In Depth: The Social Workers Helping Patients Navigate China’s Health Care System

In the spring, Liu Pei, a medical social worker, received a thankful message from the mother of Xin Xin, an 11-year-old boy with congenital heart disease who had undergone three surgeries at Beijing’s Fuwai Hospital. Xin Xin initially resisted surgery, once fleeing the operating room in panic, but Liu provided emotional support, aiding his eventual return to surgery and recovery [para. 1][para. 2][para. 3][para. 4].

China’s development of medical social care services has been slow, with the field emerging after the early 2000s. Typically, social workers are introduced through charitable organizations, third-party services, or direct hiring by hospitals. While the first two are prevalent, recent national policies have encouraged hospitals to hire full-time social workers, which have become crucial in shifting the healthcare model from disease-centered to patient-centered care [para. 5][para. 6][para. 7].

Liu often faces skepticism and misunderstanding, as many patients and families are unfamiliar with the role of medical social workers. Unlike caregivers who attend to daily needs, social workers offer guidance on navigating social welfare, financial assistance policies, and provide psychosocial support. They also facilitate financial aid and streamline hospital processes for patients [para. 8][para. 9][para. 11].

Social workers can significantly impact treatment outcomes by bridging gaps between doctors and patients. While doctors focus on direct treatment, social workers address family and psychological factors crucial for recovery. They continue to support families beyond hospital walls, offering services like parenting guidance and psychological support for families with premature infants [para. 12][para. 13][para. 14].

Data from 2023 showed that in Beijing, only 101 out of 12,518 healthcare institutions offered medical social work services. Nationally, 1,034 hospitals have social work services, with just 18.1% of social workers being full-time. The field is relatively new; the first social work major was introduced in 1988, and social services departments began forming in the early 2000s. Today, regional coverage and resource allocation remain inconsistent [para. 15][para. 16][para. 17][para. 21].

Training and recruitment pose challenges. Primary healthcare institutions may not yet be prepared to integrate social workers. Training competent social workers takes time, and competitive job markets make roles in top hospitals attractive. However, charities face difficulties due to lower salaries compared to hospitals, impacting recruitment [para. 22][para. 23][para. 24].

Policy support has been growing. In 2009, policy documents first called for the development of medical social work, which was further emphasized in 2024. Beijing, leading these efforts, aims for full coverage in medical institutions by 2025. To this end, improved certification and evaluation systems for social workers have been suggested [para. 25][para. 26][para. 27][para. 29].

Ultimately, Liu Pei and her colleagues hope that, as recognition of their profession grows, patients will understand and seek their support readily, underscoring the essential role they play in modern healthcare [para. 30].