Doctor, patient part ways over health care debate

It's no secret that proposals for health care reform have been divisive.

The issue has intensified partisanship in Congress. A seemingly endless stream of special-interest groups from across the country has weighed in with rhetoric and money. The debate ranges from talk radio to office water coolers.

In Tampa, the issue has transcended rhetoric to become intensely personal.

It has severed the relationship between a doctor and a patient.

The doctor is Madelyn Butler, founder of an obstetrics and gynecology practice called The Woman's Group. She doesn't like President Barack Obama's health care proposal and has posters in her office urging people to contact lawmakers and tell them to vote against the legislation.

The patient is Barbara Gabriel, pregnant with her first child and a backer of the president's plan for health care reform. She saw the posters during a routine checkup at Butler's office.

Offended, Gabriel pulled them down and tossed them out, she said. Then she sent a letter to Butler on Dec. 29, admonishing the doctor for a "lack of professionalism" and for "introducing political propaganda in a clinical setting."

The doctor responded a week later. She wrote that she, too, was offended.

Butler said in her letter that Gabriel went overboard in her reaction to the posters and that it was clear from Gabriel's letter "that your opinion of us is beneath the threshold of goodness that a patient should have for her health caretaker."

"It is for this reason that we ask that you seek the care of another OB/Gyn," Butler wrote.

Gabriel, four months pregnant at the time, said she was surprised she had been fired as a patient. Other than the posters, she was happy with the care she was given.

For her part, Butler said, she would have welcomed a healthy discourse on the topic. She said she would have told Gabriel that government should not come between the doctor-patient relationship.

The doctor said she didn't mind Gabriel voicing her opinions and that the decision to dismiss her as a patient didn't come lightly.

But Gabriel crossed the line when she took the Florida Medical Association-endorsed posters from private property, the doctor said. She said her former patient's letter also had a disparaging tone.

"It was very strongly worded," Butler said. "It was hostile."

It appeared Gabriel had lost respect for her doctors, Butler said. Without that respect, she said, trust was shattered.

In her letter, Gabriel wrote, "The bloated salaries that specialists such as the physicians at The Woman's Group earn are a symptom of the sickness that currently plagues our broken healthcare system."

Later in the letter she writes, "For you to suggest to your patients that healthcare reform is coming in between you and those you serve is, quite frankly, disgusting."

Gabriel said she's passionate about what she believes and admitted her letter might have been a little strong.

"Looking back, I could've softened it a little bit," she said.

Gabriel has found another obstetrician.

Both Gabriel and Butler said they are aware what happened between them is symbolic of the charged emotions on both sides of the national debate.

"All of us have the same desire," Butler said. "We all want high-quality affordable care, but I think we have differing views on how to get there. We have to be respectful to each other when we disagree."