As we prepare for the EQuiP 2026 Conference in Kraków, we are honoured to feature a deep dive into the clinical resilience of our keynote speaker, Dr. Anastasiya Spasibo. As a practice head in Kharkiv and a trainer for the Academy of Family Medicine of Ukraine, Dr. Spasibo has managed the relocation of her clinic from Vovchansk while maintaining high standards of patient safety under full-scale war. Her reflections offer a profound look at the "unwritten rules" of family medicine when the systems we rely on are pushed to the brink.
EQuiP Editorial Team: In your keynote, you discuss "Medicine Without Textbooks." What is the most significant shift you’ve had to make to keep patients safe when infrastructure collapses?
Dr. Anastasiya Spasibo: The most critical shift is the transition toward radical patient autonomy and self-management. In extraordinary circumstances—where communication is severed and the healthcare system may collapse—safety depends on the patient’s ability to manage urgent conditions independently.
In Kharkiv, we have frequently encountered situations where patients had to act without immediate access to medical care for hypertensive crises, acute respiratory infections with high fever in children, asthma exacerbations, panic attacks, and injuries. This highlights that "safe care" in a crisis starts long before the crisis hits; it is built through prior education, clear action plans, and accessible guidance that empowers the patient to be their own first responder.
EQuiP: How do you approach clinical decision-making when the physical or social infrastructure of a community is shifting?
Dr. Spasibo: When formal referral systems are disrupted, we rely on establishing strong horizontal professional networks. Building direct, "doctor-to-doctor" connections across different specialties is essential. In crisis conditions, the ability to reach out directly—in a "manual mode"—becomes the primary factor in clinical decision-making and patient safety. These informal yet reliable networks often replace formal systems entirely, ensuring that the chain of care remains unbroken even when the infrastructure is not functioning.
EQuiP: As a trainer, how do you teach colleagues to maintain high standards of patient safety and data protection when standard resources are inaccessible?
Dr. Spasibo: We emphasize that Information Security and data protection are cornerstones of patient safety in unstable, high-risk environments. This includes ensuring secure communication channels and maintaining strict confidentiality, even when we are forced to use alternative or improvised tools. We teach our colleagues that while our tools may change, our ethical and safety standards must remain absolute to maintain the trust that underpins primary care.
EQuiP: What is the one message you want your colleagues across Europe to take away regarding the resilience of family doctors working under extreme pressure?
Dr. Spasibo: Resilience is not just a personal trait; it is a professional strategy. By focusing on patient education, building robust peer networks, and safeguarding our data, we can provide safe care even in the most hostile environments. The international visibility and educational exchange provided by the WONCA Europe "Supporting Medicine in Ukraine" initiative are vital for our morale—it reminds us that while we may be working in isolation, we are part of a larger, supportive professional family.
Don’t miss Dr. Anastasiya Spasibo’s full Keynote Session, "Delivering Safe Care in Extraordinary Times: Ukrainian Primary Care During Full-Scale War" on Friday, May 22, at the EQuiP 2026 Conference.
Register for EQuiP 2026 Today https://conference.qualityfamilymedicine.eu/page/registration
View the Full Conference Program: https://conference.qualityfamilymedicine.eu/
Published on 21 March 2026.
