As medical social workers often have large case-loads and have to meet tight deadlines for arranging necessary services, medical social work is a demanding job that is vulnerable to detrimental impact. Often this job requires tolerance due to its lackluster reality of unsupportive and hostile environment and cross-departmental nature with Nursing and Public Relations which diminishes the visibility (authority gradient) of the profession within an institution. The inadequate salary and restrained professional growth is also a major concern for Medical Social Workers. Medical social workers often deal with complex cases involving patients who come into the hospital with multiple psycho-social issues, all of which require assessment and treatment. It is not uncommon for medical social workers to tackle cases involving homelessness, chronic unemployment, lack of income, lack of health insurance coverage, history of incarceration, and substance abuse problems. Any of these problems, separately and together, can impede timely care services. Sometimes situations as seemingly ordinary as the patient needing bus fare or a decent pair of shoes can lead to delays in discharge, which could incur social and healthcare costs especially if these needs are not identified quickly and early. A poor or non existent relationship between assessment and interventions due to lack of structured communication (SBAR:Situation, Background, Assessment and Recommendation), policies, economic restraints could also cause this. This is why a complete and timely assessment of the patient's psychosocial needs are critical for empowering and recovery, by a medical social worker with a repertoire of management, assessment and treatment skills who is adept in functioning within the hospital's continuum atmosphere of change and shifting priorities is required.