Between duty and dignity navigating medical social work practice with unknown patients in India's government medical college and public healthcare system.

This article explores the complex role of medical social workers (MSWs) in addressing structural determinants of health among unidentified and homeless patients within India's public health system. Drawing on grounded field experiences, it reveals how MSWs act as crucial intermediaries navigating institutional apathy, legal ambiguity, and human rights obligations to uphold dignity and ensure care. The study highlights how caste, poverty, mental health stigma, and systemic neglect intersect to deepen marginalization. It further examines the strategies employed by MSWs to mitigate these inequities, including advocacy, ethical negotiation, and inter-sectoral coordination. By foregrounding MSWs' practice-based knowledge, this study contributes to limited empirical literature on social work interventions with unidentified patients and underscores the need for clearer institutional protocols, legal safeguards, and policy recognition of MSWs as central actors in advancing health equity within public healthcare systems in India.