March 14, 2022

https://doi.org/10.23999/j.dtomp.2022.3.1

J Diagn Treat Oral Maxillofac Pathol 2022;6:35–36.

Under a Creative Commons license

HOW TO CITE THIS ARTICLE

Nagorniak IV. Managing private practice in a war zone. J Diagn Treat Oral Maxillofac Pathol 2022;6(3):35–6.

ARTICLE

The private sector [in a war time] can help push the whole social and economic environment in a better, more functional direction.¹

–James Robinson

Professor

 

Eighteen days of the full-scale Russian invasion into Ukraine^2,3 gave us urgently a need to rethink the ways we can run private dental and oral surgery practice. Wartime dictate us completely different and sometimes highly risky agenda.

 

For the need to provide emergency dental care and oral surgery to those residents of the city/village who cannot or do not want to be evacuated from the regions of hostilities, some private practices continue to work. Although they are not providing a full range of services, they are highly efficient even carrying out emergency care, e.g. 16 private practices in Kyiv during the first 13 days of Russian-Ukraine war of February-March 2022.⁴

 

Let's pray for our businessmen. … Every workplace [in wartime] is sacred.⁵

–Oleksiy Honcharenko

Deputy of Verkhovna Rada of Ukraine

 

Among problematic sides of managing private clinic in war zones are: (1) supply chain disruption (Williams, 2013)⁶ of the dental and oral surgery materials, (2) interruption in work of dental technicians or complete cessation of their activities due to the evacuation or absence of materials, (3) termination of work of diagnostic centers that are important for diagnosis establishment and for control of treatment results, (4) difficulties (increased price for taxi and risks for life) for patients and staff members on transfer to the clinic, (5) significant decrease of clinic`s personnel members due to the possible evacuation, (6) decrease of the number of performed procedures due to the paragraphs 1, 2, 3, and 5, (7) the need to go down to the bomb shelters in case of air alarm, forcing the interruption of treatment procedure, (8) injury of the staff members, (9) significant decrease of amount of financial resources due to the paragraphs 1, 2, 3, 4, 6, etc.

 

In some cases the whole clinic’s staff may be evacuated from the work place and town. Of course, modern video technologies with a remote control via your laptop or smartphone can assist in controlling the condition of the private practice infrastructure and gave a possibility to call the local police in case marauders break into your premises. But, if this happened and the police do not have enough staff to send it to your business location–defending the property with a rifle in own hands could be a measure what will stop the marauders from the criminal act.

 

The other positive aspect for practice owners to remain in private practice, even in wartime, include the gratitude of patients who have been helped with acute pain, maxillofacial trauma, post-operative complication, and a sharp increase in the reputation of this particular medical institution in the region.

 

Williams (2013) emphasized―for businesses (i.e., private clinics) that take a risk and survive, the long-term rewards in the rapidly expanding market can be high.⁶

 

Doing business in zones of conflict is well-described in the work of Rosenau et al (2009).⁷ Their conclusions are: doing business contributes to “state-building,” organization of the security measures, improving local community relations, and establishment of an acceptable level of risk for the business (predictable environment is acceptable even if it`s not peaceful).⁷ The “state-building”⁷ and “defense forces-supporting” can be done by paying salaries, taxes, and even creating new jobs5 for the temporarily displaced people.

 

Thus, each clinic’s owner decides whether to stay in the clinic and support the work of the practice in wartime. Depending on the decision, the business may even grow, the owner may save expensive equipment, and make her/his own direct (financial transfer) or indirect contribution (jobs, salaries, and taxes) to the national militaries and economy what can help the army to achieve victory over the occupiers faster and to make the state economic situation stronger. Although the safety of life of the employees is a priority, some owners of the practice may remain, taking into account the activity of hostilities and the presence of the missile defense systems in that particular region of the country.

 

The private sector creates wealth, promotes socio-economic development and contributes to preventing and resolving conflict.⁸

–Dean C. Alexander

Associate Professor of Homeland Security at Western Illinois University, IL, USA

 

The government will do everything possible to help the regions adapt to new realities [of wartime].⁹

–Oleksii Reznikov

Minister of Defense of Ukraine

REFERENCES (9)

1. Doing business in a war zone [document on the internet]; Oct 15, 2018 [cited 2022 Mar 08]. Available from: Link
2. Fesenko II. Stop the war! Europeans, homes, kindergartens, hospitals, universities, and global science are under the missiles. J Diagn Treat Oral Maxillofac Pathol 2022;6(2):32–4. Crossref
3. Winsor M, Shapiro E, El-Bawab N, Pereira I, Jacobo J, Deliso M, Hutchinson B, Shalvey K, Darrough С. Russia-Ukraine updates: Zelenskyy claims nearly 13,000 Russian soldiers dead [document on the internet]; Mar 13, 2018 [cited 2022 Mar 13]. Available from: Link
4. Osadcha Y. Where in Kyiv you can treat your teeth for free - the addresses of dental clinics [in Ukrainian] [document on the internet]; Mar 05, 2022 [cited 2022 Mar 08]. Available from: Link
5. Putin’s biggest fear! Honcharenko told why it is important to work and when the war will end [in Ukrainian] [document on the internet]; Mar 13, 2022 [cited 2022 Mar 13]. Available from: Link
6. Williams J. Creating sustainable business in a conflict zone [document on the internet]; Oct 31, 2013 [cited 2022 Mar 09]. Available from: Link
7. Rosenau W, Chalk P, McPherson R, Parker M, Long A. Doing business in zones of conflict. In: Rosenau W, Chalk P, McPherson R, Parker M, Long A. Corporations and counterinsurgency. 1st edition. Santa Monica: RAND Corporation, 2009:3–8. Link
8. Alexander DC. Threats and opportunities of doing business in conflict zones [document on the internet]; May 08, 2013 [cited 2022 Mar 10]. Available from: Link
9. Address of the Minister of Defense of Ukraine Oleksii Reznikov on the 15th day of heroic resistance of the Ukrainian people [in Ukrainian] [document on the internet]; Mar 10, 2022 [cited 2022 Mar 10]. Available from: Link