By Tiffany Ferguson, LMSW, CMAC, ACM
If I had to be honest with the readers of this blog, I never anticipated a career in social work—much less in medical social work or case management. My younger self was ambitiously plotting a path in psychology, largely unaware of social workers' roles outside of child welfare. It wasn't until I applied to Social Psychology Ph.D. programs that my post-graduate professor remarked, "I think you are more of a social worker." By then, I had been working in behavioral health as a case manager alongside colleagues pursuing their social work degrees, aiming to become licensed therapists. That's when I began to see myself in social work and decided to apply to both Social Psychology and Social Work programs to find my best fit.
In the end, I chose UCLA's Social Welfare program, which proved to be one of the best educational experiences of my life. I still draw heavily on those lessons as I precept and supervise social workers obtaining their master's degrees.
During my first year of grad school, our program didn't allow us to select our field placements. Instead, placements were chosen based on our previous experiences. Given my background in behavioral health and working with the court-ordered treatment population in South Tucson, I expected something along those lines. Instead, I was placed in pediatric nephrology, working with children and families on dialysis and those awaiting kidney transplantation. Though I resisted this placement for nearly a year, it ultimately provided me with the foundational knowledge essential for a career in medical social work and case management.
Fast forward to graduation: the 2009 recession was in full bloom, and while I was more interested in macro-level social work, the job market directed me to a weekend and float coverage care coordinator position at a Level I trauma hospital and health system. This environment was progressive, where case managers were nurses or social workers. I quickly learned that I needed a solid grasp of clinical knowledge beyond renal care to gain respect among the nursing and medical staff.
To hold my own while covering ICU, trauma, the ED, women & infants, and post-CABG patients, I spent considerable time studying clinical pathways, medications, treatment modalities, and lab values. There was always a looming threat that if we, as social workers, didn't demonstrate clinical knowledge and proactively anticipate the care plan, our roles could be at risk. I was fortunate to have an amazing team of nurses and senior social workers who provided invaluable guidance in case management and utilization review—training that has been instrumental in my current role as CEO of Phoenix Medical Management.
The clinical understanding of patient needs, complemented by social work training in assessment and treatment planning, has been key to what makes case management so valuable. Advocacy, meeting patients where they are, and interdisciplinary care planning are essential for optimal outcomes. Today, I can't imagine any other career, and I am deeply grateful for the early push into medical social work and case management.
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Bio: Tiffany Ferguson, MSW, ACM, CMAC is CEO of Phoenix Medical Management, Inc. Tiffany serves as an adjunct professor at Northern Arizona University, Department of Social Work, and on the American College of Physician Advisors (ACPA) Observation Committee. Tiffany is co-author of The Hospital Guide to Contemporary Case Management through HcPro. She is a contributor for RACmonitor and Case Management Monthly; she also serves on the editorial board for CMSAToday and Care Management. She is a weekly correspondent on SDoH for the news podcast Talk Ten Tuesday. After practicing as a hospital social worker, she went on to serve as Director of Case Management and quickly assumed responsibilities in system level leadership roles in Health & Care Management, which includes CM, UR, CDI, HIM, and coding. She has held C-level responsibility for a large employed medical group which included value-based arrangements and outpatient care management. Tiffany is a graduate of Northern Arizona University and received her MSW at UCLA.