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Lyme Medical, Legal, and Political Issues -- POINTS

Here are some points we think important. Consider whether any reflect YOUR views when you write letters to newspapers, legislators, and other interest groups. But remember that brief letters are more likely to be read than long ones. You can trust that others will mention points you don't use. Everyone doesn't have to say everything!

1. Conflict of interest: complainants may be paid by insurance companies to review (and deny) Lyme disease treatment claims. Complainants may be competing with target physicians in some way (research funding? patients? something else?) Complainants may have financial stakes in laboratories, research programs, tests, clinical practices, etc. which are threatened by the beliefs, practices and success of physicians who are targeted.

2. Standard of care: there is no consensus in the medical community regarding treatment for chronic Lyme disease. Many researchers are investigating many aspects of treatment issues. The 2- or 3-week treatment protocols are arbitrary and have been shown to be unsuccessful in many cases. Dr. Steere's most recently published protocol suggests up to 6 weeks of treatment, but -- beyond its recognition of the failure of shorter protocols -- this too is arbitrary.

3. Lyme disease is often difficult to diagnose and difficult to treat. This is highlighted and attested to by the existence of thousands of Lyme Disease Support Groups across the nation. If cure were simple there would be no support groups.

4. Persistence of infection: many articles published in the peer-reviewed medical literature provide strong evidence for persistence and chronicity of Lyme disease. The Lyme organism has been identified by PCR, culture, electron microscopy, antigen capture, etc. in the tissues of patients and animals who have previously received multiple courses of currently recommended antibiotics.

5. Unreliability of tests: no test even approaches adequate sensitivity for detection of Lyme disease. No test approaches 100% reliability. There is considerable debate over the current CDC-recommended two-tier testing criteria, which were originally intended for surveillance purposes only, but now are being promoted in lieu of clinical diagnosis. No test can definitively rule out Lyme disease. There is no test that shows whether or not the infection has been eliminated.

6. Co-infections: New tick-borne infections are being discovered all the time; the role they play in interacting with Lyme disease is only beginning to be explored.

7. Scientific issues should be decided in the scientific forum, not in the proceedings of medical boards investigating alleged "misconduct."

8. The intention of the reporting law was to protect patients from unprofessional conduct by physicians. Using this process to threaten, intimidate, and restrict certain physicians (particularly LLMDs) is clearly politically and/or financially motivated.

9. Anonymity of complainant: complainants are allowed to remain anonymous. This gives the complainant protection against reprisals, but it also prevents accountability. Without full disclosure, one can never explore the motives of the accuser.

10. Undefined charges: by law, the charges brought against a physician are not specified. In New York, the law authorizes the OPMC to use the original complaint to gain access to the physician's charts, but the final charges may not be the same as the original complaint. In other words, they can use anything they find, even if totally unrelated to the original complaint. (Shades of Ken Starr)

11. Regardless of innocence or guilt, investigations can be ruinous to the practice, reputation, finances, and ultimately to the family security of the physician accused. Thus totally unfounded charges can be used to attack a physician very effectively.

12. Widespread campaign of intimidation: numerous other Lyme doctors have been targeted, resulting in their licenses being restricted (typically restricted from treating Lyme patients). Significantly, allegations are seldom based on complaints from a patient. To the contrary, patients have jumped to the defense of their treating doctors and contributed to defense funds.

13. Long range effects: other doctors are reluctant to accept Lyme patients because of controversy, the acrimonious atmosphere, and fear of this kind of attack. This leads to further difficulties for all Lyme patients. Doctors with Lyme patients often choose not to report cases because they believe it invites trouble that might put their practices at risk.