This piece explores the relationships between hospital social work and the community. Medical social service in hospitals and medical care agencies have as their primary purpose the provision of social case work service to individuals who have social and emotional problems associated with illness. The unique position of this field in the constellation of social work arises from its dual affiliationsâ?"on the one hand, an alliance with doctors, clinical medicine, hospitals and hospital administrative policies; and on the other hand, a vital and necessary affiliation with the cooperating social services in the community. To the extent that medical social work can effectively interpret this philosophy of service, it makes a contribution to the community. This will depend in part upon the quality of its relatedness to the community and an interest on the part of all community agencies in adapting their services to the swiftly changing and unpredictable needs of the ill.