1. Maryland Lyme-treating doctors already have protection from being targeted for over diagnosing and over treating Lyme disease. The Maryland Board of Physicians issued an official statement and the Maryland Department of Health and Mental Hygiene Task Force Report confirmed that position.
2. Several years ago a Lyme disease bill that would have helped patients passed in the House. It was later gutted, combined with another bill and rewritten by the Senate Health Committee. The resulting bill would have been potentially dangerous for Lyme patients and their treating doctors and would have limited the patients ability to be treated. In the final version the Maryland Board of Physicians would have been required to develop and subsequently deliver to all Maryland doctors a set of diagnostic and treatment guidelines that would determine what the State of Maryland determined to be appropriate medical treatment for patients with Lyme disease, taking choices away from doctors and patients.
"(THE BOARD SHALL DEVELOP AND DISSEMINATE A DOCUMENT TO ALL LICENSEES
REGARDING THE MOST RECENT DIAGNOSIS AND TREATMENT INFORMATION
FOR LYME DISEASE
AND OTHER RELATED TICK-BORNE ILLNESS.
(B) THE DOCUMENT DEVELOPED AND DISSEMINATED UNDER SUBSECTION
(A) OF THIS SECTION SHALL:
(1) INCLUDE THE MOST RECENT INFORMATION REGARDING THE USE
OF LONG-TERM ANTIBIOTIC OR ANTIMICROBIAL THERAPY; AND
(2) BE DISTRIBUTED ANNUALLY."
3. The Maryland DHMH hosted a Task Force that included patient advocates on its subcommittee. Their final report included a re-confirmation of the doctor protection statement originally issued by the Maryland Board of Physicians. The statement also confirmed that no set standard of care had been enacted for our State, leaving doctors and patients open to making choices for their health care issues.
3. The recently established IDSA Guideline Review Panel has not issued its final report concerning the revision of the IDSA's biased and totally unacceptable Lyme disease guidelines. The very foundation of Lyme disease and the science behind it remains unsettled. To enact laws based on scientific and medical theories that are being reviewed and revised would not be advisable.
Letter to Legislators
January 2, 2010
Dear Legislator,
We will be forwarding our annual Lyme Disease 2010 Update in the near future. In the meantime, questions concerning Lyme disease related legislation have been circulating through the community and we would like to address that situation with you.
Due to ongoing developments and legal actions that have the potential to change the policies regarding Lyme disease diagnosis and treatment protocols, Lyme-related insurance issues, prevention methods, reporting criteria and a physicians ability to treat patients without fear of reprisal, we humbly request that no legislation be enacted into law during the 2010 session.
As you may know, the Infectious Diseases Society of America (IDSA) Lyme Disease Guideline authors (lead author, one panel member and editor, an IDSA spokesman, all from or currently located at Johns Hopkins), were investigated by Attorney General Richard Blumenthal (CT) for questionable practices related to the IDSA Lyme disease guideline development process. The AG’s report included, in part, the following significant findings:
"The IDSA's 2006 Lyme disease guideline panel undercut its credibility by allowing individuals with financial interests -- in drug companies, Lyme disease diagnostic tests, patents and consulting arrangements with insurance companies -- to exclude divergent medical evidence and opinion. … The IDSA portrayed another medical association's Lyme disease guidelines [Neurology] as corroborating its own when it knew that the two panels shared several authors, including the chairmen of both groups, and were working on guidelines at the same time.”
As part of a settlement agreement, the following actions were required of the IDSA and were eventually set in motion to address the conflict of interest issues.
"… the panel will conduct an open scientific hearing at which it will hear scientific and medical presentations from interested parties... Once the panel has acted on each recommendation, it will have three options: make no changes, modify the guidelines in part or replace them entirely."
The IDSA Guideline Review Panel met on July 30, 2009. Over 1900 pages of analysis strongly contesting IDSA recommendations were submitted by the International Lyme and Associated Diseases Society (ILADS). Members of the Lyme Disease Education and Support Groups of Maryland also submitted several detailed documents addressing the inadequate treatment of chronic Lyme disease patients, the faulty “one pill” cures all theory, the diagnostic tests which miss 75% of those infected and the prevention and reporting practices that are at best, sub-standard.
Until all submissions have been thoroughly reviewed by the Panel and the IDSA Guidelines have been adequately addressed (possibly revised/discarded), and the findings are approved by AG Blumenthal’s office and our legal/medical advisors, we feel legislation regarding Lyme disease should be not be enacted into law in Maryland.
Diana Olson, IDSA VP of Communications, stated that the IDSA review panel is hoping to release their recommendations “as early as possible in the new year [2010]”; however, revising the guidelines would take an additional “several months to a year or more”.
At the federal level, Congressional hearings to address multiple Lyme disease issues and the related federal bill, HR 741 (sponsored by Christopher Smith, NJ and unanimously supported and cosponsored by all Maryland Congressmen) were in the planning stages. Due to the potential changes expected in the IDSA Lyme disease guidelines the hearings were postponed by Congressman Frank Pallone until the legal actions taken against the IDSA are settled and a final report is released.
Success surrounding legislation that was recently passed in Connecticut (HB 6200) to address doctor protection issues, where it was a significant problem, has created a flurry of activity throughout the Lyme community and we realize as a result that some Maryland patients may want to join in the victory celebration and initiate legislation in our State to try to help patients and doctors here. Some patients may not be aware of the fact that we have already addressed this situation.
As a result the Maryland Board of Physicians issued an official statement that doctors in Maryland would not be targeted for over diagnosing or over treating Lyme patients. The Maryland Department of Health and Mental Hygiene (DHMH) reissued the Board's statement and also confirmed the fact that there is no set 'standard of care' in Maryland that would limit reasonable treatment options. Over the years the Board has kept their word to not target our health care professionals. Additionally, no charges have been filed against Lyme-treating doctors for over treating Lyme disease and the Board has allowed responsible Maryland physicians to practice medicine on a case by case situation.
The ‘DHMH 2007 Report of the Lyme Disease Subcommittee of the Maryland Vector-Borne Disease Interagency Task Force’ (pg. 12) stated:
“In its Fall 2005 Newsletter5, the Board clarified that: § It does not target or restrict the treatment of LD. § It does not support the concept of “immunization” of any physician from scrutiny because of the particular disease, patients treated or location of practice. § The Board does not create, promulgate, or endorse in advance specific guidelines regarding any disease state.
As long time supporters of our situation, we are confident you would not want to see legislation passed in Maryland that may be non-relevant, outdated, dangerous or require significant changes after it became law. Therefore, we hope you will proceed accordingly and not support Lyme related legislation this year. We thank you in advance for your continuing support.
Sincerely,
Lucy Barnes, Director
Lyme Disease Education and Support Groups of Maryland
References
Attorney General Report
http://www.ct.gov/ag/cwp/view.asp?a=2795&q=414284
Report of the Lyme Disease Subcommittee
http://www.edcp.org/vet_med/pdf/Recommendations_LD_Plan07.pdf