The social work profession in the United States has experienced many changes in the last fifty years. Changes in health care practices, the increasing costs of healthcare, and the rising number of uninsured in the United States all have an impact on the social work practice. Currently, managed care is the premier mode of healthcare delivery in the United States. Managed care organizations aim to improve the quality and reduce the rising costs of health care in the United States. Managed care involvement has meant changes in social work education and practice. Schools of social work are incorporating these changes in their curricula in order to prepare future social workers and to empower them with the changing health care environment. The social work practice faces many ethical dilemmas within the changing environment in health care practices. This manuscript analyses major changes happening in the social work practice with an emphasis on social work education, ethical dilemmas, and social work practice in the acute and long-term health care settings. Suggestions for preparation include implementing evidence-based practices focusing on treatment plans, with measurable goals and outcomes