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ROUGH DRAFT
Doctor Protection Bill
Administration of alternative and long-term antimicrobial therapy upon diagnosis of Lyme disease or tick and vector borne diseases
Section 1. (a) As used in this section, the following words shall have the following meanings:
“Alternative”- method of diagnostic evaluation and treatment that can be considered integrative, complementary, alternative or nonconventional.
“Long-term antimicrobial therapy”- administration of oral, intramuscular or intravenous antimicrobials singly or in combination, for periods of time in excess of two (2) weeks.
“Lyme disease”- the clinical diagnosis of a patient by a licensed provider of the presence of signs or symptoms compatible with acute infection with one or more known or emerging Borrelia strains; late stage, relapsing, persistent or chronic infection with one or more known or emerging Borrelia strains; or complications related to such infections.
“Tick or vector borne diseases” the clinical diagnosis of a patient by a licensed provider of the presence of signs or symptoms compatible with acute infection with known or emerging tick or vector borne organisms, including, but not limited to Lyme disease, spotted fevers (Rickettsia); Ehrlichia, Anaplasma, Babesia; Bartonella; Powassan, Heartland, Bourbon and emerging viruses; Mycoplasma; Q-fever (Coxiella burnetti); Tularemia (Francisella tularensis); late stage, persistent or chronic infection with one or more tick or vector borne organisms; or complications related to such infectious organisms.
(b) Clinical diagnosis for Lyme and tick or vector borne diseases shall be based on knowledge obtained through a medical history and physical examination only, or in conjunction with available testing that may provide supportive data for such clinical diagnosis.
(c) A licensed physician may prescribe, administer or dispense long-term antimicrobial therapy for a therapeutic purpose to eliminate infection or to control a patient’s symptoms upon making a clinical diagnosis that the patient has Lyme or other tick or vector borne diseases or displays symptoms consistent with a clinical diagnosis of tick or vector borne diseases if the licensee has obtained informed consent and such clinical diagnosis and treatment are documented in the patient’s medical record by the prescribing licensed physician as described in Section 2(b).
(d) A licensed health care provider may prescribe, administer or dispense alternative treatment considered to be integrative, complementary, alternative or nonconventional for a therapeutic purpose to eliminate infection or to control a patient’s symptoms upon making a clinical diagnosis that the patient has Lyme or other tick or vector borne diseases or displays symptoms consistent with a clinical diagnosis of Lyme or tick or vector borne diseases if the licensee has obtained informed consent and such clinical diagnosis and treatment are documented in the patient’s medical record by the prescribing licensed health care professional as described in Section 2(b).
Section 2. (a) A health occupations board shall not revoke, fail to renew, suspend or take any action against a health care provider’s license for prescribing, administering or dispensing long-term antimicrobial therapy for a therapeutic purpose to eliminate infection or to control a patient’s symptoms or because the licensee’s methods of diagnostic evaluation or treatment are integrative, complementary, alternative or nonconventional if the licensee has obtained informed consent consistent with Section 2(b).
(b) Informed consent shall document by written consent that the patient, guardian or parent of a minor child has been reasonably informed:
1.) The diagnostic or treatment methods employed by a licensed health care professional generally or in the instance proposed for use exceeds two (2) weeks of antimicrobial therapy for treatment related to Lyme or tick or vector borne diseases or the related symptoms, or is considered integrative, complementary, alternative or nonconventional; and
2.) Of the known risks and benefits of the proposed methods.
Section 3. The protections provided in this Chapter do not apply in a case in which it can be shown by clear and convincing evidence that the health care provider knew that the diagnostic or treatment method did not have a reasonable basis and was intended to defraud the patient.
[NOTE- I predict this bill would have about a 20% chance of passing in the current Maryland Legislature (2019). It would certainly help Lyme patients and doctors, and be very nice if it did.]
Lucy Barnes
September 2018
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