Though much is known about organ transplant (TX) patient and family psychosocial needs, there is virtually no information about the nature of the interaction that exists between TX social workers and patients. A comparison of TX patient-social worker attitudes and beliefs found (i) patients supported a more egalitarian "consumer-centered" approach to health care, but were reluctant to assume the accompanying responsibility, and (ii) social workers were more "traditional" in their approach, which focused primarily on assessment and social support. Results argue for a more comprehensive clinical approach by social workers to deal with problems of patient compliance, substance abuse, and psychological needs in a TX service where emphasis is placed on results rather than subjective process measures.