Lyme Disease Doctor's Survey
Your City, County, State and Zipcode ________________________________________________
Number of patients seen per week (average) _______
Specialty _________________________
1. Where do you generally get your information about Lyme disease?
Internet _______ Medical Journals _______ Colleagues _______
Department of Health and Mental Hygiene _______ CDC _________
Other- please indicate ___________________________________________________
2. Do you have a private practice, are you connected to a hospital/academic center or are you in a group practice setting?
Private Practice _______ Group Practice _______ Hospital/Academic Setting _______
3. How many patients with tick bites have you seen in the past 12 months?
Zero _______ 1-10 _______ 11-20 ______ 21-30 _______ 30- 40 _______ 40-50 _______
More than 50 _______ More than 100 _______ Other ________
4. How many patients with Lyme disease have you seen in the past 12 months?
Zero _______ 1-10 _______ 11-20 ______ 21-30 _______ 30- 40 _______ 40-50 _______
More than 50 _______ More than 100 _______ Other ________
5. How many tests have you ordered for Lyme disease in the past 12 months?
Zero _______ 1-10 _______ 11-20 ______ 21-30 _______ 30- 40 _______ 40-50 _______
More than 50 _______ More than 100 _______ Other ________
6. Do you routinely provide information (handouts) to patients about Lyme disease?
Yes _______ No _______ If so, where did you get the materials? __________________________
7. Do you discuss prevention methods concerning tick bites or Lyme disease with your patients?
Always _______ Seldom _______ Only when approached _______ Never _______
8. The physical exam finding of erythema migrans rash alone is sufficient to establish the diagnosis of Lyme disease?
True _______ False _______ Don’t Know _______
9. What is the name of the infectious agent that causes Lyme disease?
Babesia microti _______ Ixodes damini _______
Borrelia burgdorferi _______ Bartonella quintana _______
10. Do you report cases of Lyme disease to the Maryland Department of Health and Mental Hygiene?
Always ________ Sometimes ________ Rarely _______ Never ________
11. Which of the following may be signs or symptoms of Lyme disease?
Fever _______ Third-degree heart block _______ Fatigue _______
Migratory arthralgias _______ Conjunctivitis _______ Bell’s palsy _______
Pain in bursae, tendon, muscle or bone _______ Goiter _______
Cranial neuropathies _______ Meningitis _______ Arthritis _______
12. How would you usually treat an asymptomatic patient with a recent tick bite who had no lab testing performed to date?
_______ Query patient about length of tick attachment/type of tick, then determine action to take
_______ Test patient and wait for results to determine appropriate action to take (follow-up)
_______ Prescribe antibiotics as a preventative measure- If so please indicate duration __________
_______ Wait to see if symptoms develop and then treat
_______ Other- please specify _________________________________________________________
13. When is testing for Lyme disease most appropriate?
_______ At the time of tick attachment
_______ One week after tick is removed
_______ Three weeks after a tick bite
_______ All of the above
14. If a patient has an erythema migrans rash and negative Lyme test(s) should they be treated for Lyme disease?
Yes _______ No _______ Don’t know _______
15. How often do you test for tick-borne coinfections?
Never _______ Occasionally _______ Always _______
16. What tick borne coinfections have you tested for in symptomatic patients with a history of a tick bite?
Rocky Mountain Spotted Fever _______ Babesiosis _______ Borrelia lonestari _______
Anaplasmosis _______ Ehrlichiosis _______ None _______
17. If patient remains symptomatic after initial treatment or relapses, what course of action do you generally take?
Re-treat ____ Re-test ___ Consider alternate diagnosis ____ Treat symptomatically _______
Refer to another specialty _____ If so, what specialty? _________ None of the Above ________
Thank you for participating in this survey.