Section 3: Family-Centered Practice as a Framework

Top 3 Takeaways

1. Family-centered veterinary practitioners recognize that pet caregivers exist across the whole socioeconomic spectrum and promote health equity by considering the caregiver’s financial situation and other realities critical to ensuring quality care.
2. Family-centered veterinary practice redefines the historically narrow definition of “gold standard” care as high-quality, system-level care that ensures services regardless of socioeconomic status and other barriers.
3. Family-centered practice considers the contextual needs and circumstances of each patient and their family.

Family-Centered Veterinary Practice

Family-centered veterinary practice is an approach that views the family as an interconnected system and aims to provide comprehensive, coordinated care that meets the diverse health needs of all family members (Box 3.1). Family-centered veterinary practitioners recognize that the illness or injury of a family member, especially when it involves a dependent like a pet, can threaten the physical and mental health of the household. Caregivers that lack a network of emotional and practical support when these incidents arise experience additional distress as especially vulnerable members of society. Family-centered veterinary practice is system-level care that engages the family as essential participants, follows the highest professional standards, and aims for the best possible outcomes for the pet and the family.

Family-centered veterinary practice embraces a One Health health care system, which recognizes the interconnectedness of humans, animals, and their shared environment. Such a system unifies care for the family, reaching beyond medical care to include other professions such as social work and behavioral health care (for more on One Health health care systems for small animal practices, watch for the 2025 AAHA One Health Guidelines).

Traditional veterinary care focuses on disease management, sometimes in isolation from the context of the family system and needs. Veterinary teams may expect pet caregivers to comply with recommendations inaccessible for financial, practical, or personal reasons. For example, prescribing pills when the responsible person has severe dexterity limitations sets unreasonable expectations, resulting in poor-quality care. What may appear as lack of compliance is caused by other factors that can be addressed within a family-centered practice paradigm, by tailoring treatment administration to the capabilities of the caregiver without compromising patient care.

• Preventive Care: Family health care emphasizes prevention through vaccinations, screenings, lifestyle and behavior counseling, and other proactive measures. The practitioner helps patients reduce the risk of developing chronic diseases and other health issues by focusing on prevention.
• Contextualized Care: Family health care considers the physical, emotional, social, environmental, and economic factors that might affect an individual pet’s health. Family health care seeks to provide more personalized, effective care by addressing these interconnected elements.
• Coordination of Care: In a family health care setting, practitioners often focus on coordinating care between family members and medical specialties. Zoonotic diseases provide a particular example where coordination is critical.
• Education and Support: Family health care practitioners can play a crucial role in directing family members to health and wellness resources. This includes resources guiding nutrition, exercise, mental health, and other aspects of healthy living and resources to support managing chronic conditions.
• Community Engagement: Some family health care models also involve community engagement, working to understand and address broader social determinants of health within the community where the family lives.
• Emphasis on Relationships: A strong therapeutic relationship between the provider and the family centers this approach, emphasizing communication, trust, collaboration, and nonjudgment.

Download Box 3.1 PDF

Taking Back the “Gold Standard”

The term “gold standard” does not have a universally agreed-upon definition, but it is often used to describe patient-level care that is the highest-quality or the best practice approach, which is often, by default, the most expensive. As an industry, veterinary medicine advances models of gold standard care as the best or highest treatment for a condition, while often adhering to a single idealized course of care.¹ However, this approach does not serve a substantial portion of families and implies that other treatment options are substandard. Although “gold standard” has been recognized in recent years as increasingly problematic within the veterinary profession,² it is still commonly used to denote the highest or best level of care.

Spectrum of care, which may seem contradictory to the gold standard to some, offers strategies for patient management based on medical and family priorities, available scientific evidence, and practitioner experience. SOC expands the range of diagnostic and treatment options to be able to help more patients and families. If gold standard care meant employing the widest possible range of options for pet caregivers within a family-centered practice model, rather than just the most expensive or advanced, private practitioners could better meet the goal of increasing access to care.

Restricting gold standard care to the excessively narrow definition of the most expensive and technologically advanced diagnostics and treatments does a disservice to the veterinary profession and its clients.³ Instead, it would benefit the profession to reclaim this term and adopt a broader meaning for the gold standard that encompasses SOC. This redefined gold standard includes a range of diagnostic and treatment options, accessibility, consideration of the family’s contextual needs, high quality and safety of care, high likelihood of positive outcomes for the patient, and evidence based medicine. In other words, the new definition of gold standard care adheres to the principles of family-centered veterinary practice.

The 2024 AAHA Community Care Guidelines for Small Animal Practice are generously supported by CareCredit, Hill’s Pet Nutrition, IDEXX,  Merck Animal Health, and Pawlicy Advisor.