(MIS)Treated

In Ontario, family doctors are the gateway to the healthcare system, including providing a referral for a specialist. If you are one of the nearly 2 million Ontarians without a family doctor and need to see a specialist, say a gynaecologist, it can be incredibly challenging to get the care you need.
Nam Kiwanuka speaks to Dr. Zainab Abdurrahman, the president of the Ontario Medical Association about the crisis in public healthcare.
Got a question or comment? Email us at: [email protected]
If you, or someone you know, is struggling with mental health, visit any of the following resources for support: Canada.ca/mental-health Kids Help Phone Call 1-800-668-6868 (toll-free) or text CONNECT to 686868.
The Government of Ontario's Mental Health Support Resources: https://www.ontario.ca/page/find-mental-health-support
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Research links
Meet the first Black woman elected to represent Ontario doctors: https://www.cbc.ca/news/canada/london/meet-the-first-black-woman-elected-to-represent-ontario-doctors-1.7525349
Gynecologic Surgery Delayed for Up to 3 Years in Canada: https://www.medscape.com/viewarticle/gynecologic-surgery-delayed-3-years-canada-2025a1000iev?form=fpf
A Toronto-area doctor spent 10 days caring for a dying baby without pay. Here’s why she’s speaking up: https://www.cbc.ca/news/canada/toronto/doctors-ontario-ohip-billing-rejected-9.6958953
Ontario, medical association near new compensation deal they say will help retain, recruit family
Ontario Government and Ontario Medical Association Confirm Funding Increase That Will Protect Provincial Health Care: https://news.ontario.ca/en/release/1005805/ontario-government-and-ontario-medical-association-confirm-funding-increase-that-will-protect-provincial-health-care
Ontario, medical association near new compensation deal they say will help retain, recruit family doctors: https://www.cbc.ca/news/canada/toronto/ontario-family-doctors-new-contract-1.7602189
Province's 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 system's 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. In general, two thirds of these claims are categorized as Complex Surgical Claims, where there are multiple procedures performed, and where a three-tier review process, as is used in a manual review, is fitting.
Claims are reviewed in three tiers. A Claims Assessor handles the initial review, and if deemed necessary, it is escalated to an Assessment Officer, who further evaluates the claim and supporting context. More nuanced cases go to a Medical Advisor, a physician, for final review. Outcomes include full payment, partial payment, or return to the provider, and physicians can appeal with additional information.
This reliable, structured process ensures that claims subjected to manual review comprehensively align with the payment requirements of the Schedule of Benefits.
It’s ultimately disappointing that the OMA is choosing to focus on .58% of OHIP claims, rather than highlighting the real progress we’ve made together to support physicians.
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Until the early 1900s if a woman had symptoms like cramps, depression, or a headache, a doctor would probably diagnose her with hysteria, which was removed as a medical diagnosis in 1980 by the American Psychiatric Association.
When you consider that women weren’t included in clinical trials until 1993, how much do we really know about women’s mental health? We speak to science researcher Misty Pratt about this and her book “All in Her Head: How Gender Bias Harms Women’s Mental Health.”
Got a question or comment? Email us at: [email protected]
If you, or someone you know, is struggling with mental health, visit any of the following resources for support: Canada.ca/mental-health Kids Help Phone Call 1-800-668-6868 (toll-free) or text CONNECT to 686868.
The Government of Ontario's Mental Health Support Resources: https://www.ontario.ca/page/find-mental-health-support
Follow TVO on social: https://www.youtube.com/theagenda https://www.instagram.com/mistreatedtvo
Join our newsletter: https://www.tvo.org/newsletters
Visit the TVO Today website for current affairs journalism, documentaries and podcasts: https://www.tvo.org
Research links
https://quillandquire.com/authors/misty-pratts-own-experiences-inspired-her-book-on-women-and-the-mental-health-care-system
https://www.mcgill.ca/oss/article/history-quackery/history-hysteria
https://www.smithsonianmag.com/science-nature/for-some-women-with-serious-physical-ailments-mental-illness-has-become-a-scapegoat-diagnosis-180986203
https://www.pbs.org/wgbh/aso/databank/entries/bhchar.html
https://www.plannedparenthood.org/planned-parenthood-florida/blog/the-history-of-hysteria-and-how-it-impacts-you
https://theconversation.com/inaccurate-and-misogynistic-why-we-need-to-make-the-term-hysterectomy-history-257972#:~:text=From%20the%20defunct%20condition%20'hysteria,link%20the%20uterus%20to%20hysteria.
https://medicine.yale.edu/news/yale-medicine-magazine/article/from-hysteria-to-empowerment/
https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/conversion-disorder-the-modern-hysteria/73F77976DFC9802B4C0E3EC7CA88F1A9
https://adaa.org/find-help-for/women/anxiety
https://www.relationalpsych.group/articles/adhd-in-women-why-its-often-misdiagnosed
https://pubmed.ncbi.nlm.nih.gov/32007945
https://www.uchealth.com/en/media-room/wellness/suicide-risk-women
https://www.psychologytoday.com/ca/blog/the-leading-edge/202505/why-womens-mental-health-needs-special-attention
Charcot argues that hysteria isn't just a gynaecological issue but neurological disorder: https://pubmed.ncbi.nlm.nih.gov/21154220/#:~:text=Results:%20In%201870%20the%20interpretation,transformed%20into%20a%20neurological%20disorder
https://pubmed.ncbi.nlm.nih.gov/39186636

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Consider that while the symptoms of ADHD were first identified back in 1798, it wasn’t until the 1990s that science began to study how ADHD presents in girls and how it might be affecting them.
Nam Kiwanuka speaks to writer Carla Ciccone, who became one of the growing numbers of women to be diagnosed with ADHD during the pandemic. She speaks to her about the challenges she felt in school as a young child and why she wrote the book “Nowhere Girl: Life as a Member of ADHD's Lost Generation”.
Got a question or comment? Email us at: [email protected]
If you, or someone you know, is struggling with mental health, visit any of the following resources for support: Canada.ca/mental-health
Kids Help Phone Call 1-800-668-6868 (toll-free) or text CONNECT to 686868.
The Government of Ontario's Mental Health Support Resources: https://www.ontario.ca/page/find-mental-health-support
Follow TVO on social: https://www.youtube.com/theagenda
https://www.instagram.com/mistreatedtvo
Join our newsletter: https://www.tvo.org/newsletters
Visit the TVO Today website for current affairs journalism, documentaries and podcasts: https://www.tvo.org
Research links
How ADHD Shaped My Life Without Me Knowing It: https://www.elle.com/culture/books/a65994230/nowhere-girls-book-excerpt-women-adhd-2025
The “devastating” findings of a decades-long ADHD study: https://www.understood.org/en/podcasts/hyperfocus/the-devastating-findings-of-a-decades-long-adhd-study
The history of attention deficit hyperactivity disorder: https://pmc.ncbi.nlm.nih.gov/articles/PMC3000907
Children with ADHD Avoid Failure and Punishment More Than Others, Study Says: https://www.additudemag.com/children-with-adhd-avoid-failure-punishment/?srsltid=AfmBOorSMFFUiJhgFMZ00QNIHdj4V63WDJfrC3o7jgSKOqkF604tYl-1
The History of ADHD: A Timeline: https://www.healthline.com/health/adhd/history#1902
Does ADHD Need a New Name?: https://www.additudemag.com/other-names-for-adhd-add/?srsltid=AfmBOoqhu7TMDAktkX9L6iyuBVwg7eoXjHvER_bZZ0MMixwlC7kF9Adr
Miss. Diagnosis: A Systematic Review of ADHD in Adult Women: https://journals.sagepub.com/doi/10.1177/10870547231161533#:~:text=There%20is%20also%20gender%20bias%20in%20the,participants%20being%20male%20and%20only%2019%25%20female
What Lies Behind the Rise in ADHD Diagnoses?: https://www.psychologytoday.com/ca/blog/brain-curiosities/202505/the-truth-about-the-adhd-epidemic
ADHD in Women vs. Men: Does Gender Play a Role in Symptoms?: https://psychcentral.com/adhd/adhd-and-gender#prevalence
Obstetric complications in mothers with ADHD: https://www.frontiersin.org/journals/reproductive-health/articles/10.3389/frph.2022.1040824/full
Screening for Adult ADHD in Patients with Fibromyalgia Syndrome: https://academic.oup.com/painmedicine/article-abstract/19/9/1825/4584482?redirectedFrom=PDF
Life expectancy and years of life lost for adults with diagnosed ADHD in the UK: matched cohort study: https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/life-expectancy-and-years-of-life-lost-for-adults-with-diagnosed-adhd-in-the-uk-matched-cohort-study/30B8B109DF2BB33CC51F72FD1C953739
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Much of gynaecology was built on surgical experiments conducted on enslaved African women. These procedures were done by Doctor James Marion Sims, who has been called the "father of modern gynaecology". His legacy lives on today with the Sims position, the speculum and the surgical technique to treat vaginal fistula. So how to reconcile that history with what happened to those young women, with the advances in gynaecology?
Got a question or comment? Email us at: [email protected]
If you, or someone you know, is struggling with mental health, visit any of the following resources for support: Canada.ca/mental-health
Kids Help Phone Call 1-800-668-6868 (toll-free) or text CONNECT to 686868.
The Government of Ontario's Mental Health Support Resources: https://www.ontario.ca/page/find-mental-health-support
Follow TVO on social: https://www.youtube.com/theagenda
https://www.instagram.com/mistreatedtvo
Join our newsletter: https://www.tvo.org/newsletters
Visit the TVO Today website for current affairs journalism, documentaries and podcasts: https://www.tvo.org
Research links:
"Father of Modern Gynaecology" J. Marion Sims: https://www.history.com/articles/the-father-of-modern-gynecology-performed-shocking-experiments-on-slaves
https://www.npr.org/2016/02/16/466942135/remembering-anarcha-lucy-and-betsey-the-mothers-of-modern-gynecology
https://www.pbs.org/wgbh/americanexperience/features/cancer-detectives-brief-history-speculum/
https://news.berkeley.edu/2020/02/17/historian-uncovers-gynecologys-brutal-roots-in-slavery/#:~:text=James%20Marion%20Sims%2C%20who%20was,same%20capacity%20as%20white%20men
https://news.harvard.edu/gazette/story/2023/03/how-lucy-betsey-and-anarcha-became-foremothers-of-gynecology/
Operating on poor Irish women: https://ugapress.manifoldapp.org/read/medical-bondage/section/403f560a-7f2d-4def-8bdf-a5767588b78b
https://www.healthinnowest.net/news/join-the-movement-to-rename-the-sims-speculum/
First record of use of anesthesia: https://pubmed.ncbi.nlm.nih.gov/26828088/#:~:text=Abstract,labor%20and%20recovery%20from%20surgery.
The pain these women suffered: https://drjengunter.com/2017/09/08/dr-sims-built-a-lab-and-experimented-on-enslaved-women-take-down-his-statues
Documentary on Anarcha: https://www.youtube.com/watch?v=JjLL-fEj0fw
https://pmc.ncbi.nlm.nih.gov/articles/PMC11682838/ https://www.ogmagazine.org.au/23/4-23/lucys-legacy-why-sims-speculum-needs-a-different-name
https://www.npr.org/2018/04/22/604789513/controversial-statue-of-19th-century-gynecologist-removed-from-central-park
https://archives.icahn.mssm.edu/disappearing-hospitals-where-did-they-go-womans-hospital
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Join Nam Kiwanuka January 20th on (MIS)Treated to hear real life stories and expert interviews on how the mistreatment and misdiagnosis of women affects us all.
Got a question or comment? Email us at: [email protected]
If you, or someone you know, is struggling with mental health, visit any of the following resources for support: Canada.ca/mental-health
Kids Help Phone Call 1-800-668-6868 (toll-free) or text CONNECT to 686868.
The Government of Ontario's Mental Health Support Resources: https://www.ontario.ca/page/find-mental-health-support
Follow TVO on social: https://www.youtube.com/theagenda
https://www.instagram.com/mistreatedtvo
Join our newsletter: https://www.tvo.org/newsletters
Visit the TVO Today website for current affairs journalism, documentaries and podcasts: https://www.tvo.org
See omnystudio.com/listener for privacy information.