OHP's mission is to provide care to people suffering from disease We focus on the medical detective work required to find and treat the sources of illness and, often, the myriad health consequences of tick bites. According to the Centers for Disease Control and Prevention, the diagnosis of Lyme disease is primarily a clinical determination made by a doctor based on a person's exposure to ticks and report of symptoms, and the doctor’s observation of signs of the disease with diagnostic tests playing a supportive role.
OHP and many other physicians follow these classical clinical criteria for diagnosing Lyme disease. We believe it is better to err on the side of treatment than to failing to treat active Lyme disease and have the patient suffer the serious consequences. Other doctors differ in how they diagnose Lyme disease and rely on narrow CDC surveillance case criteria even though the CDC itself cautions against this approach. These physicians may fail to diagnose some patients who actually have Lyme disease.
Statement by the Maryland Board of Physicians
In its Spring 2010 newsletter, the Maryland Board of Physicians published a succinct statement regarding Lyme disease, its treatment, physicians' responsibilities when following nonstandard treatments, and its position on physicians' use of long-term antibiotic therapy. Optimal Health Physicians fully agrees with this statement and complies fully with the Board's recommendations. The Board states:
"Lyme diseasecontinues to be the most commonly reported vector-borne illness in the United States, especially along the Eastern seacoast. When it is diagnosed and treated early. treatment with antibiotics may be successful. Early symptoms include the characteristic "erythema migrans" rash at the site of the bite, chills, fever, headache, stiff neck, tiredness.Joint pains, swollen lymph nodes, and a rash spreadingto other parts or the body. Without treatment, the disease may progress to arthritis, meningitis, facial nerve paralysis, or hearing abnormalities.
"There is a considerable controversy about the appropriate therapy when Lyme disease is not diagnosed early or does not respond to the standard course of treatment. Many patient advocacy groups claim that medical boards are disciplining physicians for use of non-standard treatment models, thus discouraging physicians from deviating from standard treatment protocols. The Maryland Board of Physicians has never sanctioned a physician for over-prescribing antibiotics or for treatment of patients with confirmed or suspected Lyme disease. The Board of Physicians recommends that any physician using nonstandard treatments for any patient adhere to the following principles:
1. Adequate diagnosis and an explanation of options should be provided to the patient;
2 The non-scientific method should not be used to the exclusion of scientifically proven effective methods;
3. Use of alternative therapies does not relieve a physician from the duty to refer to appropriate professionals or to keep a complete medical record;
4. If the patient rejects a scientific modality of diagnosis or treatment in favor of an unproven method, a meaningful informed consent must be completed and documented in the medical record;
5. An unproven treatment should not be pursued indefinitely in the face of failure to achieve the desired effect, and
6. The unproven method should not have the potential to harm the patient.
"Adherence to these principles and documentation in the patient's medical record should improve patient satisfaction and treatment outcomes as well as protecting the physician from a charge of failure to meet the standard of quality care."
