Valuable lessons may be learned from the honeybee and its relationship to the beehive. A hive is made up of tens of thousands of individual bees, collectively working together to function as a single organism. While each bee has its role in the colony, the survival of the hive takes precedence over that of the individual bee.
There are three types of bees in a honeybee colony: a single queen, workers, and drones. The queen is the largest bee whose main role is to reproduce and lay eggs, essentially ensuring the future generations of the colony. There are a few drone bees whose only responsibility is to mate with the queen. The worker bee is the most abundant bee by quantity and bears the burden of all critical functions to drive the hive. Some of these duties include make the comb, tend larvae, tend young drones, tend the queen, clean the hive, gather nectar, gather pollen, evaporate nectar, cap cells, defend the hive, and several other seemingly exhausting tasks. It is clear that the individual honeybee truly makes the hive thrive.
Several parallels to the honeybee colony can be made to the practice of medicine in an integrated managed care health system. The physicians make up the workforce of the organization (similar to the worker honeybee), all working together to support the organization and care for patients under the umbrella of the collective. There is efficiency in numbers, especially when one considers that each physician will be able to use the resources that an integrated system provides. Theoretically, this environment allows for doctors to be doctors—that means focus on patient care. The colony (or system) provides a framework to provide quality care, engage in preventive medicine, and participate in research. What more could one ask for? However, it is up to the individual physician to extract the honey and take advantage of such integration, and use its resources to share these experiences with the rest of the medical community.
This integrated health system provides a very unique opportunity for the foot and ankle surgeon. The honey is available to enjoy. There are opportunities to develop a full-scope practice, develop a niche practice, participate in trauma call, and/or immerse oneself in research. There may even be time for you. It is also possible to become involved in the administrative functions of the system, and help manage how the honey is preserved, distributed, and/or used.
Similar to that of a beehive nourishing its larvae, this integrated health system also nourishes its young (residents). The residencies provide some of the best training that this profession can offer, along the side of some of the most productive, experienced, and skilled honeybees. The residents are exposed to this type of medicine early in their professional development. While the benefits may appear obvious, in the “name of education,” are we really programming them to be integrated? Perhaps they will develop into future drones—ready, willing, and able to inseminate the queen and start a new hive.
The practitioners who publish and share their professional experiences while functioning within such systems, do so because we can, not because we are asked to. Publish or perish is not our motivation. We have exposure to a large volume of patients and, as medicine becomes more technologically efficient, we can extract that information, just as a bee extracts the pollen from a flower. This becomes more important as we move into the evidence-based medicine era. We inspire the future generations by sharing these experiences. We all have the power to change the momentum of medicine.
We present this small collection of our work in this issue and issues to follow. Please step inside the honeycomb and evaluate our honey. If we all gaze into the glistening gold nectar at some point in our professional careers, we may even see a reflection. Perhaps it will serve as a professional mirror for us all to evaluate our results scientifically. Isn't that what these manuscripts are supposed to do? However, if you decide to taste the honey, you may find that your current state of practice is one of three scenarios: (1) your results are consistent with the literature, (2) your results are better than the literature, or (3) your results are worse than those reported in the literature. Only through research and self-exploration will you challenge yourself, if you so choose. While I admit that sometimes it's better not to know the truth that may lie within. But don't we have an obligation to do this for the people we care for?
Whether you practice in an integrated medical system or private practice, we all share a common bond. Similar to the bond that the bees of a hive share in their journey, that is to make the honey that they love. For us, it's not the surgery that we do or how we do it that unites us. It's why you do what you do, and why we all do what we do. We are all in this to take care of people—that's our honey.
All hail the queen for making the honey available to enjoy? Remember, the queen is nothing more than an egg-laying machine and does not control the functions of the hive. Actually, the queen bee has a smaller brain than a worker bee. So, as you collect the honey, remember that the directives of the colony truly come from that of the individual within the collective.
The hive will not survive unless the bees thrive.
Published online: March 31, 2008
© 2008 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.