Nam Kiwanuka: You're listening to Mistreated. I'm Nam Kiwanuka. In Ontario, family doctors are the gateway to the health care system, including providing a referral for a specialist. If you're one of the nearly 2 million Ontarians without a family doctor and need to see a specialist, say a gynecologist, it can be incredibly challenging to get the care you need. Even with a referral, wait times for gynecology are long. And if you need surgery, they can be even longer. A February 2025 report from the Women's Health Coalition of Ontario indicates that wait times for gynecological care are quote unacceptably long with some tertiary centers having weight lists of 800 to 1,500 patients and that the quote most complex cases face delays of two to three years for surgery leading to serious health consequences and significantly reduced quality of life.

Nam Kiwanuka: According to Medscape, an online publication for physicians and health care professionals, major delays occur at every point in the patient journey from imaging and diagnosis to surgery. Before the COVID-19 pandemic began, the average period from diagnosis to treatment in Ottawa was 7 to 10 years. Since then, weight times have increased by 2 years, and some patients report a 12-year delay for initial assessment. Women with complex cases can wait two to three years for surgery. Often the condition is so far advanced by that time that it requires more serious intervention. Untreated endometriosis can lead to kidney death and bowel obstruction and fibroids can grow into two and three pound tumors thus resulting in massive bleeding and infertility. And that reporting is from July 2025. Today we're speaking with Dr. Zanab Abdur Ramen, the president of the Ontario Medical Association. We're talking to her about the work the OMA does in advocating for Ontarians and for physicians and the crisis we're seeing in public health care in Ontario. She joins me now, Zanab Abdman. Welcome to the podcast.

Zanab Abdraman: Thank you so much for having me.

Nam Kiwanuka: Um, can you tell everybody what you do?

Zanab Abdraman: So, my name is Zanab Abdraman. I'm an allergist and clinical immunologist. I'm also certified as a pediatrician and currently I'm also the president of the Ontario Medical Association.

Nam Kiwanuka: Well, yes, you are Ontario Medical Association's 144th president. What is the OMA and what does it do?

Zanab Abdraman: So, the Ontario Medical Association is the representative body of all the doctors of Ontario. So, we represent all the doctors in practice, retired, and those also in training. So we advocate for our members as well as for the health care system because that's where we work and live and function. Uh so we advocate in terms of you know wellness for our physician and also wellness for the health care system and for our patients so that they can have navigate the health care system in the easiest simplest way possible. When you said that you were the president, um, I was like, hm. Because it's a you're very humble, but when you became president, you also made history as the OMA's first black woman president. That's correct.

Nam Kiwanuka: What does that mean to you?

Zanab Abdraman: You know, for me, it means that others are going to now look over and say, you know what, I could be in that position, too. It's really important to have representation, I think, at all levels of leadership. Um, I think of just even for myself in my practice, you know, day-to-day like I see lots of little black girls and they come in and they're a bit shocked and they'll say this their mom, they're like, "She looks like me." And their mom's like, "Yeah, you could be her. You could be the doctor." And I hope now they'll look and say, "I could be the doctor. I could be the president of the doctors. I could be anything really." So, for me, it means a lot. It means a lot for just, I think, our community at large. Um, I think some people might hear that and not fully understand the magnitude of that because if you're not used to seeing people that look like you in spaces of authority,

Nam Kiwanuka: you might not be able to think that's something that I can do. And it's only now that a black woman is in your position.

Nam Kiwanuka: We're also living at a time when there's a push back on DEI and when black communities, which I might also add are not monolithic. Yes. Um, black communities are being pushed into the corners of political slogans and you've made history. What has the experience been like for you so far?

Zanab Abdraman: You know, it's been an eyeopening but very exciting experience. You know, I do have the opportunity to be parts of lots of different conversations and to be at tables which, you know, traditionally we've not had even enough women, enough racialized women. And I think it's important to recognize that, you know, when you are from, you know, a lot of there's a lot of intersectionality for all of us. You know, I'm black, I'm a woman, you know, I'm immigrant. There's a lot of different views that we bring to the table. And I think others who may not, you don't have to be the same as me to for you to appreciate that I have an understanding of what it's like to be otherred, what it's like to maybe not be considered. And I think it gives a lot of comfort to a lot of different groups. And so it's been one that I've really taken seriously. I take the the fact that I am the first black woman president. And I really take it every opportunity to really emphasize that I don't want to be the last one either. This is not something that should just happen once as a blip. The goal is to actually to really open the doors so that we continue to see this diversity. we should be able to see anyone who is in the same in this membership to be the president. That's what it means, you know, to live in the society that we do. So, I'm hoping that we'll have less and less of the first and onlyies and more of the yes, any of us can represent all of us.

Nam Kiwanuka: Mhm. I want to come back to that conversation um in a little bit about you know uh what you're doing in healthcare and the importance because some conditions uh impact some groups different in different ways. Um but I read an article about you that said that you grew up in a household where quote medicine was not just a profession but a way of life. Why did you pursue a career in healthcare?

Zanab Abdraman: you know, um I really like people. I liked talking to people. Um my dad is now a retired pediatrician and so I got to see what he did. Um and I really just loved that he got to speak to families all day. You know, as a child, I also loved that there were always children in his office. Um but I really loved the thought of having a career in something where I got to be part of people's lives. I also really liked science, math. That part also drew me. I also had other family members who were also um in kind of science driven careers. One of my um first cousins, she's you know she's a vet um although now and then since then she also now works um more in like public health realm. But I remember even as a kid you know going with her and she would take me and say come see you know a cow being delivered. I mean, it definitely ruled out abstetrics and fetch school for me, but it was really exciting to be there and to see. So, I think that our families have always just kind of said, if you're interested in something, you know, go see it. You know, think about it. There was no real limitations, per se, and it was very much encouraged. And I worked in my dad's office as a teen and I'd have all these families say, "Oh my gosh, your dad was there when I was having my baby." And it was so scary. And then he came around. He said, "Your baby's fine. Soon as you know, they're done with you. They're going to bring you to the NICU. You'll see the baby." And they talked about how comforting he was and how it was so nice to have this face, you know, kind of peeking over to talk to them. Um, and I just thought, "Wow, that's I really want to I want to be that for someone one day."

Nam Kiwanuka: So, from a young age, you understood the relationship between a doctor and their patients. It's not just numbers, but it's very intimate.

Zanab Abdraman: It is. You you get brought into really the private parts of people's lives at sometimes it could be at the worst day for them, you know, um and you have that ability to bridge and to comfort them. And you have to consider many people may be meeting a physician for the very first time. So, it's really nice that we're able to kind of touch someone and be there for them in that moment. So, that really spoke to me.

Nam Kiwanuka: Um, I wonder then how you see the situation that's happening in this province right now. Uh, you know, firsthand that the health care system in the province is strained. ERS and some jurisdictions are closed. There is a family doctor crisis. Um, I've watched the news and people would would line up for hours in the debt of winter when new clinics open. Doctors are also struggling to be paid for their work.

Nam Kiwanuka: In your role, you act as an advocate for doctors, the residents of this province, and also medical students. Correct.

Zanab Abdraman: That's correct.

Nam Kiwanuka: Um, how do you then prioritize the very different needs of those groups?

Zanab Abdraman: Yeah, there's a lot of definite moving parts, but I think some of the issues really go across, you know, when we're talking about um, you know, wellness really because I often tell people it really comes down to wellness. All the work that I'm doing in terms of equity even for phys for for physicians, it really comes to be that everyone deserve wellness.

Nam Kiwanuka: What what is what does that what do you mean when you say wellness?

Zanab Abdraman: It means that you know you deserve to be um healthy when you're working be in a healthy environment to work healthy in terms of the powers that be should pay you appropriately for services rendered you should know that you can handle all the amount of work you should know the system is also absorbing its own work and that you don't have to take on more. So for me it's really about that and so you know showing that to the medical students so that they see that they have a space moving forward that they've chosen the right path and they could choose any of the paths you know and so that for me it kind of all comes down to kind of wellness. I want our all the doctors all the residents all the medical students to feel safe where they work and know that there is their career their chosen career is still for them.

Nam Kiwanuka: Um what about the residents in the province?

Zanab Abdraman: So in terms of so when you say residents I want to clarify you mean

Nam Kiwanuka: Ontarians the people who have access to OHIP.

Zanab Abdraman: Sorry when residents are also

Nam Kiwanuka: I know that's I was like wait one of my favorite show is called the resident.

Zanab Abdraman: Yes. I was like are we talking about the residents in training? Are we talking about the people of Ontario? I just want to be sure before I answer this question.

Nam Kiwanuka: Oh my gosh. I'm so sorry.

Zanab Abdraman: The people that live in the province of Ontario. Yeah. because that's that's you know who we're also really doing this for because we I know that if if our doctors aren't you know able to sustain and survive in our health care system what happens to our patients? You see so many physicians going going and they're like I just can't go anymore. I've tried so hard. They've been fighting almost against the system to get care for their patients. And I know that if that person leaves early because they're burnt out that actually, you know, affects so many patients. We see so many people. So for the people of Ontario by advocating for their doctors, advocating for the health care system and who knows better about how hard it is to navigate the healthare system than those who are seeing the patients who are having those difficulties because we see the troubles and we see the results of not also being able to get through the system in a timely fashion and we see that unfortunately it does affect different populations in different ways. So that is, you know, to do the work to advocate for doctors is to advocate for the people of Ontario.

Nam Kiwanuka: Uh it's become a thing for people to say that I'm lucky to have a family doctor and living in a place like Ontario, one of the wealthiest jurisdictions in the world. It doesn't feel like we should be saying that.

Zanab Abdraman: No, absolutely. Because it there shouldn't be winners and losers, right? Because you know, if you're saying I'm lucky, that means that there's someone who's unlucky. there's someone who doesn't have and it is it is unfortunate because you're right we're in the largest province we're you know quite significantly well funded but we're still having this issues it's also an issue that's reflected across the country and I think there has been some lack of foresight in terms of looking at medicine looking at planning in medicine you know if you look back in the history you know you'd be surprised if I told you in the '90s they actually cut down medical school spots the in power decided to decrease those numbers

Nam Kiwanuka: because they didn't population wasn't big enough or

Zanab Abdraman: No, the population was but it was you know they felt that it wasn't they they had enough that they could do but it's a lack of foresight and not thinking that each each generation is going to be slightly different. We're going to have expansions in population. We're going to have immigration. We're going to have birth rates. There's so many you have to forecast. We spent so much time forecasting about a lot of different areas in terms of just, you know, how Canada works, but I don't think there was enough of it spent looking at the population, but looking at it in terms of physicians and how physicians share this load and realizing that we need to actually have more and the styles of care also change over time and we're going to need more physicians in different areas and you know opening up all the different there's some specialties which are very small by default but realizing but we still need more of them. Yes, we've had less but for example I'm an allergist. We don't actually have that many allergists in Canada. There's about 250 of us maybe getting close to 300 but that's across Canada.

Nam Kiwanuka: And if you're in upstate New York I think there's about 250 allergists there. So there's not quite enough. And you have to always consider that the population is increasing. We have increasing allergies. We have increasing aging population. So, we have to be forecasting and increasing to help support that. And physicians who have retired, who have been in practice for 40 years, they often have larger practices than perhaps newer physicians, a it takes you time to feel comfortable, to set up, but also the population has become a lot more complicated and more complex. So certain patients just need more time now. So you're not going to see as large of the practices anymore. So you have to also factor that in. So it's the lack of factoring so many different factors that have kind of led us here.

Nam Kiwanuka: Mistreated is a podcast on women's health and we're hearing from a lot of women who are saying that they're waiting for a long time to see a gynecologist or even just a neurosurgeon. I will ask you that in a in a moment, but I wanted to just do a quick followup. Um, Ontario's doctors and the province recently reached a new 4-year deal that concludes compensation uh, increases for your members. That said, some doctors are finding it difficult to get paid due to Ontario's billing system. What is the IM ministry and the OMA proposing to do to fix that?

Zanab Abdraman: Well, we've been speaking from the OMA perspective. We've been speaking about this issue for quite a long time and we brought it actually to the arbitration board um in terms of our negotiations and the arbitrator has said which is great. It's in writing. It said that we must find ways to address this and if it's still not resolved in the next few months then we we do go back to the arbitration board. You know, we've come up with a lot of different solutions. you know um some some of the issues can be for complicated surgeries just by putting in so many codes that gets flagged and then it gets automatically rejected asking you to manually show proof that you did do all of this complicated surgery but the people who are reading it may actually not have clinical experience so I don't know if you ever read an O note but they're really complicated even for myself in the field but not someone who does surgeries day-to-day so we're asking for them to have people with clinical expert expertise being the first ones who are reviewing these notes to determine if it's appropriate. A flip side of that is for example any of our most vulnerable populations. If you're experiencing homelessness or mental health or addictions, it's really difficult to validate your health card because one of the things that's required to renew it is an address. And so we know these people live in Ontario. We know they're eligible. We know they need care and yet their those bills would be continually rejected. but we know that they are eligible for it. So, we're asking for them to bring back some of that good faith billing.

Zanab Abdraman: Um, as I said, I'm also certified as a pediatrician. My first two years I did work in pediatrics. So, when we would see newborns, you know, once you have a baby, you have believe it's about, you know, 14 to 30 days to get to that service Ontario to get that temporary paper. Exactly. But it's difficult. You are barely

Nam Kiwanuka: I had a C-section, so I was like, I'm not

Zanab Abdraman: Exactly. But then that gets rejected for those who provided the newborn care because they also process it on a monthly basis. So usually by the time it's submitted and processed that temporary number has expired and you know sometimes we have it where you know the babies don't survive and then you know OHIP will say to someone like myself well just call the family and have them go to service Ontario and register. the families are grieving

Zanab Abdraman: and I, you know, I say I'm only going to call them to offer, you know, words um of support and to see if they want to talk, but I will not be sending them. And so, it's kind of left to you to just absorb non-payment for that because no one in their right minds would go and bother a family at that time for something like this. You should know it's registered that they passed away, so it's in the same system. So, why do we need to have them go there? we've already processed all of that through the hospital. All that information is known. So, it's things like that. Just extending any baby, giving them 90 days. That's what we're asking for because sometimes it's just you're just busy. It's difficult. Like you said, after a C-section, there's a lot of things happening. Adjusting, not sleeping. Give parents also a little bit of wiggle room, I think, is also fair.

Nam Kiwanuka: Um, right now there's a lack of data around gynecology and the way times for seeing a gynecologist. women are leaving the province and the country to access care. What needs to be done to change this to also prioritize gynec gynecological care?

Zanab Abdraman: I think firstly, you know, when you have an issue, you have to actually look at it. You have to actually measure it. There's so much data um that's being collected about time to, you know, knee surgery, time to hip surgery, time to eye surgery. It's important that we also elevate some of these issues in terms of time to I mean, you know, I know we've talked a lot on your podcast about um fibroids and that is an issue that affects so many women. So, why don't we look at time to fibroid surgery as one of the other ones or just even time to access to gynecology because unfortunately that is much longer than um people often think it is and sometimes it's very difficult to get people who do certain types of surgeries. So also looking at that, you know, often they'll say, "We don't have the data supporting this." Well, if you're not measuring something, you also don't know about it. And I think it's a reflection of the equity issue. I think this came up also during peak pandemic times when we were trying to prove to show that, you know, we were having disproportionate deaths and illnesses in black people. And they said, "Well, do you really know that?" and we said they said well you haven't been collecting race-based data but we can tell you if you're looking at certain um regions we've seen this and we've seen the postal codes we've seen and if you don't look for something you can't address an issue and I think that's one of the things we need to have is more looking at access to issues that disproportionately affect women or only affect women and we haven't had this light being shone on

Nam Kiwanuka: um I think the the pandemic shifted us in so many different ways and doctors at the front line. Um I I can't imagine the weight that you all felt over the past few uh years while I navigated my own health problems. I was really surprised to find out that we don't even track uh weight times for gynecology care. So if you don't track it, like you said, if you don't have the data, um how can you change it? And it blows my mind that we don't track conditions that impact 50% of its population. How is that anything but bias?

Zanab Abdraman: It's not. It It is bias, right? And that's, you know, why I often tell people, it's really important for us to change our leadership structures because this is when you start to determine what you look at. If you're not thinking about it, if it's not discussed at the tables that determine what we're looking at, you're not going to have those views kind of coming down to the general person. And so unfortunately when tables have been predominant a lot of the leadership tables in the past have been predominantly white and male um they have not been thinking or talking about specifically women's health issues talking about things like fibroids talking about you know even menopause. I can tell you we're talking a lot more about menopause. I can tell you in medical school I had very little education on menopause.

Zanab Abdraman: you know, I think there was a day or two where we talked about it briefly um in the classes and then on my um abstetrics and gynecology rotation um we spent a bit of time on it but that was because one of the people where I did my rotation that was an interest of hers and so she spent time speaking on it and we had teaching sessions on it but that's not necessarily built into the curriculum as well. So this is an issue. We also need to change how we're teaching about certain conditions because you know I would say as a family doctor for people who are in family medicine they are seeing this a lot and so we need to also train people to be able to identify to be able to have conversations about it to also talk about things that are okay to not be okay. you know, um, personally for myself, you know, all the times of having heavy periods, then having cramps, everyone just said that's just part of life. That's something that happens. And we should really have probably said

Nam Kiwanuka: that's not normal.

Zanab Abdraman: That's not normal. this and we shouldn't have accepted this to be the norm that it's just okay for half of the population to constantly be in pain and you know not and the thing is not everybody has that but to just some people

Nam Kiwanuka: some people have it and just to say this can just happen and no further discussion

Nam Kiwanuka: I'm still stuck on a day or two I'm just like what oh my gosh um it explains a lot because I think what's happening for a lot of women you get frustrated because you go to doctor and as well-meaning as they can be, they don't have that information. So, you go online and then you try to figure out like what is wrong with me? Like, I realized fibroids were serious from the information I read online. Um, we've also heard from women on this podcast about them being denied access to out of province care.

Nam Kiwanuka: They've gone through all the steps, have the letters from the surgeon, have these very rare conditions that impact mostly women. Um and then they're through red tape they are denied that care and then their life is just a life of trying to advocate for themselves while the quality of care for their life just goes down. What is the OMA's position on helping these patients?

Zanab Abdraman: You know, our position is really to support our physi sorry support our patients and we want there to be less red tape this part because you know a lot of times like as you said they have all the letters from their physicians their physicians are advocating for them you know we know kind of what's available in our healthare system and often yes a lot of times within our healthare system in Ontario we can get care for a lot of aspects but sometimes when we say we don't have this in the province you know and you've provided I did all this information. It's so frustrating and you're helpless because you said I've written the letter and you continue to try. So really believe that you should listen to those in the health care system. If we've written we've said we can't this is not available in Ontario. We need care elsewhere or we need to get either surgical care elsewhere or get certain medications.

Zanab Abdraman: And when it's just not approved, it's so frustrating. And we really want there to be easier ways to navigate through some of these. And for a lot of sometimes they're rare conditions, but sometimes they're not so rare, but we just don't have access within. And we have to be able to navigate this in a fair fashion because for some people they'll say, "I didn't even know you could continue to ask or there were other ways to get around." And we have to be fair that some people have the means to just opt to do something privately elsewhere and others do not. So those who have not are going to suffer more and so we really need this to be something that can be easily navigated in a fair process where you understand the rules. Sometimes it feels like you don't know what the rules are to get something across.

Nam Kiwanuka: uh do you worry about the ripple effect that can create between patients and um healthcare workers because I think from my own experience and from the people that I've spoken to it creates this lack of trust and then when something happens like around measles you're like well I don't trust the doctor or the health care system because when I needed care no one cared for me do you worry about like that create because it just feels like it's creat creating a ripple effect into many different areas that impact all of us.

Zanab Abdraman: I do worry about that impact. I worry a lot about it because exact it's exactly what you said. Sometimes, you know, when I can't get someone something that they really do need, they look they're so disappointed. They're like if you can't do this, you know, um how have you tried hard enough or you know, it's a it's seen as a failure and you can't help but obviously look at the you put everybody in that, you know, the health care system, the physicians, the nurses, you kind of put everybody there and it's really unfortunate because it's a failure of the system, but people still advocated for you and were in your corner. But you're right, at the same time, some people also have had difficulties with getting the buyin sometimes from their physicians as well because maybe they're not as versed on this. They don't recognize that certain groups are at more risk than others. And so that does lead to this kind of changing shifts with trust so that when things like this happen like the measles outbreak you know when we did the work um the pandemic is just a great example because it's a great time when everyone was really focused you know when we were talking about bringing vaccines to you know the black population because we were seeing that disproportionate um disease impact you know a lot of people said okay let's go let's mobilize and we were like whoa whoa whoa you cannot How can you not think for a second that there might be some historical aspects that you can't just go barging in with this huge vaccine campaign and without recognizing some of the issues with trust there. So you also have to be there has to be a level of humility with it to say you know what there were times when we did fail and that's when we did the black scientist task force on vaccine equity for co we went in focused on that we said let's talk about the times when the healthcare system specifically failed black people let's be open about that and that's why we all got together as different as black people in different aspects of you know myself I did a lot of work on vaccine allergy other people vaccine development. Other people did, you know, um a lot of different areas to kind of bring together and say we're bringing here to talk about this because we realize there were previous wrongs. So, you have to also be able to say in the past we have had some wrongs and address it with humility, but also with the knowledge. You have to also appreciate what has happened in the past. That's why I always had a problem with the term antivaxer

Nam Kiwanuka: because it just sounds like it's it's derogatory because there are reasons some communities might be vaccine hesitant.

Nam Kiwanuka: Um and so I think language is very important. Um what should our provincial leaders be focused on right now with the bigger picture of what's happening in this province?

Zanab Abdraman: I think right now looking across, you know, we really need to focus on ensuring that we can get I think every Ontarian a family doctor. Why? Because that's where you build trust with these one-on-one relationships where you get to know them over time so that you can have these conversations where you can talk about if you're hesitant about any kind of a vaccine or any kinds of treatments. You need to be able to build trust and it does happen in small conversations with someone that you have built, you know, relationships with over time. So, we do need to focus on that. We also need to focus on making sure there's enough of the consultant specialists in the pool so that when patients do need to see them, they're available and we're not seeing this huge weights in our system. We need the health care system and the government to also provide to allow for this and to allow for this communication across the different people in the health care system. I think one of the things that would really help I think for all of us would be if we had better digital health infrastructure across the province so it's easier to move information. You know, if someone needs to refer someone, for example, you know, your family doctor refers to one person. If they're not available or that's not their field, they decline it. They have to find someone else. And you keep going and there's no one place to go look at everybody and see what their different areas are of like hyper specialization. If we just had a system like a central referral pathway where your doctor just has to put in this is the issue specifically my patient is willing to travel 50 100 150 km everyone has different open to traveling so far and saying this is what I'm looking for and let the system do that and then let the doctor go back and spend time with their patient. surprising that we don't have that yet. But then again, as a parent, I still have those yellow cards for vaccines where it's like, why isn't this um in a system?

Nam Kiwanuka: You were talking before about data and the importance of collecting data. Recently, the Black Women's Institute for Health, released the first of its kind, Canada's first National Health Survey of Black Women and Girls, the report is called Unheard Voices, and it looked at how black women experience the health care system and how they're treated. Why do you think it's important to have reports like this?

Zanab Abdraman: It's important because in the end we still need data even though we have ample amounts of it it seems like an obvious truth for so many in the end we still need to show this data and to provide it and for it to be available to all levels of government you know like I said if you don't measure something you can say we didn't know it was a problem well now you can't unknow this so it's important for all this kind of information to get shared at every level Because health care, yes, proincially provided, federal transfers, but in the end, every level of government does play a role here because when you look at health, there's many aspects more than just seeing your doctor, seeing um the nurses, seeing all different kind of um health providers. It actually biggest determinant of health, housing, biggest determinant of health is actually having that aspect of community. you know our mental health we require community and that is a huge thing to think about. So we need social services to also hear about this. So we need data like this so that when we come out and we say look at different populations look at specifically black women and girls in Canada and look at how adversely affected they are by the health care system by our social services you cannot say we didn't know that's no longer acceptable. So this is so important, so important for any advocacy moving forward and for it to continue to be done. So we've shown that you can do it and so we hope it'll continue to be done.

Nam Kiwanuka: It's been an absolute pleasure speaking to you, Zav. It feels weird calling you by your first name, but uh is there anything that you'd like to add that I missed?

Zanab Abdraman: I think that I just want to say thank you to you. I think that so much of what you've been doing on this podcast is highlighting so many of the issues within the health care system. We still have disparities. We especially when we look at gender and then when you lay in intersectionality into that that kind of becomes wider and wider and so you know this this also provides a platform for a lot of this information to get out there. So thank you. You're also helping in terms of this. So

Nam Kiwanuka: thank you so much. I hope these conversations can push uh forward policy for women.

Zanab Abdraman: Absolutely.

Nam Kiwanuka: We appreciate your time. Thank you.

Zanab Abdraman: Thank you.

Nam Kiwanuka: We reached out to Ontario's Ministry of Health for comment following our interview with Dr. Zanab Abdul Ramen. Here is some of the response. Ontario's medical claims payment system (MCPS), efficiently processed more than 200 million claims annually. To be clear, over 99% of these claims are paid automatically, exactly as submitted, reflecting the systems productivity. Only a small fraction, 0.58% of all claims are sent for manual review. And even among these, more than 95% are resolved within 30 days. More nuanced cases go to a medical adviser, a physician for final review. Outcomes include full payment, partial payment, or return to the provider, and physicians can appeal with additional information. It's ultimately disappointing that the OMA is choosing to focus on 0.58% of OHIP claims rather than highlighting the real progress we've made together to support physicians. Our thanks to the Ministry of Health press secretary for getting back to us and to read the full response we'll post in our metadata.

Nam Kiwanuka: This was Mistreated. Thanks for listening. You can follow our show wherever you get your podcast so that you can get notified each time a new episode is available. We would love to hear your feedback. You can write me an email at mistreatedodcast@tvo.org or reach out to me on my social channels. This week's episode was produced by Matthew Omara and me, edited by Colin Kish. Camera work by Max Stussy, teleprompting by Alisa Verley, and digital shorts by Ariana Longley. Production support from Jonathan Hallowell and TVO's digital media services team. Lorie F is the executive producer of digital. John Ferry is vice president programming and content. Thanks so much for listening.