Recasting the gold standard – part I of II: delineating healthcare options across a continuum of care

Abstract

Aim This is the first part of a two-part series on spectrum of care that encourages practitioners to embrace a non-binary approach to healthcare delivery. When care is not framed as all-or-none, either/or or best versus lesser, the provider and client can agree to diagnostic and/or treatment plans that individualize the practice of veterinary medicine. Care is tailored to the patient along a continuum of acceptable options. Care may also be intentionally incremental, with plans to reassess the patient and revise case management as needed. Relevance Acknowledgment and ultimately acceptance that patient care journeys can be distinct, yet equitably appropriate, offers providers the flexibility to adapt case management competently and confidently to the patient based upon contextualized circumstances including client needs, wants and expectations for healthcare outcomes. Thinking outside the box to recast the historic gold standard with a continuum of care strategically offers feline practitioners a means by which they can overcome barriers to healthcare delivery. Series outline This first article introduces spectrum of care as an appropriate approach to case management and broadens its definition beyond cost of care. Part II explores communication strategies that enhance veterinary professionals’ delivery of spectrum of care through open exchange of relationship-centered dialogue.

Barriers and Lack of Access to Veterinary Care in Canada 2022

“…Note that percentages shown are percentage of respondents within a subgroup e.g. age [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] who could not access care, not percentage of total respondents. between the US and Canada.…”

“…12,13 Several surveys, primarily focused on the US, have addressed the impacts of the coronavirus disease 2019 (COVID-19) pandemic on veterinary care and the veterinary industry. [14][15][16] A spectrum of care, family-centred approach, 4,[17][18][19][20] has been advocated as a way to broaden AVC. In a 2022 US study, most veterinarians surveyed said the pandemic had changed their views on veterinary medicine and vulnerable populations, and that they would want to play a greater role in supporting vulnerable clients.…”

“…Compared with other citizenship groups, respondents who had been in Canada for less than 5 years were significantly more likely, and Canadian-born respondents significantly less likely, to report barriers to all three types of care. Young adults (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) were significantly more likely, and older adults (65+) significantly less likely, to report barriers to all three types of care.…”

Recasting the gold standard – part II of II: communicating healthcare options along a continuum of care

“…[1][2][3][4][5][6][7] Spectrum of care is an approach to the practice of medicine that addresses barriers to positive patient outcomes. 3,[8][9][10][11][12] Spectrum of care was defined in part I 13 as the practice of customizing care based upon case-specific factors that involve the client, veterinarian and patient (Figure 1). 3,[8][9][10]12 By offering a continuum of acceptable options for case management based upon the growing evidence base in the veterinary medical literature, veterinarians can provide contextualized care that is considerate of client needs, wants, expectations and limitations.…”