Health Professions

Medical Social Work in St. Louis

Social work in hospitals began in the first decade of the 20th century under the leadership of physicians and administrators who believed that adequate medical care included attention to the personal and social problems associated with illness. The development of medical social work grew out of the need for someone to assist patients and their families to deal with problems in their personal lives which might form obstacles to satisfactory medical treatment, rehabilitation, and prevention of further illness.

St. Louis Children's Hospital social worker making a home visit, ca. 1910
St. Louis Children’s Hospital social worker making a home visit, early 1910s

In 1910 St. Louis Children’s Hospital became the first hospital in the city to establish a Social Service division. Medical social work was considered a strong component in the efforts toward preventive medicine. The hospital’s managers and medical staff knew that many children could be protected from illness if their environment could be improved. A trained worker, Mrs. Minnie D. Weiss, was hired to provide assistance to patients. During the ten and one-half months of her service, almost 600 cases were referred to her, and over 1300 visits were made by her and by the students of the School of Social Economy who assisted her.

Julia C. Stimson
Julia C. Stimson, ca. 1917

The following year services were extended, in cooperation with Washington University, to cover the University’s hospitals and dispensaries. The first head of the enlarged and re-organized “Social Service Department of the St. Louis Children’s Hospital and Washington University Hospital” was nurse Julia C. Stimson. The aim of the Department was to aid in the treatment of patients by improving their social environment and by bringing to the physicians’ attention the knowledge of any home or working conditions that might be of value in the patients’ treatment. Social workers made sure families understood doctors’ instructions. They also helped families obtain necessary medicine and appliances, such as glasses and braces, and instructed mothers in child hygiene.

St. Louis Childen's Hospital social workers transporting patients to hospital, ca. 1910
St. Louis Children’s Hospital social workers transporting patients to the hospital for treatment, ca. 1918

Medical social work provided a means to personalize medical care in an increasingly complex and impersonal hospital environment. St. Louis Children’s Hospital, like many hospitals in the early 20th century, became affiliated with a university-based medical school. As a teaching hospital, training and research programs assumed new importance. The goals of education and research began encroaching on the former sole emphasis on patient care.

In 1914 the Social Service Department was combined with the Washington University Training School for Nurses, all under the direction of Julia Stimson, who had training and experience as both a nurse and social worker. Though the roles of nurses and medical social workers were related and somewhat overlapping, each profession was still forging its place in the male-dominated medical environment. The experiment in organization was discontinued in 1916 with the prevailing belief that nursing and social work were separate professions with distinct aims and techniques. Stimson was offered her choice of heading the Training School for Nurses or the Social Service Department. Stimson chose the former and Ethel M. Riddle, a graduate of the St. Louis School of Social Economy, became director of the Social Service Department.

The number of trained staff and volunteer workers grew as the Social Service Department continued to expand its services to a growing number of University clinics and departments. By 1918 a separate corporation, the St. Louis Association for Social Work, was established to oversee the operation of the “Social Service for Barnes Hospital, the St. Louis Children’s Hospital and the Washington University Dispensary.” [Barnes Hospital, which opened in 1914, replaced the Washington University Hospital.] The Social Service Department extended its services to the Jewish Hospital of St. Louis when the latter became affiliated with the Washington University Dispensary in 1921. The Department became a member agency of the St. Louis Community Fund in 1923 and workers’ salaries were provided by the Greater St. Louis Community Chest. In the mid-1950s, however, the responsibility for funding for the social service departments reverted back to the hospitals. In 1944 the Jewish Medical Social Service Bureau was created to provide centralized medical social services to patients at Jewish Hospital.

Medical social work student interviewing patient, ca. 1950
Washington University social work student interviews a patient at St. Louis County Hospital as part of her practical field work, ca. 1950

The Social Service Departments of Barnes, Jewish and St. Louis Children’s Hospitals focused primarily on serving the needs of patients and their families. In addition, the departments have served an important educational function. The Social Service Departments have participated in the teaching of medical, nursing, physical therapy, hospital administration, and dietetics students as well as in the training of students in social service studying at Washington University.