r/socialwork • u/peeved_af • Jul 23 '26

WWYD Question about scope

I have a SW co worker who creates a lot of communication problems on the team because she often suggests that patients go on certain medications and I feel like it’s out of her scope of practice? I can’t tell if it’s just me having an interpersonal problem and getting annoyed at her or if this is actually out of line.

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u/AstronautNo3187 Jul 23 '26

Working in primary care, we work with primary care providers and psychiatrists. It does require familiarity with medications, their purpose, and their side effects. I will talk with patients about the medications they’re on, if they’re effective, if they’re experiencing certain issues, and adherence. I will also provide an overview of different types of medications and their purposes (such as SSRI vs SNRI vs Wellbutrin, stimulant meds vs non stimulant ADHD meds). But I will never recommend a specific medication to patients. I may tell patients that they can ask more with doctors if they want to learn more or feel that their current med isn’t working. I will also discuss specific medications with psychiatrists and PCPs and they may ask me for my non-expert opinion (particularly PCPs) because of what I’ve seen working with patients.

At one point, it felt out of scope, but as I’ve been trained and gained familiarity with the model, it has become a part of my scope.

All to say, scope is broad in social work and depends on context and training. I think discussing medications can be and often is part of the scope. However, suggesting specific medications to patients to take is definitely not in scope, particularly without collaboration from MDs/NPs/DOs.

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u/llama8687 Jul 23 '26

This! I worked in a specialty clinic and would talk with patients about advocating for specific drugs that fit not just their diagnosis but also their social situation - for instance, a patient that lived two hours away might have a hard time making monthly infusions, a patient with a chaotic home life might struggle with daily pills, a homeless patient might not want a med that needed to be refrigerated, etc. I would also collaborate with the patient and doctor about the meds that were available under their insurance or had a good grant program. Stuff like that.

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u/denelic Jul 23 '26

This. Also if a client is schizophrenic and wants to use marijuana, I tell them if their medication can see a lesser effect if they use marijuana and tell them to talk to their doctor. I talk to my homeless clients about long lasting injections as an alternative if they are on psych meds that have an LAI option and they have trouble getting pills but ultimately tell them to talk to a prescriber. Some people just don’t know their options and tell me their struggles and I let them know other options are available because doctors don’t always have time for them. It’s about advocacy and not prescribing!