As Dr. Marty Ross points out, preliminary results of three CDC studies demonstrate that (1) Lyme disease is a big problem, and (2) most physicians in the community do not follow the IDSA Lyme guidelines. His conclusion is that we should simply ignore the faulty and archaic IDSA guidelines and move forward, relying on clinical experience and research advances that will improve the lot of patients with Lyme disease.
While we agree with the “move on” sentiment, the political reality of Lyme disease is not that simple. Insurance companies continue to deny treatment for Lyme disease and medical boards continue to prosecute Lyme-literate physicians based on failure to adhere to the IDSA guidelines.1,2 Hence, revision of these guidelines is essential to improve treatment options for Lyme patients and practice options for physicians. Until these guidelines are amended to reflect current clinical and research advances, patients and clinicians will continue to suffer the slings and arrows of insurance company denials and medical board disciplinary actions that are based on the inadequate “standard of care” proffered by the substandard IDSA Lyme guidelines. In summary, the IDSA guidelines are a significant stumbling block that must be removed to allow Lyme patients to benefit from appropriate treatment by physicians who are not afraid to heal them.
Raphael B. Stricker, MD* and Lorraine Johnson, JD, MBA*
*International Lyme and Associated Diseases Society, Bethesda, MD 20827-1461. www.ILADS.org
1. Johnson L, Stricker RB (2010) The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about development of clinical practice guidelines. Philos Ethics Humanit Med 5:9.
2. Stricker RB, Johnson L (2013) Chronic Lyme disease: Liberation from Lyme denialism. Am J Med 126:e13-14.