With front-page stories of overcrowded hospital wards and polls showing that Canadians rank health care as the most important issue today, the time is right for a clear-eyed look at the system.

In Operating In The Dark, Toronto Star health reporter Lisa Priest sets out to indict the ramshackle way medical care is delivered in this country, and to provide tips to patients trying to navigate the health care system. (A less-fleshed out version of her findings appeared as a series in the Star in the fall of 1997.)

Her indictment is sweeping. The main problem, in Priest’s view, is an egregious lack of accountability throughout the medical profession. Unlike commercial jet pilots, she argues, doctors get virtually no monitoring of their skill competency after medical school. And, unlike in parts of the U.S., there are no guides that rate hospitals and no statistics about which surgeons have the lowest death rates for a given operation. Nor is anyone in Canada monitoring the waiting lists for operations, so one surgeon may have a two-year waiting list while another equally good surgeon may be operating on patients within months.

In suggesting remedies and offering advice to patients, however, Priest comes up short – though the fault is not entirely her own. The lack of information (as outlined above) means patients have little recourse but to ask their doctor a lot of questions. The author ends almost every chapter advising readers to lobby the provincial and federal governments for change.

Considering that Priest has been a full-time health writer for years, and conducted much of the research for this book while away on a one-year Atkinson Fellowship, the book is unusually slight. Time and again, Priest uses material from The Globe and Mail and the Star. If these quotes or facts were from classified documents or sources that other reporters had the sole copy of, that would be understandable, but none of them were, leaving one to wonder why Priest herself didn’t do more of the research legwork.