Shadow Me Next!

Quality of Life vs. Medical Protocol: A Social Worker's Perspective | Catherine Moore, LCSW

• Ashley Love • Season 1 • Episode 37

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The medical world often focuses on protocols and procedures, but what happens when a patient's quality of life conflicts with the "safest" option? Catherine Moore, a licensed clinical social worker and creator of the top-performing Social Workers, Rise! podcast, who's worked in settings from hospice to ICUs, joins us to explore this crucial intersection of healthcare and humanity.

Catherine reveals how social workers serve as the essential bridge between medical teams and patients, especially when communication breaks down. Through powerful stories like the hospice patient who knew living at home was more important than following medical recommendations, she illustrates how social workers advocate for patients while helping clinical teams understand the deeper human narratives behind "non-compliance."

We dive into the versatile career paths available to social workers, from veterinary and sports social work to roles in schools, homeless services, and private practice. Catherine's creation of the RISE Directory, connecting social work associates with clinical supervisors, addresses a critical gap in the profession and highlights her commitment to mentorship and accessibility.

For pre-health students considering their career options, Catherine offers invaluable guidance on aligning natural gifts with professional choices. If you're the person friends call after a breakup or strangers randomly share their stories with, social work might be your calling. Her current telehealth practice focuses on women struggling with anxiety, providing them space to process emotions in a supportive environment.

Virtual shadowing is an important tool to use when planning your medical career. At Shadow Me Next! we want to provide you with the resources you need to find your role in healthcare and secure your place in medicine.

Check out our pre-health resources. Great for pre-med, pre-PA, pre-nursing, pre-therapy students or anyone else with an upcoming interview!
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Ashley Love:

Hello and welcome to Shadow Me Next, a podcast where I take you into and behind the scenes of the medical world to provide you with a deeper understanding of the human side of medicine. I'm Ashley, a physician assistant, medical editor, clinical preceptor and the creator of Shadow Me Next. It is my pleasure to introduce you to incredible members of the healthcare field and uncover their unique stories, the joys and challenges they face and what drives them in their careers. It's access you want and stories you need, whether you're a pre-health student or simply curious about the healthcare field. I invite you to join me as we take a conversational and personal look into the lives and minds of leaders in medicine. I don't want you to miss a single one of these conversations, so make sure that you subscribe to this podcast, which will automatically notify you when new episodes are dropped, and follow us on Instagram and Facebook at shadow me next, where we will review highlights from this conversation and where I'll give you sneak previews of our upcoming guests.

Ashley Love:

When you meet Catherine Moore, you quickly realize she's built her career around connection, both in the most human sense and in the systems that make healthcare possible. Catherine is a licensed clinical social worker and the host of Social Workers Rise, one of the top 10 social work podcasts in the world. Her path has taken her from hospice rooms to ICUs, from policy work to palliative care, always serving as a bridge, helping medical teams understand the human stories behind a patient's resistance, compliance or change. In our conversation, she shares the moments that shape her, like the patient who knew exactly what quality of life meant for themselves, even when the medical plan said otherwise, and how those moments reaffirm her belief in advocacy, empathy and listening deeply. We'll also talk about her creation of the RISE Directory, a national platform connecting social work associates with clinical supervisors, and the importance of mentorship, access and ethical leadership. Catherine's work is a reminder that healthcare is as much about honoring the whole person as it is about treating their condition.

Ashley Love:

Please keep in mind that the content of this podcast is intended for informational and entertainment purposes only and should not be considered as professional medical advice. The views and opinions expressed in this podcast are those of the host and guests and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. This is Shadow Me Next with Katherine Moore. Katherine, thank you so much for joining us on Shadow Me Next today. I personally am really excited to talk to you about what you do and gain a little bit more clarity on exactly what a licensed clinical social worker does. So thanks for being here, thanks for joining us.

Ashley Love:

Yeah, thank you so much for having me. So to start, just because definitions are so important, tell me exactly what your title is and perhaps how you got there, because I know you've had a couple of additional elements of schooling too.

Catherine Moore:

Yes, yes, that's true. So right now I am a licensed clinical social worker. I do teletherapy a lot as my day job, but I do have years and years of experience working in the medical field as a clinical social worker and I worked in different settings. As far as hospices, outpatient palliative goes, I worked in the hospital and all of the departments with that, as far as the ICU, the emergency department, the maternity ward, discharge, working with people who are going into surgery, who are coming out of surgery, people who have cancer going on to hospice. So the whole spectrum.

Ashley Love:

Wow, literally everything. Yeah, that's very cool. Now, when it comes to schooling, for social work, do you have to have a certain element of college? Do you go immediately into social work, and then what does it look like beyond that too? So, typically, for social work, do you have to have a certain element of college. Do you go immediately into social work, and then what does it look like beyond that too?

Catherine Moore:

So typically for social work in the United States, you're going to have either a bachelor's in social work, your master's in social work, and then the top tier is going to be a licensed social worker, a licensed clinical social worker. Depending on your state, you can do different things, but having the license is really the ultimate end-all, be-all place because that opens the most amount of doors of what you can do. It means that you are licensed to provide individual therapy. So all of these organizations love to have therapists because they know how valuable it is in connecting with the clients, because healthcare is all about the people, the clients. You have to have the empathy, the compassion, the understanding and that's where we fit in.

Catherine Moore:

But yeah, so having a bachelor's you're going to learn kind of basically an intro to the field. You're going to get your feet wet in the different areas. If you have a master's, that's where you're learning advanced interventions as far as in each setting you know what would be appropriate to do as a school social worker versus a medical social worker versus if you're working in child protection services or if you are running your own nonprofit or running your own business. So that's the master's is where you're going to get more into those nitty gritty details. And then the license, of course, is can you actually do the clinical interventions effectively? Can you work as a therapist without causing harm and by saying ethical? You know all of those different areas.

Ashley Love:

Wow, that's really really cool. You know, it's so interesting because obviously I just have like my medical hat on right now, but it sounds like it is so multifaceted and there's so many different ways. You know, I think a lot of people right now are so worried that they're going to spend so much time in school and so much money in school and then they're going to get to the end and go well, I've made a terrible mistake. What have I done? You know, and I think in medicine that can, that can happen to people. It's one of the risks. But in social work, you know, maybe you find yourself in a place you might not really enjoy. You can pivot right. What does that pivot look like? Is it incredibly complicated or are the roads pretty clear?

Catherine Moore:

For me it's been pretty clear because what you learn in school is how to work with people, how to do an assessment, how to build that rapport, how to just help people feel comfortable around you, how to ask questions, how to be curious, and those skills are transferable to everybody. So, for example, with my own experience, I started my bachelor's program. I did an internship in an elementary school. I quickly learned I didn't like working with parents so that was not for me. But I also ran an after-school program which is more macro level right, like hiring staff, doing programming, activity planning. How are we going to develop these emotional and social skills in the kids?

Catherine Moore:

Also, I worked with policy and creating a policy around elder abuse. And then I went on to do affordable housing. I worked with the food bank and, like I said, I kind of pivoted my career into the medical setting because I just loved the interaction between the human and the medical and the science and being that bridge for the whole IDT team, interdisciplinary medical team, to just be like hey, this is why your client is so resistant, this is why they're not being compliant with the medication, this is why you can't talk to the client, but you must talk to the spouse or the mom, or all of those different cultural dynamics. We really help to be that bridge there, those different cultural dynamics. You know, we really helped to be that bridge there.

Ashley Love:

Absolutely, and I know so many of us in medicine are so grateful for you guys because you are the professionals when it comes to understanding and liaising and communicating between two people that might be interpreting things very differently. You mentioned the interdisciplinary team. Tell me about that. I mean, is it always kumbaya and everybody agrees and it is just fantastic? Or do you kind of have to stand on things sometimes and say, hey, let's get this done for this patient? What does that look like?

Catherine Moore:

Yes, that's a great question. I wish it was always kumbaya. But, like you said, a lot of people just don't understand what the role of social workers are, so we can get called in for things that aren't appropriate or we have some magic wand like, hey, make the patient do this, even though the patient is just not ready to do that. For example, a lot of times I would get called in for a hospice consult. So the patient has been coming in reoccurringly to the hospital. They don't know what to do and the patient is just noncompliant and the medical team is saying they need to be on hospice. But when you talk to the client, they're not ready for hospice and actually what's going on is they live by themselves and they keep falling.

Catherine Moore:

Wow, and so by being able to bring in that extra support and being that, those eyes and ears and the advocate for the patient, a lot of times it's saying, okay, the real issue is safety. Right now we just need to figure out how do we get a caregiver in? How do we maybe recruit your adult children who live down the street to come in and help you a little bit better? Maybe we need a home health nurse to visit for medication management, so that we can kind of get all of these things organized so that we can have you on the right medication at the right time so you're not feeling dizzy and falling Because somebody who, yes, they have a chronic illness and it likely will end their life. They probably have many, many more years if you put the right supports in there. And that's where we come in as far as how do we maximize those resources.

Ashley Love:

That's fabulous. What a gift you offer to not just the patients but the clinicians too. And I'm going to ask a question, and it is coming from a little bit of a place of humility for me as a PA. I think specifically as a PA and a lot of other providers that I talk to. We like to think that we are always perfect patient advocates. We love to feel that right. I mean that's why we went into medicine. We love people, we, we love our patients. But if that was true then we would not necessarily need our incredible social workers all the time. When you bump into a clinician that perhaps has lost that view of patient advocacy, or perhaps they're just so frustrated with the fact that this patient perhaps isn't getting better, or maybe there's a little bit of pride, a little pride problem in that clinician, how do you approach that?

Catherine Moore:

I would first validate that your emotions are real. It's just maybe there's a piece of the picture that we're missing, and there's always a reason why people do what they do and the clinicians you're busy, you guys do like so much work and you don't have the time that social workers often spend to just sit there and say, hey, what's going on? Because you say that you want this, but you keep doing this. What's the disconnect? What's happening here? Because we want to make sure that we're all on the same page, on the same goals, because you, as a clinician, you have your goals, you know what's best for the client, right? Or a lot of times we come with our medical provider goggles and like you need to do this, this and this to extend your life, right?

Catherine Moore:

So a great example that I had was this woman. She lived at home with her daughter and she was on hospice. So she was a little bit older, she was able to be independent, ambulate, and one day she fell and she broke her hip and her daughter was like you know, I need more help. I just can't be the caregiver for her and the doctor's like she must go to the, to the sniff right, to a skilled nursing facility, there's no other options, and the daughter's like, well, okay.

Catherine Moore:

And the doctor's like she must go to the SNF, right to a skilled nursing facility, there's no other options. And the daughter's like, well, okay. And the patient says, no, I don't want to go to a SNF, I just want to be by myself. And the client, the patient, knew what was best for her because ultimately, what ended up happening is, even though her issue was the broken hip, she ended up passing just a couple of months later because she was so incredibly depressed and that depression impacts the physical health. So we see a lot of tragic endings like that, where the medical team thinks that they know what's best safety-wise, but there's so much more to human as far as quality of life and what makes life worth living.

Ashley Love:

Now Catherine and I did not have a chance to discuss a quality question, but she brings up an excellent opportunity to discuss something so important in one of your pre-health school interviews. How do you balance what you believe is best for a patient with what the patient says they want for themselves, especially when those two things don't align? We talk a lot about advocacy in healthcare, but what happens when your version of advocacy conflicts with the patient's? Catherine has been in those moments where the safest medical option wasn't what the patient wanted and the right answer depended on whose voice you listened to. If you're headed into healthcare, think about how you would approach that situation.

Ashley Love:

Keep in mind that there's more interview prep, such as mock interviews and personal statement review over on shadowmenextcom. There you'll find amazing resources to help you as you prepare to answer your own quality questions. Absolutely and I think that is. You guys are just such heroes in that sense. I cannot tell you the number of times I've had guests on this podcast and we've started talking about the team in medicine, and they are always mentioning our incredible social workers and our case managers and the way that you guys just bring such perspective back into that patient and back into that patient's life outside of the hospital, outside of the clinic, outside of where we live and think and focus and work. So gosh, the tools you guys afford us are just incredible and I'm so grateful for them. Catherine, did you always know you wanted to be a social worker? Is this something you've always wanted to do?

Catherine Moore:

No, I had no idea. So I was raised in the 90s and nobody talked about social work or social advocacy, and the only time that we talked about therapy was for people who have schizophrenia and they're being locked up, and so I'm so grateful that over the past 25 years, this narrative has changed significantly and, especially since 2020, therapy has become very normalized and this mental health component is becoming more normalized. It still has a long way to go as far as the stigma, but I always tell people, just like you have physical health, that can vary day to day, and your physical health can be good sometimes and bad it's the same with your mental health. We all have mental health, and sometimes it's worse and sometimes you're feeling great.

Ashley Love:

I think that is perfect what you just said. We all have mental health. I think people like to pretend like they don't and it's just. It would be like saying, well, I don't have a heartbeat. I mean you do and you have mental health and it is something like you said. That can be extremely healthy and it can have. It can have bad days too. It doesn't necessarily mean it's, you know, totally fractured, you know, with one small incident. Thank you for saying that. Um, catherine, you, um, you have an incredible podcast called social workers rise. It reaches a global audience. Tell me what topics or what stories really seem to resonate with your listener base.

Catherine Moore:

Yeah, that's a great question and, surprisingly, that my top episode is what can you do with an MSW, a master's in social work? And so it just goes back to that narrative around we don't know what social workers do, we just don't, even if you're interested in the field. A lot of times the only time that we hear about social workers is when they're taking people's kids away in child protection services and I mean, thank God, I've never worked in child protection services. That is not my calling, I could not do that work. And it's just like in the medical field. There's so many different areas and specialties that social workers have and it really just there's so much education to do around that area. And I think that that episode is most popular because for a couple of different reasons.

Catherine Moore:

One, new social workers coming in. They're excited, they want to know what their options are. They want to hear stories from other people in the field who are doing amazing things. So you know, for example, some lesser known social work areas veterinary social work. There's sports social work. There's social workers who work in the NFL and these large leagues. There's also school social workers. There's social workers who work in the jail. They work with homeless population. They help with reentry into the general population. So there's so many different niches that you can go into. Also, on the second part, it helps the seasoned social workers too. Also on the second part, it helps the seasoned social workers too, because a lot of times in school we're taught all right, you got three main options. There's government, non-profit and private practice and sometimes those just don't sound appealing to people. So the seasoned social workers love to know what's out there. What kind of jobs can I be searching for? How can I take my skills of working with people and put them into a different area?

Ashley Love:

It's such a gift, the podcast that you have. It's educational. It's incredibly helpful for so many different people. You know people who are just interested, people who are afraid to ask a social worker, hey, what do you do? They don't want to be offensive. They come to your page and they get to learn all of this stuff and it's just thank you for doing that hard work and it is hard work. Let's talk about the Rise Directory. This is pretty special, so Shadow Me Next. This podcast was originally created because of access. It's hard for students to get access to healthcare professionals and other people working in healthcare and see what they do, and it sounds like the RISE directory was kind of born out of a similar need. Tell me a little bit about it.

Catherine Moore:

Yes. So in my state, where I'm at in California, you must be a licensed clinical social worker for two years in order to supervise new and incoming social workers. And I love mentorship, I love teaching. So I was super stoked when I finally reached my two years post licensure and I'm like, okay, great, when are the interns and the associates and the supervisees? And I'm ready for you. But there was no, nowhere to go, no platform, nowhere to say hey, I'm available. You know, see if we want to work together.

Catherine Moore:

And so, in doing my research, when I realized this was a massive gap in the industry and you know, before the directory, and currently people are still, they're relying just either on their boss or the social connections that they know in their limited circle or Facebook groups, and there's a lot of problem with all of those, mainly being that it's such a limited pool of people. And when you have all of these niches and specialties, you really want to make sure that the supervisor that you have they're essentially your mentor after you graduate from graduate school. They're your mentor for the next couple years and you want to make sure that they're quality, that they know what they're doing, that they're skilled and, more importantly, that you have a safe place to process how you're feeling and the emotions and self-care and balance and ethics and cultural differences, because all of these things come up. You know humans, working with humans and as once you're well in any professional, but once you're a therapist especially, you have to be able to be very clear on these are my beliefs and that is not.

Catherine Moore:

It should not impact my client's belief. Right, and we could use just a hot topic as far as abortion, right, If my client is wanting to get an abortion, but maybe I personally am against that, I have to be able to recognize my own resistance and honor that their journey is different and whatever they feel is best for their journey, to respect that autonomy and that right to self-determination and be able to hold space for that. Your job is not to convince who's right or wrong, but to hold space for those emotions and be able to process it.

Ashley Love:

Right, so the RISE directory. It connects social workers with supervisors.

Catherine Moore:

then, I created the RISE directory as a platform to connect clinical supervisors with associates, because the associates need anywhere from like 500 to 3000 supervised hours, so a lot like the medical professionals. You know you have to do your internships and be supervised by a license. It's the same thing for licensed clinical social workers.

Ashley Love:

That's very cool. Now you mentioned a couple of times you've mentioned, you know, in the United States. You've mentioned in California. So different states have different requirements.

Catherine Moore:

Where would somebody go?

Ashley Love:

If, like I'm in Florida, for example, the other sunny state, where would somebody go to to figure out what that looks?

Catherine Moore:

like that is a great question If you were to kind of search the social work governing board in Florida.

Ashley Love:

Okay, that makes sense.

Catherine Moore:

Yeah, then it'll pop up Right, and even then they have different names, like in California it's the Board of Behavioral Sciences.

Ashley Love:

Very cool. So you know, just a nice general search wherever you're at, is probably going to be the best option. That is so interesting. Medicine is such a wide world, isn't it? There are so many different avenues and options. What would you say to a student who knows that they want to make a difference in someone's life and they want to be in the medical field just because they feel drawn to it? They love, like you said, they love human, but they love the biology and the inner workings. For somebody trying to choose between, maybe, social work or becoming a therapist or counselor, etc. What would you say to them and how they should think about these things?

Catherine Moore:

I would really encourage them to do the research around what kind of work each of these professions do, because that's going to determine what your lifestyle looks like. So, if you are the kind who likes talking to people, likes hearing the stories, if you are the kind who likes talking to people, likes hearing the stories, if you are the kind who likes to problem solve and put together resources and be empathetic and be touchy-feely, as far as like emotions and you're not scared, or if you're the person who your friends call after they have a breakup or when they're having a bad day, if people randomly in public come up to you and just start sharing their story with you, that might mean that you might be a good social worker. But if, on the other side, if you just like the physical aspect of it, as far as maybe like exercise and sports, then maybe look into sports therapy.

Ashley Love:

I love the fact that you highlighted some of our innate gifts right. You know, I'm sure you run into people who think they want to go into social work and in the back of your mind you're thinking maybe not, maybe you want to try something different. You know, just kind of knowing your own natural strengths, people coming up to you, just the approachability that one might have. Knowing that, I think, really does help. Now, does that mean that somebody who isn't highly approachable can't succeed in social work? Absolutely not, but I do think that it helps Oftentimes. It helps that road be a little bit less bumpy and it helps prevent burnout because you know you're in a position that you really you were called to do. I think in those cases that's fabulous. Catherine, tell me a little bit right now about one of the initiatives that you're doing, which is telehealth, telemedicine, anxiety management. Describe that for me.

Catherine Moore:

Yes, definitely. So. My main work that I'm doing right now is focusing on providing telehealth for women who are struggling with anxiety, and so what this looks like is women who maybe they're new moms or they're busy working and so they just need an hour out of their week in order to process everything that is happening, or even space to just cry, because so many times we feel this pressure to hold it all together and sometimes we have to right, but maybe we need a place to talk to somebody, to cry it out and to hear no, you're not crazy, you're doing a great job. This is just a really, really hard situation, and that in itself can be so powerful in just being able to sit for an hour and to say brain dump, this is everything that's happening, and I feel like I'm going crazy and just hear like, well, no, you just told me you're doing this, this, that and that, and that that's a lot. And they'll say, oh, yeah, I guess when you put it that way, it is a lot.

Catherine Moore:

So I work with women who are going into college, who are new moms, who are just going through life transitions, relationship struggles, and that's my main focus. As far as therapy, I do also have services for social workers, because I am really passionate about mentoring the next generation. So, you know, still doing the social workers rise podcast, I am working on revamping my course, which is designed for new social workers who have graduated and they're kind of making that transition into the field, connecting the dots there as far as how to do that and also running the Rise Directory around. How do we grow it, how do we increase the awareness, how do we let these busy professionals know that this exists? And then I've also written some books that complement that work as well for developing professionals.

Ashley Love:

Where do you find the time? It's just such a well-rounded gift that you have given to this field, so tell us a little bit about where we can find you. We've mentioned Social Workers Rise podcast. We've mentioned the Rise Directory, which is risedirectorycom. Where else can we find some of these things you just mentioned?

Catherine Moore:

Yeah, so my biggest following is on Instagram. It's at social workers rise, and then I'm also on LinkedIn. Catherine LCSW, I believe, is my last little thing for the hyperlink.

Ashley Love:

Perfect, catherine. Thank you so much for what you do. It is truly incredible and we're so grateful for you and all of the other social workers that really just help us offer the best care. Thanks for joining us on shadow me next. Thank you, ashley. Thank you so very much for listening to this episode of shadow me next. If you liked this episode or if you think it could be useful for a friend, please subscribe and invite them to join us next Monday, as always. If you have any questions, let me know on Facebook or Instagram Access. You want stories you need. You're always invited to shadow me next.

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Ashley Love

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