Where are the Social Workers on Medical Television Shows?

SocialWorkersSpeak.Org Panel Discusses Ways to Get Hollywood to Include Social Work Roles

WASHINGTON—Medical television series such as TNT’s “HawthoRNe,” Showtime’s “Nurse Jackie,” and Fox’s “House” have been a staple for years and continue to be some of the highest rated, longest running and most critically acclaimed programs on television.

While nurses and doctors have been prominently featured you would be hard-pressed to find a social worker on a hospital show. This is surprising. About one out of five of the 642,000 social workers in the United States in 2008 worked in the medical and public health field, according to Labor Department data.

Social workers are an integral part of our nation’s health care system and provide a dizzying array of services in hospitals. These include patient advocacy, counseling, hospice care and clinical, financial, social and educational interventions.

SocialWorkersSpeak.org invited health care social work experts to discuss this dilemma and offer suggestions on how social workers can improve their portrayal on medical programs. SocialWorkersSpeak.org is a Web site that gets social workers talking about and influencing how they and issues they care about are portrayed in media.

The panel participants were:

Here is the discussion:

Q: Social workers provide many services in hospitals and the health care field. Is this represented well in movies and television programs?

GURLAND: Not at all! Social workers are usually only represented in situations of child or domestic abuse, sometimes rape and once in awhile to find temporary housing for a patient.

KATES: Movies, TV and literature sadly portray clichéd perceptions of social workers as income maintenance workers or child protective services only.

SHAW: Not always. I think for the most part society, based in part on media description, misunderstands what social workers do and can do and are trained to do.

 Q: Why do you think the representation of social workers is so poor?

GURLAND: Because the general public is very uneducated and misinformed about social workers and therefore, so are the writers, directors, producers etc. who write and produce the scripts. The main reason I am writing articles for Women magazine is to educate everybody about the real function of medical social workers.

KATES: Considering how long it took for our own profession to carve out our own identity (ensure licensure, billing, etc.) the public retains only veiled perceptions of the old concepts of either the “friendly visitor” social worker or the hard-nose, child-removing ogre who threatens low income and (minority) families in an authoritative and racist manner. NASW does try to refocus the media on the accomplishments of social workers. However, the clichés still outweigh any public change in perception.

LAFLAMME: They don’t seem to be represented at all, unless the movie has some element in the plot line involving child abuse or the department of human services.

Q: Do you think it would be easy for Hollywood writers to include social worker characters in their programs?

SHAW: Most definitely!

GURLAND: Piece of cake! It would be much more interesting to include a social worker role and it could also add some dimensions and elements to the plot. Unlike registered nurse and doctor roles, the public doesn’t know what social workers are all about or what they do. So by writing in a social worker role they are also adding pertinent and educational information to the story or episode.

Q: Can you give us an example of shows where a social worker character would be a welcome addition?

LAFLAMME: “Mercy” on NBC, “Nurse Jackie” on Showtime,  and “Grey’s Anatomy” and “Private Practice” on ABC – pretty much any medical drama!
GURLAND: Lots of them – “House,” “Grey’s Anatomy,” “Nurse Jackie,” even “Scrubs” (laughs) seriously! I think there’s a new show “Trauma”? Basically any television series or movie that includes a medical venue would benefit from adding depth to the plot by writing in a social worker role.

KATES: The television show “ER” is a good example. During its initial years the show tackled several social issues for which hospital social workers would have been integral and essential to accomplish a patient’s safe transitional plan. After several years of “ER” having the George Clooneys of this world calling indigent pharmaceutical programs, adoption agencies, child welfare and visiting nurses (truly roles of a social worker!) they finally placed a social worker in the cast. Unfortunately, she was a dysfunctional character and the negative outweighed the positive role representation. It was reported that the show’s director or producer’s wife was a hospital social worker. However, her influence sorely missed the target!

Q: In an ideal world, what would you want a social worker character on “HawthoRNe” or “Grey’s Anatomy” to do?

KATES: On the current television show “Mercy” there is a social worker who is pretty much portrayed as an antagonistic, non-patient advocate and resourceless individual. Sad. I believe there is a real opportunity to show a strong character, who is creative and resourceful advocate for whom the family actually demonstrates appreciation for their intervention.

LAFLAMME: I would like a character that does what social workers do in real life – solve problems, put out fires, and be an important and valuable part of the health care team.

SHAW: Since I’m a fan of “Grey’s Anatomy” I have noticed that sometimes the medical staff sees a psychologist for counseling. There is absolutely no reason why that role couldn’t be a social worker. Also, for the more complicated cases that come through that hospital social workers can be an active part of team discussions. For example, a recent episode had a young woman who was asking for physician-assisted suicide since she had a terminal prognosis. A social worker should have been included in the end-of-life care discussion and to provide support to the patient and husband as they processed and worked through this choice and the social worker could have also functioned as a support to the physician who was working on the case.

Q: What can social workers do to get better representation on such programs?

GURLAND: Exactly what SocialWorkersSpeak.org is doing! And then also what I am doing. Starting small and posting smart comments on blogs, getting interviewed by magazines, writing articles instead of abstracts and pitching those articles to newspapers and magazines, etc.

SHAW: Social workers should make a united effort through the organizations that represent us to put more energy towards educating the media about all that we do. Oftentimes, people don’t really know what social workers do unless they have had an experience where they were introduced to one in the context of needing support and then through that venue they find out what it is that we actually do instead of the misconception of what they had believed.

LAFLAMME: Promote ourselves and our professions in a positive way. I think Kathy Gurland is a good example of this.

KATES: I believe a “walk in my shoes” campaign to all media types would be helpful, especially those in television and movies. It will both educate and expand opportunities for character development, in addition to furthering NASW’s agenda. Equally, when an existing show does portray a social worker in an accurate way, it is as important for NASW to thank the producers, directors and screenwriters just as much as when they fail.

Q: Should social workers get aggressive and flood the Facebook and Web sites of these medical shows to get notice or try to arrange meetings with the producers and writers?

GURLAND: I’m not sure that flooding Facebook or Web sites of the program will reach people who can affect change. I believe your latter suggestion would be most effective – contact the producers, writers, directors, and casting directors and have meetings with them. You’ll probably want to gather supportive data to convince the writers and others that this is worth their investigating. They will be primarily interested in what adding a social worker role will do to increase their viewership. In other words money talks (laughter).

SHAW: I’m not really sure. I’m not a huge fan of Facebook and so I don’t know how that could be arranged or if the effort would lead to a productive outcome or be a failing effort.

LAFLAMME: It may be a good strategy. I’m not sure of the overall effectiveness of utilizing social media for this purpose but I don’t think it would hurt the cause.

KATES: I believe the key is to begin with education and advocacy, leading towards the development and green lighting of powerful and profound stories that include social workers in highlighted roles. So many social workers have stories to tell that would translate into wonderful documentaries or films. Hmmm…do I hear the beginning of a NASW production company? Calling Harvey Weinstein and Miramax!

To learn more about the role social workers play in health care visit the National Association of Social Workers’ “Help Starts Here” Health & Wellness Web site: www.helpstartshere.org/health-wellness

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