P ~ .05 • • difference is not significant.

Setting

Private

Public

Table 6.18

I'lean No. of Respondents

0.62 26

0.40 118

-----------------------~--------------------------------0.44 144


t value = 1.4128; D.R. = 56; P = 0.159750;

P .> .05 • difference is not significant. • •

322

Different settings did not make any difference

as regards the knowledge of the various committees.

No relationship was found between the different

settings and knowledge of social workers about various

committees and their reports.

The findings as regards the knowledge about

various government committees and their reports can

be summarised as follows:

1 • Female respondents had more knowledge about

various committees and their reports than male

respondents.

2. There was no difference between inexperienced

and experienced respondents as regards the

knowledge of various committees.

3. The field of specialization did not make any

difference to the knowledge of various committees

except between MPSW and UNT. respondents.

4. No relationship was found between the different

• medical settings and knowledge' about various

committees and their reports.

In conclusion one can say that the respondents

did very little about professional growth once they

were out of schools of social work.

323

chalp'ter-vi medical social. workers as...

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