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Contextualised care

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Ratification Date: 04 Mar 2026

Purpose

To guide members and advocate for education and delivery of contextualised veterinary care, promoting collaborative approaches that improve animal welfare, client satisfaction, and veterinary team wellbeing (Corrigan et al., 2025; Vincent et al., 2024).

Definition

Contextualised veterinary care can be defined as the ability to provide a variety of suitable evidence-based options that meet the needs of the patient, owner/carer and the veterinary team.

Policy

  1. The Australian Veterinary Association (AVA) supports the delivery of contextualised veterinary care, which should provide a spectrum of evidence-based options tailored to the specific animal-veterinarian-owner context.
  2. The AVA encourages collaborative decision-making, where veterinarians present clear, evidence-based recommendations and work with owners/carers to select the most suitable option for the individual circumstances of the animal and their owner, while aligning with professional ethics and animal welfare legislation.
  3. The AVA advocates for education and regulatory support to build competency in contextualised care, ensuring equitable access to quality veterinary services while supporting veterinary profession wellbeing.

Background

The veterinary profession faces multifaceted challenges in delivering optimal care to animals due to increasing expectations, constraints and complex owner/carer interactions (AVA, 2021; Brown et al., 2021; Doorly et al., 2025; Li et al., 2024; Rogers et al., 2022; Stull et al., 2018).

Contextualised care, while not a new concept, integrates evidence-based medicine with adaptive options tailored to the animal’s needs, the client’s unique circumstances (including financial, emotional and practical resources), practice capabilities and cultural context all aimed at achieving the highest possible animal welfare. Some ethical frameworks highlight potential conflicts of interest that may arise when owner or veterinarian influences prevail over the animal’s best interests (Gray & Fordyce, 2020; Hiestand, 2022; Rosoff et al., 2018). Thus, to prioritise animal welfare and ethical practice, veterinarians must advocate for the patient by providing informed, evidence-based recommendations. Respecting owners’ legal role as decision-makers providing consent, veterinarians should collaborate with clients through skilled communication, including discussion of their recommendations and any alternative options, and help select the most suitable plan for the context. This approach enables veterinary teams to fulfil their ethical responsibilities and exercise professional judgement by providing flexible, diverse solutions.

Developing veterinary competency in contextualised care

Veterinary schools and regulators have recognised these essential skills, with contextualised care now forming part of the Day One Competencies (AVBC, 2024; Warman et al., 2023). Curricula are evolving from specialised content to include communication and relationship-centred care for routine cases (van Gelderen & Taylor, 2023). New graduates may experience a range of challenges transitioning to practice, including uncertainty about the spectrum of treatment options that might be offered in any one situation. Introducing contextualised care within veterinary undergraduate training may help to better prepare them to manage this particular challenge (Fedesco et al., 2025).  

Regulatory expectations for standards of care

State and Territory legislation enables Veterinary Boards to set, monitor, and enforce standards of care that “meet peer and public expectations”. Concise, robust clinical records remain essential to justify recommendations and decisions. Efforts to improve public and veterinary understanding of evidence-based assessments that consider contextual factors are ongoing (Doorly et al., 2025; VPRBV, 2024; VSBQ, 2025).

Potential benefits of contextualised care to veterinary teams 

Provision of contextualised care may provide opportunities for veterinarians to develop and use more complex problem-solving skills to strengthen collaboration with clients. A potential benefit of this may be improved engagement by clients and veterinary professionals, leading to greater job satisfaction which has potential to reduce the attrition rate (Brown et al., 2021; Corrigan et al., 2025; Vincent et al., 2024).

How veterinary teams practice contextualised care

An animal-owner centred approach, where the veterinarian asks the owner open-ended questions and actively listens, may help the owner to share important information about the context.

Contextual factors that may assist a veterinarian to tailor appropriate care options include: 

  • Individual animal health and welfare factors, such as, individual characteristics and temperament, clinical signs/status and quality of life (QOL).
  • Owner/carer factors, such as, financial resources (to meet short and long-term costs), logistics of animal treatment (including time and physical factors), values and beliefs, expectations, and care goals. There is an opportunity to utilise multi-disciplinary human health service providers to complement veterinary care.
  • Veterinarian factors, including knowledge, skills, experience of the clinician and their extended team along with accessibility of case referral.
  • Practice factors, such as, availability of equipment, facilities and infrastructure.
  • Scientific evidence and contemporary professional guidelines.

Based on these factors, the range of care options a veterinarian recommends and develops with an owner/carer will vary. Along the continuum of care, a veterinarian and their client may consider multiple options from euthanasia, conservative or basic and less expensive approaches, such as pain relief with less intensive diagnostic workup, through to more intensive, usually more expensive, state-of-the-art diagnostics and treatment (Fingland et al., 2021). 

The veterinarian must discuss with the owner/carer to determine the most suitable plan for the animal, resulting in the highest possible animal welfare outcomes for the patient. The veterinarian is responsible for providing clear evidence-based advice in relation to each option presented, about:

  • The short- and long-term advantages and disadvantages, including potential favourable and unfavourable outcomes.
  • Whether additional testing or treatment might be needed.
  • The costs associated with each option.

Recommendations

  1. Veterinary schools, regulators and profession-level organisations should continue to incorporate contextualised care principles into veterinary student training, regulatory guidelines and continuing education to build competency.
  2. Veterinary workplaces and leaders should foster a culture supporting contextualised care and educate their teams on providing this approach.
  3. Veterinarians must use open communication in all client interactions, and when exploring contextual factors, present balanced recommendations, have discussions with owners/carers to co-develop plans that optimise animal welfare within their circumstances. Veterinarians must reflect these communications within their medical records, to enable peers and regulators to understand the context and reasons for decisions and clinical management.

Relevant AVA policies

Animal welfare and human wellbeing – vulnerability of clients and veterinary staff (ava.com.au)

Great Veterinary Workplaces

Unpaid veterinary services performed for public good

Enhancing veterinary care through Veterinary Social Services 

Resources

References

AVA. (2021). The Veterinary Industry Mental health & wellness snapshot. https://www.ava.com.au/siteassets/resources/thrive/documents/the-veterinary-industry---mental-health-wellness-snapshot-1.pdf

AVBC. (2024). AVBC-Day-One-Competencies_Final_2024-v1-Jan-24. https://avbc.asn.au/wp-content/uploads/2023/01/AVBC-Day-One-Competencies_Final_2024-v1-Jan-24.pdf

Block, G. (2018). A new look at standard of care. Journal of the American Veterinary Medical Association, 252(11), 1343–1344.

Brown, C. R., Garrett, L. D., Gilles, W. K., Houlihan, K. E., McCobb, E., Pailler, S., Putnam, H., Scarlett, J. L., Treglia, L., & Watson, B. (2021). Spectrum of care: More than treatment options. Journal of the American Veterinary Medical Association, 259(7), 712–717.

Corrigan, V. K., Newman, R. L., Richmond, P., Strand, E. B., & Vaisman, J. M. (2025). The future of flourishing in veterinary medicine: A systems-informed positive psychology approach in veterinary education. Frontiers in Veterinary Science, Volume 11-2024. https://doi.org/10.3389/fvets.2024.1484412

Doorly, A., Everitt, S., & Mantell, K. (2025). How to achieve contextualised care: Insights from the veterinary sector and pet owners. RCVS Knowledge. https://knowledge.rcvs.org.uk/evidence-based-veterinary-medicine/contextualised-care/how-to-achieve-contextualised-care/

Fedesco, H. N., Brodsky, J. E., Warman, S. M., & Khosa, D. K. (2025). The American Association of Veterinary Medical Colleges Spectrum of Care Initiative: Supporting spectrum of care preparation in veterinary education programs. Journal of the American Veterinary Medical Association, 263(S3), S85–S91.

Fingland, R. B., Stone, L. R., Read, E. K., & Moore, R. M. (2021). Preparing veterinary students for excellence in general practice: Building confidence and competence by focusing on spectrum of care. Journal of the American Veterinary Medical Association, 259(5), 463–470.

Gray, C., & Fordyce, P. (2020). Legal and ethical aspects of ‘best interests’ decision-making for medical treatment of companion animals in the UK. Animals, 10(6), 1009.

Gray, C., Fox, M., & Hobson-West, P. (2018). Reconciling autonomy and beneficence in treatment decision-making for companion animal patients. Liverpool Law Review, 39(1), 47–69.

Hiestand, K. M. (2022). The autonomy principle in companion veterinary medicine: A critique. Frontiers in Veterinary Science, 9, 953925.

Hughes, K., Rhind, S. M., Mossop, L., Cobb, K., Morley, E., Kerrin, M., Morton, C., & Cake, M. (2018). ‘Care about my animal, know your stuff and take me seriously’: United Kingdom and Australian clients’ views on the capabilities most important in their veterinarians. Veterinary Record, 183(17), 534–534.

Li, K., Mooney, E., McArthur, M., Hall, E., & Quain, A. (2024). A comparison between veterinary small animal general practitioners and emergency practitioners in Australia. Part 2: Client-related, work-related, and personal burnout. Frontiers in Veterinary Science, 11, 1355511.

Rogers, C. W., Murphy, L. A., Murphy, R. A., Malouf, K. A., Natsume, R. E., Ward, B. D., Tansey, C., & Nakamura, R. K. (2022). An analysis of client complaints and their effects on veterinary support staff. Veterinary Medicine and Science, 8(2), 925–934.

Rosoff, P. M., Moga, J., Keene, B., Adin, C., Fogle, C., Ruderman, R., Hopkinso, H., & Weyhrauch, C. (2018). Resolving ethical dilemmas in a tertiary care veterinary specialty hospital: Adaptation of the human clinical consultation committee model. The American Journal of Bioethics, 18(2), 41–53.

Skipper, A., Gray, C., Serlin, R., O’Neill, D., Elwood, C., & Davidson, J. (2021). ‘Gold standard care’is an unhelpful term. Veterinary Record, 189(8), 331–331.

Stephens, T. (2020). It is Time to Ditch the Gold Standard. In Veterinary Controversies and Ethical Dilemmas (pp. 247–255). CRC Press.

Stephens, T. (2022). The Customer Isn’t Always Right: Why Business Ethics is not Professional Ethics. In Veterinary Controversies and Ethical Dilemmas (pp. 287–296). CRC Press.

Stephens, T., Clutton, R. E., Taylor, P., & Murphy, K. (2025). Veterinary Controversies and Ethical Dilemmas: Provocative Reflections on Clinical Practice. CRC Press.

Stull, J. W., Shelby, J. A., Bonnett, B. N., Block, G., Budsberg, S. C., Dean, R. S., Dicks, M. R., Forsgren, B. W., Golab, G. C., & Hamil, J. A. (2018). Barriers and next steps to providing a spectrum of effective health care to companion animals. Journal of the American Veterinary Medical Association, 253(11), 1386–1389.

van Gelderen, I., & Taylor, R. (2023). Developing communication competency in the veterinary curriculum. Animals, 13(23), 3668.

Vincent, A., Rautkis, M., Maxwell, L., & Knudsen, E. (2024). Caring for those who care for our pets: Veterinary social workers’ perceived role in veterinary medicine. Social Work in Mental Health, 22(6), 788–806. https://doi.org/10.1080/15332985.2024.2362686

VPRBV. (2024). March 2024 newsletter. https://www.vetboard.vic.gov.au/VPRBV/VPRBV/News/March_2024_newsletter.aspx

VSBQ. (2025). Spectrum of Care. Queensland; government; https://www.vsb.qld.gov.au/for-vets/guidelines-and-policies/guidelines/customers/spectrum-of-care

Warman, S. M., Armitage-Chan, E., Banse, H., Khosa, D. K., Noyes, J. A., & Read, E. K. (2023). Preparing Veterinarians to Practice Across the Spectrum of Care. Advances in Small Animal Care, 4(1), 171–183. https://doi.org/10.1016/j.yasa.2023.04.004