新自由主義下的醫務社會工作

Medical Social Work Under Neoliberalism

本研究探討新自由主義對醫務社會工作的挑戰與應對策略。新自由主義強調績效與成本效益，可能弱化醫務社工在心理社會支持中的角色。為因應此挑戰，醫務社工可運用「四Rs社會心理診斷」與「SOAP醫療紀錄法」，系統呈現專業價值，並倡導全人照護與關懷倫理，強調身心社靈的整合照顧。面對醫療體系中的階層化與去專業化風險，醫務社工應強化與醫療團隊的溝通合作，確保病人獲得公平對待。政策上，建議強化醫務社工的法定地位與多元績效評估，支持跨部門協作。實務上，社工應持續精進能力、強化能見度，並堅守社會正義核心，以提升專業影響力與服務品質。

This study explored the challenges that neoliberalism poses to medical social workand the strategies that can be used to address them. Neoliberalism emphasizes performance and efficiency, prompting health-care systems to prioritize cost-effectiveness, which may undervalue the role of medical social workers in providing psychosocial support to patients. In response, medical social workers can employ the“4Rs assessment method”and“SOAP notes”to systematically assess and document patients’conditions, thereby demonstrating their professional value. In the face of hierarchical structures within medical teams and the risk of deprofessionalization, medical social workers should advocate for holistic care and ethics of care and should emphasize integration of physical, psychological, social, and spiritual dimensions. Through effective communication and collaboration with healthcare teams, medical social workers can help ensure that patients receive equitable treatment within market-oriented health-care systems. On the basis of this study, we recommend that policies formally recognize the legal status and professional value of medical social work, promote holistic health care, establish diverse performance evaluation indicators, and strengthen interdepartmental collaboration. In practice, medical social workers are encouraged to use assessment tools, reinforce patient-centered care, engage in interdisciplinary teamwork, and continually develop their professional competence and visibility. Ultimately, medical social workers must actively confront the effects of neoliberalism; uphold social justice, a core value; and strengthen their professional influence to deliver high-quality services to patients.