“I’m here because my doctor sent me, but I don’t need a social worker. What do you even do?”

This is an actual quote from a patient who was sitting in my office with her arms folded and an “I don’t have time for this” look on her face. I bet this is familiar to many of you. In fact, this wasn’t the first time a patient questioned why he or she had been referred to a “social worker.” This was just the first time in a while that someone had been so up front and clear about how much she didn’t even want to be in my presence.

We all have moments in our lives that shape the ones that follow. For me, one of those moments happened when I was a junior in college. Someone at the career center asked what I planned to do with my Bachelor’s in Psychology. I proudly announced my plan to get a Master’s in Counseling Psych, followed by details of the kind of therapy I wanted to do. He had an interesting look on his face—one I hadn’t seen before. He had no comments, just one question, “Have you ever considered clinical social work?” My response was, “Clinical social work? What is that?” He told me to just look into it…and I did.

I went to the Occupational Outlook Handbook (https://www.bls.gov/ooh/)—a wonderful government publication that details nearly any career one could possibly think of—and flipped to the psychology page. It sounded pretty much like what I’d always thought. In the “similar occupations” section, however, clinical social work was listed. What was that doing there? I had never seen it before. As I clicked on the link and started reading more, I was only a couple of sentences in when I began to feel like I was having an existential crisis. “THIS sounds amazing! THIS is what I want to do!” But wait, I was a junior in college, in a different major, and nothing was going to stop me from graduating in four years! I took an introductory course—loved it. I took another—loved it. Before I knew it, I’d added a minor in social welfare and yes, I still graduated in four years and was headed to Temple University to get my MSW.

I’m sharing these details with you because in that moment with this patient, I reflected on my own reaction to someone even suggesting that I consider social work as a career. As far as I was concerned, social workers were the people who took children from their homes and did that kind of work. Just as she’d emphatically stated that she didn’t need a social worker, I was quite clear that I didn’t want to be a social worker. Her tone was one of offense, almost like she was thinking, “How dare my doctor send me to the social worker.” But, you know what? She came.

I have often been asked by patients what I do. I’ve also been asked clarifying questions over the years by members of my team as they try to understand my role. For a while, I think the only person who had any idea about my role was me! The oncology social worker before me mainly conducted groups. Unfortunately, as my caseload has grown, so have the needs of my patients. As the only outpatient OSW, I’m spread even more thinly than in years past. My team has come to understand the breadth of my role; however, new patients sometimes don’t. In fact, for many of my patients, their experiences with me are their first with a social worker—ever.

Some patients and colleagues have suggested I call myself something other than a “social worker” because then maybe more people would want to utilize my services. This is an interesting suggestion; however, in the 16 years since earning my MSW, I’ve fully embraced this title. In fact, I announce it like a badge of honor. I think I’ve even convinced some others to pursue an MSW with all of its career versatility and the ability to work quite autonomously. I don’t have to convince any of you about this; you’ve already made the same decision!

Like me, many of you have shared that oncology social work just “happened.” For some it was your exposure during a field placement, for others it was a job you accepted and came to love, for some it was an intentional career path. Whatever brought you to this work, the results of our 2016 Member Survey show that people continue in this line of work for many years; in fact, based on 390 responses to the question about number of years worked in oncology social work, 83 members (21.28 percent) said 7-10 years and 168 members (43.08 percent) said 11+ years.

What have your responses been when patients, administrators, caregivers or even co-workers ask, “What do you do?” This is a very important question. How we respond provides a larger context for our services, our interactions and even for our profession. This question is often an introduction about services that some aren’t seeking but can’t live without.

For our patients and caregivers, at first it may be hard to get past the notion that they “need” a social worker, even if they don’t have any negative connotations associated with our title. Often, by the time I’ve worked with someone, they don’t care much about my title but rather the impact I’ve had in their life as they now have the emotional support they were seeking, the grant that helped them make ends meet for another month, transportation to get to treatment, etc. Taking the step to seek or receive help is huge and, as we’ve all learned, starting where our patients are is key to forming an effective working relationship.

Years ago, a wise colleague taught me about the power of an elevator speech. Quite literally, if you were stuck in an elevator for a few minutes with (fill in the blank), what would you tell them about the role of an oncology social worker or about our role on the multidisciplinary team? Your response will vary depending on who you’re with and the information you want to communicate. If you are reading this and don’t have an answer to this question, it’s time to start formulating one. What if you were on that elevator with the patient I started this article about? Do you have a prepared response for someone who isn’t on board with you yet?

My response? I smiled then stated, “Some patients don’t need a social worker, you’re right. Your physician sent you because she thinks there is some support I may be able to provide, given that you’re newly diagnosed. I know that when people hear “social worker” they sometimes assume that means there is a problem. I’m an oncology social worker and I’m part of your treatment team; my role is different than what you may expect. I provide a variety of services depending upon the needs of our patients; however, in general, I provide resources, support, education and even referrals. Since you’re here, I’d like to get some information to see if I can help. You’re not required to stay and I’m not going to try and convince you that you must.” I got a raised eyebrow and silence but she stayed. We were able to talk about the reason for the referral and yes, she was very open and receptive to the assistance I provided. She later told me that she was surprised by my response and that I didn’t “force” her to talk to me—that I gave her the choice.

My own reaction to hearing the words “social worker” all those years ago was not that much different from hers, albeit under completely different circumstances. As stated in our current strategic plan’s professional development goal: “AOSW will be THE catalyst for the advancement of oncology social work.” Fulfillment of this goal starts with you and me. The example used here is a micro level example of the power of one—one response to one patient at one point in time. This patient now tells everyone she knows to seek out their oncology social worker, no matter where they are treated.

When speaking to an administrator last year, I asked about a community program that was being promoted and whether oncology social workers had been considered among the healthcare professionals included. The response, “Prior to this conversation, I don’t think I even knew there were oncology social workers. May I ask what you do?” Same question, different level of practice. Even on a mezzo or macro level, there are opportunities to advance our profession—even in the midst of a conversation where we haven’t been asked.

Are there opportunities for you to actively help AOSW achieve our professional development goal? That might mean taking a student for the first time, accepting the invitation to participate or speak at a local event or connecting with other oncology social workers in a way that you haven’t. Seek opportunities and be prepared. You never know when you’ll be on that elevator or the impact of your “speech.”