CASE

“Does being a doctor include being a social worker?”

As a fourth year medical student I was assigned to care for an elderly Hispanic woman with frequent hospital admissions. As I got to know her it became clear that there were a number of nonstrictly medical issues that were having a decided impact on her health. She lived alone in a small unheated inner city apartment, accessible only by a long flight of steps. Because of her severe arthritis she seldom went outside. Her decreased mobility made it difficult for her to shop properly; she favored an ethnic grocery store at some distance from her neighborhood. The resulting poor nutrition contributed to her anemia. My patient was an extremely private woman who had few personal contacts and valued her solitary life. She confided in me that her greatest fear was losing her independence.

What are the boundaries of the doctor's professional responsibilities in such a situation? Does being a doctor also involve being a social worker? Was it part of my duties to be concerned about the separate, but not medically unrelated, issues of food and housing for this patient?