Medical social workers are responsible for helping people find a variety of health care services, supporting those with serious or chronic illnesses, helping the homeless, drug addicts, and abused children, and finding legal health resources and financial assistance for patients. Their work is not easy at all. Most of the people they work with come from the lower class of the society, and it requires patience, empathy, a certain amount of physical strength, and problem-solving abilities and skills to be able to do their job. When I was rotating in the AIDS unit, a social worker named Roswell once took me to follow a transgender AIDS patient. We went to one of the most chaotic neighborhoods in San Francisco, where we were constantly being asked for money and where drug dealing was said to be a common sight on the streets. I followed Roswell closely to the transgender man's home, where Roswell treated him like a friend, asking him why he wasn't staying on HARRT and encouraging him to cheer up. When he learned that the patient had been very depressed for a few days, he left a phone number to contact an organization that treats depression. Although this was only a short home visit with the patient, it was enough to make me respect the work of American medical social workers. Afterward, Roswell told me that the key to being a successful social worker is one word: Respect.
In China, we don't have a dire need for medical social workers because most patients have the full support of their families behind them, and honoring the elderly has been a traditional virtue in China for many years. In addition, even with the help of social workers, it would be difficult to find many charitable organizations or business groups in China that would support those at the bottom of the social ladder. However, there is a great need in China to introduce the American family doctor system, which is the gatekeeper of the entire U.S. health care system and plays an important role.
In China, tertiary hospitals like Union Hospital are always overcrowded, while primary hospitals have far fewer patients. The main reason for this is that we don't have a referral system, and the prices are the same at all levels, so anyone with a minor illness like a cold can come see a professor at Concordia. In contrast, the referral system in the United States greatly relieves the pressure on the tertiary hospitals and saves time and money for the patients. In the U.S., patients are first seen by their family doctor, who decides whether they need to be referred to a specialty hospital for further treatment. At the UCSF endocrine clinic, a doctor can spend nearly an hour answering a patient's wide range of questions and educating them about the disease. I have followed many doctors in the clinic and found that they all ask the same question before the patient leaves, which is "Do you have any other questions". Chinese doctors are afraid that patients will have endless questions, because there are so many anxious patients waiting at the door. American doctors can't compare the number of patients they see in a morning with Chinese doctors, but it's clear that the quality of their service is beyond our reach. Fortunately, the reform of China's health care system has also noticed this prominent uneven distribution of health care resources, and is actively raising the establishment of a family doctor system and referral system with Chinese characteristics.