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A War Over Lyme Disease
The debate about how to treat this illness has patients raging—and doctors losing their licenses
By David France

  Nov. 13 issue — A few days before Halloween, a popular Long Island, N.Y., Lyme-disease specialist named Joseph Burrascano entered a state Health Department hearing room where one of medicine’s rancorous academic disputes will be played out: how much antibiotics is too much when treating Lyme?   THIS IS NO mere intellectual inquiry. Burrascano is standing trial before the Office of Professional Medical Conduct on negligence charges for medicating some patients for several years on end. By next February he could be censured or even stripped of his medical license as a result.   Behind this drama is a seemingly simple problem that has balkanized the Hippocratic community. One side, which includes academics and insurance companies, says Lyme can be cured with just four weeks of antibiotics; much more than that is unwarranted, hard on gallbladders and costly besides. The other side, mostly doctors and their patients, says that in rare intractable cases the infection will require repeated or prolonged courses of antibiotics, costing up to $20,000. Both sides have won huge research grants and have published their studies in medical journals.

        Other medical fields are marked by roiling disputes, like whether too many children are drugged for attention-deficit disorders. But as Robert Cassidy, director of biomedical ethics at Long Island Jewish Hospital in New York, puts it: “This is usually the sort of thing that is fought out at professional meetings, not by tearing off epaulettes in the parade ground.” Nonetheless, physicians who use antibiotics aggressively have been scrutinized in Michigan, New Jersey, New York, Pennsylvania, Connecticut, Rhode Island and Oregon, at the urging of scientists from the other side of the dispute, advocates say. Several have lost their licenses. What is going on? Connecticut Attorney General Richard Blumenthal, for one, sees conflict of interest: some witnesses against these doctors may collect money from insurers, he says. “Our doctors are on tenterhooks,” says Pat Smith, president of the Lyme Disease Association. “What have these people done outside of treating sick people for their Lyme disease?”   Burrascano is convinced his prosecution is entirely political, “about differences in opinion about treatment.” As a published Lyme expert who has testified before Congress, Burrascano says he has treated some 7,000 people from 42 states and 11 countries. “I’m no country doc,” he says. “It’s not like I’m doing hocus-pocus.”

        In their complaint, state investigators charged him with mistreating nine patients. But those patients side with their doctor. Ruth Giglio, 77, a retired schoolteacher who took several courses of antibiotics over a six-year illness, was surprised to learn her charts are evidence against Burrascano. “I totally agree with everything he did,” she says. “I’m better, and that’s thanks to Dr. B.” So now it is she who ministers to the doctor—she plans to join other patients at a defense rally this week. “This is tantamount to a witch hunt as far as I’m concerned.”
        2000 Newsweek, Inc.

“Our doctors are on tenterhooks.”
president of the Lyme Disease Association