Defining the initiative and what "Spectrum of Care" means in context
In veterinary medicine, "Spectrum of Care" is most accurately understood as shorthand for a profession-wide the American Association of Veterinary Medical Colleges (AAVMC) calls the Spectrum of Care Initiative (SOCI) or (SOC)—an organized effort to better prepare veterinary graduates to practice in ways that are evidence-based and responsive to the real-life context of each pet and family. AAVMC describes SOCI as supporting veterinary programs in preparing graduates to deliver "contextually appropriate, evidence-based care" across clinical settings, backed by shared infrastructure and resources for competency-based spectrum-of-care education. [1]
"Spectrum of care" (SOC) is generally framed as the range of diagnostic and treatment options that can be appropriate in a given case, with "practicing across the spectrum" meaning clinicians tailor recommendations based on contextual factors like client goals, abilities, resources, and patient/practice factors while considering available evidence. [2]
This framing is important because it positions spectrum-of-care practice as a structured clinical reasoning and communication approach, not as a synonym for "discount medicine," and not as an abandonment of quality. For example, the 2024 AAHA Community Care Guidelines explicitly define spectrum of care as a "continuum of acceptable care" aligned with evidence-based medicine and responsive to client expectations and financial limitations, while also placing it inside a broader "family-centered" access-to-care framework. [3]
Historical drivers and why spectrum-of-care thinking gained momentum
The spectrum-of-care movement is best understood as a response to a reality that has become increasingly visible to both pet families and veterinary teams: many households encounter barriers to veterinary care, and the most common barrier is financial, but it is not the only one. [4] [46]
A frequently cited benchmark is the Access to Veterinary Care Coalition (AVCC) 2018 report, which has been widely used across the profession to quantify access barriers and to motivate solutions (education, practice redesign, policy, partnerships). In a 2022 Today's Veterinary Practice article summarizing AVCC findings, 28% of U.S. pet owners reported a barrier to veterinary care in the previous two years, and "financial barriers were the most common barrier across all types of care." Importantly, this same summary highlights "concern that providers would think poorly of them" as one of the reported barriers—directly tying access-to-care to shame and fear of judgment, not only dollars. [5]
Maddie's Fund's public-facing summary of the AVCC work reinforces that financial obstacles show up across care types (preventive, sick, emergency). [6]
As veterinary medicine has advanced (specialization, diagnostics, sophisticated therapeutics) and as costs and client expectations have evolved, the gap between a "textbook" plan and a feasible plan has become harder for new graduates—and practicing teams—to navigate without an explicit framework. Ohio State's College of Veterinary Medicine (OSU CVM) describes this tension directly: the traditional teaching-hospital exposure to complex referral/specialty cases is valuable, but feedback from faculty, students, practitioners, and alumni indicated a need for more hands-on training across a broader spectrum of cases, including business and communication skills and other non-technical competencies. [7]
In parallel, the United Kingdom and other settings have used closely related language such as "contextualised care," explicitly broadening the idea beyond affordability alone to include the owner/patient relationship and wider influences. [8]
A practical implication of this history is that spectrum-of-care practice matured from "what clinicians often do anyway" into a defined educational, communication, and change-management agenda—with AAVMC's SOC representing a major step in professional coordination. [9]
AAVMC Spectrum of Care Initiative and its goals, structure, and deliverables
AAVMC formally situates SOCI as an education-focused initiative: helping veterinary schools teach future clinicians to integrate evidence, clinical expertise, and context; tailor care to client goals and resources; offer flexible options; and support long-term business sustainability. [10]
Origin, funding, and leadership model
AAVMC's Winter 2022 SOCI newsletter states that, with support from the Stanton Foundation, AAVMC established SOCI in 2021, and that SOCI received a $1.3 million Stanton Foundation grant in 2022 to further support the effort. [11]
That same newsletter documents that SOCI is guided by a leadership committee and task force spanning educators and practitioners across the U.S., Canada, and the UK—explicitly including Ohio State leaders on the leadership committee. [12]
Core goals and timeline
AAVMC's SOCI goals document lays out a straightforward multi-year plan:
- Develop a Spectrum of Care Education Model (Goal 1, 2022–23)
- Establish implementation guidelines (Goal 2, 2023–24)
- Conduct pilot studies to evaluate and refine the model and implementation strategies (Future Steps) [13]
This is a notable design choice: the initiative is not only advocating for a philosophy, but also building an implementation pathway (competencies → assessments → learning experiences → mapping and sequencing → evaluation). [14]
Major resources produced to date
AAVMC has now published several interlocking resources that collectively turn spectrum-of-care practice into something teachable, assessable, and scalable.
The Spectrum of Care Education Model (Version 1.0, January 2024) positions SOC-readiness as part of graduating "compassionate leaders" who can navigate evolving care, client relationships, and business sustainability; it describes a SOC-ready graduate as able to offer high-quality, evidence-based options tailored to unique client and patient circumstances, meeting societal demand for accessible veterinary healthcare. [15]
The Implementation Strategies Guide (2025) is a major "how-to" resource for programs seeking to plan, implement, and sustain curricular change. AAVMC notes it was built with contributions from approximately 40 veterinary educators from 25 member institutions across five countries, plus more than 25 practitioners and professionals from veterinary organizations—underscoring that this is a broad, multi-institution effort rather than a single-school project. [16]
AAVMC also provides a change-management flowchart executive summary (planning → implementing → sustaining), explicitly emphasizing that curricular change is iterative and may require revisiting steps as barriers emerge. [17]
To address practitioner concerns and practical adoption, AAVMC has published targeted guidance elements, such as a Q&A on financial implications, which argues that while revenue can fluctuate in the near term as practices broaden their options, a spectrum-of-care strategy can improve compliance and promote more regular visits over time; it also frames long-term benefits as improved client loyalty/retention and more steady income, alongside improved access and outcomes for clients/patients. [18]
Community building and continuing momentum
The initiative has consistently used convenings to spread implementation know-how.
A UC Davis-hosted recap notes that AAVMC held a day-long Spectrum of Care Symposium on April 11, 2024 (as part of the AAVMC Catalyze Conference), aimed at supporting colleges interested in implementing the SOC Education Model; it reports over 100 participants and highlights that faculty asked for "train-the-trainer" tools and examples of teaching materials, while also raising the need for more empirical evidence on the efficacy of care options across the spectrum. [19]
Looking forward, AAVMC's VetEd AAVMC 2026 materials indicate that a Spectrum of Care Symposium (sponsored by the Stanton Foundation) will be a track at VetEd AAVMC on Friday, June 5—a signal that spectrum-of-care pedagogy is becoming a recurring, mainstream theme for educator development and cross-school exchange. [20]
Ohio State University's role as an early adopter and applied model
Ohio State is repeatedly cited—both by AAVMC and by Ohio State itself—as an early adopter translating spectrum-of-care ideas into concrete curriculum, facilities, partnerships, and research.
Curriculum redesign and the "practice-ready" orientation
Ohio State reports that in January 2019 it began a major curriculum redesign as part of its "Preparing for Excellence in Veterinary General Practice" program, using outcomes-based education principles and aligning spectrum-of-care preparation with the AAVMC Competency-Based Veterinary Education (CBVE) framework. [21]
Ohio State's description of the program highlights an explicit mixture of clinical and non-clinical competencies: skills training, case-based reasoning, critical thinking/problem-solving, business and practice management, and training in pet-centered care/human-animal bond, with immersive training beginning in year one and culminating in fourth-year primary care at the Frank Stanton clinic. [22]
Ohio State also directly addresses the "textbook vs. real world" challenge flagged: it notes that new graduates can struggle in general practice when financial limitations necessitate selectivity in diagnostics and treatments, especially if most training occurred in a tertiary referral setting; Ohio State's goal is to integrate spectrum-of-care thinking early so graduates can be more resourceful and appropriately flexible from day one. [23]
The Frank Stanton Veterinary Spectrum of Care Clinic as a training and service platform
Ohio State opened the Frank Stanton Veterinary Spectrum of Care Clinic on June 1, 2021, describing it as a 35,000-square-foot primary care training clinic and one of the first primary care clinics operated by a college of veterinary medicine to embrace a spectrum-of-care model, serving as a home for its existing community/primary care service. [24]
Ohio State's materials emphasize that spectrum-of-care education is strengthened by a clinic that simulates real private practice and enables longitudinal student involvement. For example, OSU states that students will build business, marketing, customer service, and communication skills in the earlier years and then serve as clinical leads (with oversight and coaching) as fourth-year student-doctors. [25]
The clinic is also tied to broader access-to-care goals through outreach: OSU notes that its veterinary outreach programming can use the clinic as a home base to create access for underserved populations and provide expanded care beyond what can be delivered in homes or partner locations. [26]
A philanthropic "why" that fits the initiative's framing
Ohio State credits a gift from the Stanton Foundation as funding the clinic and recounts the origin story: Frank Stanton's dog received critical care that many owners could not afford, motivating a search for an imaginative and sustainable approach to help millions of animals, not only thousands—an ethos aligned with system-level solutions (education models, scalable practice approaches) rather than one-off subsidy. [27]
What the model looks like in a real client experience
Ohio State's Veterinary Medical Center describes how visits function in a way that operationalizes spectrum-of-care values: a senior veterinary student serves as team lead, elicits history and goals, discusses potential diagnostics and treatment options, and then returns with a licensed faculty veterinarian who examines the pet and explains recommendations and estimated costs, with the plan proceeding after the client approves and signs the estimate. [28]
This structure is especially relevant to empathy and practicality—it makes "talking through options within constraints" a standardized teaching moment, with coaching built in. [29]
Research contributions aligned with affordability and outcomes
Ohio State also frames spectrum-of-care as a research agenda, not only a communication philosophy. For example, it describes a joint parvovirus research initiative with Gigi's (a nonprofit focused on shelter dogs), aimed at identifying clinically effective and more affordable treatment strategies, explicitly noting that current effective parvovirus treatment can be very costly and that cost barriers prevent many owners and shelters from treating the disease. [30]
Practical impacts for pet owners, veterinary teams, and clinics
Spectrum-of-care initiatives tend to resonate most when they are described in terms of outcomes that matter to stakeholders: pets receive more appropriate care; owners feel respected and able to act; clinics retain clients and reduce conflict; new graduates experience fewer "impossible" cases.
Reducing shame and creating "options without judgment"
A key insight from access-to-care research and practice is that barriers are not purely financial. In the Today's Veterinary Practice access-to-care summary, pet owners reported barriers such as lack of transportation and language access, but also concern that providers would think poorly of them—a direct signal that shame and anticipated judgment can prevent care-seeking even before price is discussed. [5]
Spectrum-of-care approaches attempt to replace this dynamic with one where choices are normal and ethically framed. AAHA's spectrum-of-care educational content explicitly cautions against equating conservative choices with lack of love for the pet, emphasizing that selecting a less intensive option is not a proxy for the strength of the human-animal bond. [31]
AAHA also addresses a common clinic concern: that spectrum-of-care means discounting or lowering standards. In its myth-busting discussion, AAHA argues that adopting an SOC approach can increase access and benefit clients and the field overall without requiring practices to "discount services or lower standards," framing SOC more as evidence-based flexibility and prioritization rather than "cheaper care." [32]
Communication, empathy, and shared decision-making as core skills
The framework emphasizes empathy and the ability to troubleshoot with the pet parent. In the spectrum-of-care literature, that often maps to shared decision-making—a structured way to ensure clients understand they have choices, understand risks/benefits/costs, and participate as much as they want in selecting a plan.
A 2024 Today's Veterinary Practice communication article explicitly ties rising interest in "contextualized care" (UK) and "spectrum of care" (U.S.) to shared decision-making, recommending a practical model (choice talk → options talk → decision talk) and emphasizing that this can improve client satisfaction while also ensuring consent and reducing clinician stress in situations where the client declines a clinician's preferred option. [33]
The 2024 AAHA Community Care Guidelines similarly place spectrum-of-care inside a family-centered practice model, arguing that lack of access can cause distress for families and moral distress for the veterinary team, and that expanding access requires communication and collaboration—within and beyond the practice. [3]
Business sustainability, retention, and the "long view" of client relationships
Spectrum-of-care work is increasingly explicit that access and sustainability are linked. AAVMC's SOCI positioning includes "long-term business sustainability" as part of the intended value proposition of an SOC approach. [10]
AAVMC's financial implications Q&A takes this further: it anticipates that revenue can dip initially when teams expand beyond only high-end plans, but argues that, over time, offering a broader range of evidence-based options can improve compliance and frequency of visits, expand the client base, and strengthen client loyalty/retention and long-term revenue stability. [18] [47]
Ohio State's education model also reflects this business realism: it explicitly builds practice management, marketing, customer service, and the "client experience" into the four-year training arc, suggesting spectrum-of-care training is being treated as part medical skill and part practice operations skill. [34]
Legal, ethical, and documentation guardrails that make SOC safer to adopt
A recurring concern among clinicians is whether offering less intensive options increases licensure or disciplinary risk. A 2025 JAVMA-informed consent paper (authored by an AAVSB leader and shared via AAVSB) directly addresses this: it notes that veterinarians may fear that practicing along a spectrum-of-care endangers their license, but argues that when done correctly, SOC practice typically aligns with board requirements and can optimize patient care and client satisfaction; it further emphasizes that risk often comes from failures in communication, consent, and recordkeeping—areas that spectrum-of-care approaches explicitly try to strengthen. [35]
This is a meaningful "professionalization" point: SOC is not about improvising without standards; it is about expanding acceptable options while tightening the consent-and-documentation process that protects the patient, client, and clinician. [36]
Future direction and what the initiative is trying to accomplish next
A professional "positive but not gushing" outlook is strongest when it ties future expectations to explicit roadmaps and emerging investments rather than speculative claims. SOCI and aligned organizations have provided several clear signals about what comes next.
From models and guides to pilots and outcomes evidence
AAVMC's published goals and its own symposium feedback converge on the same next step: evaluation.
SOCI's goals document explicitly lists "pilot studies" as a future step to evaluate and refine the model and implementation strategies. [13]
The UC Davis recap of the 2024 SOC Symposium reports that faculty participants identified a need for "train-the-trainer" practical tools and examples of teaching materials, and that there was consensus about the need for more empirical evidence regarding the efficacy of care options across the spectrum. [19]
In practice, this points toward a research-and-evaluation agenda that likely includes: measurable educational outcomes (decision-making, communication competence, "day one readiness"); clinical outcomes under stepped/sequence care approaches; and business metrics (retention, compliance, repeat visits) for clinics implementing SOC. This is consistent with AAVMC's emphasis on "gathering evidence of impact and curricular outcomes" and sustaining change over time. [37]
Scaling "how" through shared learning experiences and assessment tools
AAVMC's SOCI resource library continues to expand beyond the core model and guide into reusable instructional assets.
For example, an AAVMC "learning experiences" compilation (posted in 2026 but framed as part of the SOC Implementation Strategies Guide ecosystem) documents concrete program examples, including the University of Minnesota's Spectrum of Care Longitudinal Integrated Clerkship, a multi-week fourth-year elective designed to integrate SOC practice across partnered community clinics with real-time mentoring and feedback—illustrating how SOC can be operationalized as experiential education, not just didactics. [38]
The same compilation includes SOC learning experiences connected to access-to-care settings (e.g., WisCARES rotations are referenced as SOC-oriented clinical experiences), signaling that community medicine, nonprofit partnerships, and social-service-linked clinics are increasingly treated as legitimate and valuable teaching environments for SOC competency development. [39]
Continued convenings and mainstreaming within educator development
The SOC Symposium's presence as a named track at VetEd AAVMC 2026 (sponsored by the Stanton Foundation) suggests SOC pedagogy is not a short-lived trend but is becoming a recurring theme in educator professional development and cross-institution exchange. [20]
This matters because implementation barriers are often cultural and operational (e.g., faculty alignment, misconceptions about "gold standard," assessment design). A recurring convening creates a mechanism for norms to shift in a measured, evidence-informed way. [40]
A likely "near future" framing for pet owners and the profession
Based on the published direction of SOCI and aligned guidelines, the most defensible forward-looking claims are:
- Spectrum-of-care models will increasingly position access-to-care as a professional obligation that must be balanced with practice sustainability, rather than treating affordability as "someone else's problem." [41]
- Veterinary education will keep expanding from specialty-centered exposure toward supervised primary-care leadership experiences, where students practice presenting options (including cost) and documenting consent—Ohio State's clinic model is an example already operating at scale. [42]
- Clinical communication training will likely continue to emphasize shared decision-making structures (options talk, cost/risk framing, and team-based support), because these tools directly address both client satisfaction and clinician comfort in non-ideal scenarios. [43]
Why the net effect is plausibly positive without being "too rosy"
Taken together, the spectrum-of-care initiative's strongest positive thesis is not that it eliminates hard cases. Rather, it makes the hard cases more navigable by giving clinicians and students a shared framework for:
- offering ethically defensible options that align with evidence and context,
- reducing stigma and judgment that can block care,
- improving communication, consent, and documentation,
- keeping more pets connected to ongoing veterinary relationships (which can improve outcomes over time). [44]
Ohio State's applied model (curriculum redesign + dedicated primary care clinic + partner involvement + affordability-oriented research) provides a concrete example of how this can become "real" for both pet owners and the training pipeline. [45]
References
[1, 2, 9, 10, 37] ↩ AAVMC, "Spectrum of Care," aavmc.org/resources/spectrum-of-care
[3, 4, 41, 44] ↩ AAHA, "2024 AAHA Community Care Guidelines," jaaha.kglmeridian.com
[5] ↩ "Beyond the Clinic," Today's Veterinary Practice, 2022, todaysveterinarypractice.com (PDF)
[6] ↩ Maddie's Fund, "Access to Veterinary Care," maddiesfund.org
[7, 23] ↩ OSU CVM, "Introducing the Spectrum of Care Concept," vet.osu.edu
[8] ↩ BVA, "Contextualised Care," bva.co.uk
[11, 12] ↩ AAVMC SOCI Newsletter, Winter 2022, constantcontact.com
[13, 14] ↩ AAVMC SOCI Goals, 2023, aavmc.org (PDF)
[15] ↩ AAVMC SOC Education Model v1.0, January 2024, aavmc.org (PDF)
[16] ↩ AAVMC SOC Implementation Strategies Guide, 2025, aavmc.org (PDF)
[17] ↩ AAVMC SOC Curricular Change Flowcharts, 2025, aavmc.org (PDF)
[18] ↩ AAVMC Q&A Financial Implications, 2025, aavmc.org (PDF)
[19, 40] ↩ UC Davis, "Spectrum of Care Initiative," vetmed.ucdavis.edu
[20] ↩ VetEd AAVMC 2026, cvent.com
[21, 22, 45] ↩ OSU CVM, "Preparing for Excellence in Veterinary General Practice," vet.osu.edu
[24, 27] ↩ OSU, "Ohio State Opens Unique Primary Care Training Clinic," vet.osu.edu
[25, 26, 34] ↩ OSU CVM, "A New Pathway to Success for Our Graduates," vet.osu.edu
[28, 29, 42] ↩ OSU VMC, "Primary Care," vmc.vet.osu.edu
[30] ↩ OSU CVM, "Innovative Spectrum of Care Clinical Trial," vet.osu.edu
[31] ↩ AAHA, "What Is the Spectrum of Care?" aaha.org
[32] ↩ AAHA, "Spectrum of Care: Busting Common Myths," aaha.org
[33, 43] ↩ "Communication Techniques," Today's Veterinary Practice, 2024, todaysveterinarypractice.com (PDF)
[35, 36] ↩ AAVSB/JAVMA, "Informed Consent," aavsb.org (PDF)
[38, 39] ↩ AAVMC, "Learning Experiences," 2026, aavmc.org (PDF)
[46] ↩ "Older Adults Lean on Pets as Purpose Grows, but Costs Bite Harder," The Herd, theherd.news
[47] ↩ "Veterinary Surveys Show AI Gains but Staffing Strain Persists," The Herd, theherd.news