Robert Allan Bear is a physician and health care consultant.

The myth of free health care in Canada

Health Policy
August 7, 2026

Discussions related to the strengths and weaknesses of the American health care system abound. When discussing the latter, some may argue that the American system should more closely mirror that of its northern neighbor, one that is described as publicly funded and that allegedly provides “free” and readily available health service to all citizens regardless of social status or financial means. Sadly, there is little truth in the above description. …

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The myth of free health care in Canada

The culture of my health care organization is broken. Is there hope?

Physician
April 3, 2023

A strong organizational culture is considered the secret sauce of successful organizations. But the Latin term, “Abyssus Abyssum Invocat” (“One Hell Calls Forth Another”), explains perfectly why it is increasingly difficult to maintain optimized organizational cultures in health care organizations.

Hell #1: Pre-pandemic, health systems and their workers in both Canada and the United States were highly stressed. The reasons were different; the end-consequences the same. And then, as predicted, this …

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The culture of my health care organization is broken. Is there hope?

To aspiring physician-writers: It’s time to write that book!

Physician
February 12, 2018

In 2011, my first novel was published. It is a medical novel, and, unsurprisingly, since I practiced as a nephrologist for many years, it takes place in a dialysis unit. I learned a lot from writing this book, seeing it published and living with the consequences. Since its publication, many professionals have confided to me that they harbor a secret desire to write a book. I want to share my …

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To aspiring physician-writers: It’s time to write that book!

Involuntary discharge from dialysis: A health care practice like no other

Physician
January 9, 2017

Chronic kidney failure is a serious disease. When progression to end-stage renal disease (ESRD) occurs, dialysis is required to sustain life.

It is shocking, then, that in the United States, it is estimated that over 1,000 patients annually are involuntarily discharged from their dialysis clinics. Further, they are often “blackballed” from other local clinics. The consequences for such patients, predominately African-American, are dire. A patient may be unable to find a …

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Involuntary discharge from dialysis: A health care practice like no other

The secret sauce of great health care organizations

Health Policy
September 9, 2012

Greg Smith, formerly of Goldman Sachs, has described a positive organizational culture as being the “secret sauce of greatness.” What is the nature of this secret sauce? A simple, popular definition is that “organizational culture is the way we do things here.”

The relationship between organizational culture and organizational success is unassailable. In our commercial dealings, has not each of us easily recognized when a business culture is truly customer-focused, and …

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The secret sauce of great health care organizations

Is patient-centered care an outmoded concept?

Physician
April 21, 2012

Hospitals commonly espouse a commitment to patient-centered care (PCC). Most fail to achieve it. Causative factors are legion. PCC is often considered a strategy or a tactic, for example, when it really should be integral to an organization’s culture, and enabled by a supportive vision. Some organizations appreciate this, yet still struggle. This is understandable. Today’s health care providers were not trained to provide PCC. They lack the requisite skills, …

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Is patient-centered care an outmoded concept?