One Size Doesn’t Fit All: How Plumb’s™ Embraces the Spectrum of Care

July 31, 2023
4 min

In veterinary medicine, we have more options for diagnosing and treating our patients than ever before, and they’re living longer, healthier lives because of it.1 From widespread access to specialists to technologies like advanced imaging and laparoscopy, veterinary medicine has come a long way over the past few decades. But these advancements have led to new—often higher—expectations from pet owners, colleagues, and the veterinary industry as a whole.

Most of us heard the term “gold standard” in veterinary school. It’s a method, procedure, or measurement that is widely accepted as being the best available to test for or treat a disease.2 And we’re familiar with examples of gold standard treatments—like intradermal allergy testing for atopic dermatitis, arthroscopy for evaluation of elbow dysplasia, or radioiodine therapy for hyperthyroid cats. 

But gold standard medicine often comes at a cost. Literally.

Barriers to Providing “Gold Standard” Veterinary Care

Most of us encounter pet owner financial constraints every single day in practice, so it’s no surprise that 1 out of 4 pet owners report experiencing barriers to veterinary care and that financial constraints are the primary barrier.3 And as pet owner income decreases, barriers to care have been found to increase.

Balancing gold standard care for our patients with the financial limitations of pet owners is one of the greatest challenges we face in practice.

If we provide less than the highest level of care for all patients, many of us fear litigation or disciplinary action if something goes awry. This can lead to practices encouraging or solely offering advanced diagnostic tests or treatments and a misconception that more expensive and technology-intensive treatment automatically equals superior care. 

If this level of care isn’t possible, pets may receive little or no care at all or may even be euthanized. Not only does this adversely affect animal health and welfare, but it can lead to stress and burnout in veterinary team members.

The challenges with gold standard care also go beyond financial. It can mean more invasive procedures or intensive care that may not be a good fit for every pet or pet owner.

How a Spectrum of Veterinary Care Can Help

The concept of “spectrum of care” has arisen in recent years to address these concerns and recognize the diverse needs of clients and their pets. It involves providing a continuum of treatment options that may not be the gold standard but still represent acceptable care that is responsive to client expectations and financial limitations.5 

At one end of the continuum is the most extensive, expensive, and often invasive diagnostic and treatment option. At the other end is the less expensive, least extensive, and least invasive option—which could be symptomatic treatment, palliative care, or euthanasia. Between the two ends of the spectrum lies a wide range of diagnostic and treatment options. 

The hope is that the spectrum of care allows veterinarians to find the best fit for each individual patient and pet owner while maintaining the veterinarian’s moral, ethical, and legal obligations to the pet and their family.6

Plumb’s™ Dx & Tx and the Spectrum of Care

The team behind Plumb’s™ fully embraces the spectrum of care concept. In each Dx & Tx monograph in Plumb’s Pro™, we include a Spectrum of Care section that offers reasonable alternatives to the gold standard in general practice and takes pet owners’ expectations and financial limitations into account. 

The information in the Spectrum of Care section is closely evaluated by our team of experts and focuses on sharing decision-making with pet owners. That way, the veterinarian and pet owner can decide on a plan that considers the knowledge and skills of the veterinarian, the safety and efficacy of available treatments, the practice’s available resources, and the pet owner’s goals, values, and financial resources.

“As general practice veterinarians, we know families have a variety of constraints and beliefs that impact their choices for diagnostic and treatment plans. Balancing recommendations for each individual case with pet owner desires and financial constraints is one of the biggest challenges we face as veterinarians. Our goal in providing a Spectrum of Care section is to support veterinarians as they navigate these scenarios, providing solid guidance on a range of acceptable options where those options exist and removing some of the stress veterinarians and pet owners face when pet owners aren’t willing or able to choose the most expensive, intensive, or technologically advanced option.”

Amy Mohl, DVM
Chief Medical Officer
VetMedux

Benefits of a Veterinary Spectrum of Care

Including this information in Plumb’s Pro™ means that veterinarians—who might be anxious about offering less intensive or advanced treatment options—can feel more confident in their diagnostic and treatment decisions.

Providing a spectrum of care can also decrease costs for pet owners, which has many benefits for patients. Pets may be treated for conditions that might otherwise not have been treated and when relinquishment or euthanasia would previously have been the only options.

When you rely on Plumb’s Pro™ for diagnostic and treatment recommendations, you can be confident that you’ll have support for the scenarios you navigate every day in practice.

Already subscribed to Plumb’s Pro™? Take a look at Dx & Tx on Plumb’s™.

Think you could use Plumb’s™ in your practice? Choose your Plumb’s™ plan today.

References

  1. Montoya M, Morrison JA, Arrignon F, et al. Life expectancy tables for dogs and cats derived from clinical data. Front Vet Sci. 2023;10:1082102.
  2. Glossary. National Institute for Health and Care Excellence. Published 2023. Accessed July 25, 2023 https://www.nice.org.uk/glossary?letter=g#:~:text=Gold%20standard,for%20or%20treat%20a%20disease.
  3. Access to Veterinary Care Coalition. Access to veterinary care: barriers, current practices, and public policy. Published December 17, 2018.  Accessed July 25, 2023. https://trace.tennessee.edu/cgi/viewcontent.cgi?article=1016&context=utk_smalpubs
  4. Stull JW, Shelby JA, Bonnett BN, et al. Barriers and next steps to providing a spectrum of effective health care to companion animals. J Am Vet Med Assoc. 2018;253(11):1386-1389. doi:10.2460/javma.253.11.1386
  5. Brown CR, Garrett LD, Gilles WK et al. Spectrum of care: more than treatment options. J Am Vet Med Assoc. 2021; 259(7):712-717. doi.org/10.2460/javma.259.7.712
  6. Boatright K. What is the spectrum of care? AAHA NEWStat. Published October 28, 2022. Accessed July 25, 2023.  https://www.aaha.org/publications/newstat/articles/2022-11/what-is-the-spectrum-of-care/