ABSTRACT
Medical social work is the oldest speciality of the profession, social service departments first appearing in hospitals and clinics in the early years of this century. These social services were designed for the specific purpose of helping patients to solve those nonmedical problems that interfered with their recovery from illnesses. The Syracuse Dispensary's Social Service Department was staffed by four social workers and a supervisor, and it provided four basic services: arrangements, coordination, referral, and casework. In spite of the workers' impressions that their clients had multiple problems, two-thirds of them complained only of not being able to afford the expense associated with illness. Arrangements are among the more controlling of services because they tend to keep the client within the regulative network. The agency workers routinely acted in concert with other agencies in the course of giving service, thus enhancing their control over the clients' lives.
