Jakob or Justin?

Following on from my recent Archers post, now seems as good a time as any to explore the differences between pragmatic and contextualised thinking (stick with me here…).

First, I will say that neither is necessarily wrong or right, but both have applications to veterinary practice. Second, pragmatic or contextualised care are not the same, and identifying the different aspects of both can identify what type of decision-making you are using.

Following on from the previous article – In context: The Archers and contextualised care – I have framed these two theories on two fictional characters in the show: Justin and Jakob, both of whom have an interest in the local stable yard – Jakob as the vet providing care, Justin as a business partner.

Setting the scene

Both characters have taken a different route to solving a staffing issue and they lend themselves to a simple comparison between pragmatism and contextualism.

The staffing situation is that the job share manager/riding teacher Alice is off work. It is not known how long she will be away from work for, or if she can return at all.

Aspects of the situation and the characters are determined by me, as the filter for this writing (there is a need here, I believe, to acknowledge my role as an “actor” in the contexts being discussed).

Reviewing the evidence

There are times for both types of decision-making in clinical practice and pragmatic care would sit within the framework of Contextualised Care. With all this in mind let’s look at Jakob and Justin’s reactions:

Pragmatic thinking: Jakob

Considering the pros and cons of pragmatism, we can see Jakob’s approach is:

• practical only
• current situation focussed
• a short-term answer for quickest results
• considerate of the impact on his own role

Contextualised thinking: Justin

Contextualised care was established in the 2021 article “Gold standard is an unhelpful term”, written by the founder members of Veterinary Humanities UK. Based on concepts from this article, Justin’s approach is:

• holistic
• a long-term plan for future situations with Alice
• theoretical and practical
• considerate of Lilian and the situation for the business as a whole

Either/or

Now, neither of these people has considered that their actions fall into different types of decision-making, and neither is fulfilling the criteria of both, but we know that is how clinical decision-making works – we have our understanding of the situation and also the patient’s individual needs, as well as the owner’s and the wider care team’s abilities.

See if you are a Justin or a Jakob and join in the discussions on LinkedIn – or tune in to The Archers!

• Catch up with the latest goings-on in Ambridge on BBC Radio 4 or via BBC Sounds.