It’s an exciting time to be a veterinarian. A better understanding of the strength of the human-animal bond and changes in the role pets play in the family –over 80% of pet owners now consider their pet a family member – has increased pet owners’ interests in caring for their pets.1 We can now offer animals medical care equivalent to, or sometimes better than, that offered to people.
However, the availability of new options does not mean they are right for every patient. The rise of specialists offering higher levels of care, particularly in companion animal medicine, has contributed to increased pet care costs.2 The definitions of standard versus advanced care have evolved in response to new techniques, new technologies, and owners’ evolving expectations.2
How do you define improved care for your patients? Is it better animal welfare? Better clinical outcomes? Increased client satisfaction?1 Or is it using the newest, often most expensive, technology? Basic veterinary care has been defined as low cost, low-tech, using basic clinical skills and few complex resources, while still maintaining the standard of care.2 This tension between basic care and advanced care has brought the concept of Spectrum of Care to the forefront of veterinary medicine.
Definition: What is Spectrum of Care?
What do we mean by providing a Spectrum of Care in veterinary medicine? It has been described as “a continuum of acceptable care that considers available evidence-based medicine while remaining responsive to client expectations and financial limitations, thereby successfully serving an economically diverse clientele.”3
A simpler version might be to think of it as contextual care – providing the animal with their most appropriate care, given the overall context, including the animal’s individual circumstances, the owner’s lifestyle and financial situation, and the available diagnostic and treatment options.4
Spectrum of Care is not the same as access to care, although offering different levels of veterinary care can make it possible for more animals to receive medical assistance. Forty-three percent of cats and 26% of dogs do not visit their veterinarian annually, with financial limitations among the most commonly cited barriers to veterinary care.1,5 Offering owners a range of care options, all of which meet the basic standard of acceptable veterinary care, ensures that more patients receive the care they need.1,5
Most veterinarians are already embracing the Spectrum of Care, whether or not they label it as such.6 If you offer clients options in caring for their animals, from conservative to extensive, you are already practicing along the veterinary Spectrum of Care.7
Benefits of a Spectrum of Care approach
Embracing a Spectrum of Care approach in your veterinary practice allows you to offer owners care that fits their needs, recognizing that those needs are not always financial. Research has identified three drivers of veterinary care decisions: Convenience, choice and cost.8
Convenience
Owners driven by convenience want fewer interventions, fewer visits, or fewer (or simpler) activities to perform, even if this costs them more money.8 When deciding on a pet’s care plan, convenience may be the driving factor for a family with two working parents and three busy teenagers.
Choice
Owners driven by choice want to know all the options available for their animal, and they don’t want you to start by offering the most expensive one.8 Veterinary teams that provide all the options this way build trust with owners, who often choose a middle level of care.8
Cost
Owners motivated by cost need to stay within financial constraints, whether those are set by the amount of money they have available, or the animal’s role in the family or in life.8 Financial limitations may vary between a barn cat and one considered a family member, or a retired racehorse and a current champion. Many of these owners worry that the care team will judge them for making this type of decision.8
When you use a Spectrum of Care approach, more animals will be treated instead of euthanised, and more of those treatments will take place in your practice, instead of being referred out.7 As you build trust with clients, your practice will have a better reputation and closer ties with your community.7 For you and your staff, embracing this way of practice builds confidence.7 Yes, you might have to pull out the books and stretch your brains and skills as a team – but you (and your staff members) don’t really know what you can do until you try!
Making Spectrum of Care part of your practice
When surveyed, 89% of veterinarians believed that offering the Spectrum of Care is the right thing to do.6 Here are five actions that will help you to offer it successfully.
Align your staff
Does your entire staff agree on your practice’s minimum acceptable level of care? Aligning expectations makes staff more comfortable as they support clients faced with tough decisions. Clients may ask a staff member for their opinion about what’s best for their animal. That’s why it’s important to bring everyone, from your senior associates to your front desk staff, along on this journey. Invest the time and energy in open dialogue to get your entire staff on the same page. New graduates coming from tertiary care centers where clients expect and are willing to pay more for top-tier care may need support and guidance as they adjust to discussing cost and treatment options with owners. Your leadership and patience are critical.
Listen and understand
We know how effective open-ended questions and reflective listening are when talking with clients. When preparing different care plans, use those skills to encourage clients to share their particular context and their goals for care. Make sure that you understand the client’s priorities for their animal and use that understanding to offer a care plan that you think is the best fit, along with other options they can consider.4,7 The AVMA Language of Care website has resources to help you brush up on communicating with clients about patient care.
Offer specifics
Offering extensive care is easy; making choices about what steps are truly essential can take a bit of thought. As you prepare different options, ask yourself: How will the results of this test change my treatment plan? Could this owner handle this treatment at home, given their knowledge and context? What are the trade-offs of doing so? Answering these questions for yourself will help you develop appropriate care options that fit the owner’s needs. Thinking them through makes it far easier to explain the benefits and trade-offs of each step.
When talking with owners, consider describing the benefit of each suggested item. For diagnostics, how will having this result change your treatment plan or improve your understanding of the pet’s condition? Will a particular treatment reduce, slow, or solve the underlying problem or an important clinical sign? If an owner elects to care for their pet at home rather than hospitalize it, what treatments are not possible? What should they do in an emergency? Allow owners time and space to consider these factors while making their decision.
Be empathetic
Be clear with owners that you understand that they may be making difficult decisions. Reassure them that they can change tracks if the first treatment plan turns out not to work for them. Never place value judgements on an owner or another veterinarian for choosing any option across the Spectrum of Care.3,6,7 Each owner, each animal, and each situation is unique. The Spectrum of Care allows a spectrum of responses.
Brainstorm with your Study Group
Your VMG Study Group can be a wonderful source of ideas and suggestions for successfully implementing a Spectrum of Care approach. Consider bringing it up as a topic for one of your upcoming meetings. Your VMG facilitator can organize the meeting or bring in an expert to help you make the best possible plan for your practice.
Embracing the Spectrum of Care helps patients, clients and practices
The Spectrum of Care approach to veterinary medicine can make care more accessible for more patients, honors each unique human-animal bond, and allows you to practice quality, compassionate care. It’s time to make it a regular part of your client relationships. Your clients and patients will thank you.
References
- Kent, M. AVMA 2024 Pet Ownership and Demographics Sourcebook. 2024. American Veterinary Medical Association, Schaumburg, IL.
- Quain A, Wand MP, Mullan S. ‘Ethical Challenges Posed by Advanced Veterinary Care in Companion Animal Veterinary Practice.’ Animals 2021, 11, 3010. https://doi.org/10.3390/ani11113010.
- Fingland RB, Stone LR, Read EK, Moore RM. ‘Preparing veterinary students for excellence in general practice: building confidence and competence by focusing on Spectrum of Care.’ JAVMA (2021) 259;(5): 463-470.
- Clinician’s Brief: The Podcast ‘Special Episode: Will Spectrum of Care Get Me Sued?’ Episode 293. https://www.cliniciansbrief.com/article/podcast-spectrum-care-legality Accessed 7 February 2025.
- Pasteur K, Diana A, Yatcilla JK, Barnard S, Croney CC. ‘Access to veterinary care: evaluating working definitions, barriers, and implications for animal welfare.’ Front. Vet. Sci. (2024) 11:1335410. doi: 10.3389/fvets.2024.1335410
- Dolan ED, Slater MR. ‘Veterinarians’ Self-Reported Behaviors and Attitudes toward Spectrum of Care Practices.’ Animals (2024) 14.10: 1416.
- Brown CR, Garrett LD, Gilles WK, Houlihan KE, McCobb E, Pailler S, et al. ‘Spectrum of Care: more than treatment options’. JAVMA (2021) 259(7): 712-717.
- Benson J, Tincher EM. ‘Cost of Care, Access to Care, and Payment Options in Veterinary Practice.’ Vet Clin North Am Small Anim Pract. (2024);54(2):235-250.
