Managed care: The new context for social work in health care-implications for survivors of childhood cancer and their families

The changing organization of health care requires social workers to deal wi th a variety of new demands, and in some cases alter their traditional prof essional practice. Using the specific case of childhood cancer as a framewo rk (or set of case examples), this paper identifies key issues faced by onc ology social workers in hospital settings under managed care and ways they have responded to them. The general content involves pressures on oncology social workers to adapt to the new corporate culture and ideals fundamental to managed care at the same time that the expressed psychsocial needs and desires of survivors of childhood cancer necessitate Increased attention an d expansion of service provision. Caught in conflicts that challenge them t o reconcile simultaneous commitments to client service/empowerment and inst itutional conformity, social workers must establish a more powerful positio n to negotiate institutional and public policies that uphold the primacy of a core Social Work ethic: A commitment to client-centered serv ice.