In the Lymelight: Law and Clinical Practice Guidelines

Susan J.D. Ronn


South Med J. 2009;102(6):626-630. 

In This Article

What's Next?

Will the Lyme Wars give way to consensus? Or yield to a more transparent and possibly fruitful discussion about the disagreements concerning the diagnosis and treatment of Lyme disease?

Although the investigation and agreement are unprecedented in a narrow sense of the idea, legal action in Lyme-related issues is not new. For instance, some states, including Rhode Island, Connecticut, New Hampshire, New York, New Jersey, California, Maryland, Maine, and West Virginia have enacted legislation covering Lyme disease issues such as mandating insurance coverage for long-term antibiotic use and protecting doctors from discipline when they utilize treatment modalities other than those proscribed by IDSA.[24] Hearings have also been conducted in Pennsylvania, Florida, and Massachusetts.

Medical practice in the United States is a business. Healthcare entities cannot be shielded from the law. Indeed, the law helps ensure due process and fair practice within the healthcare industry. In this particular instance, the law has stepped into a veritable war zone, and demanded that no biased restraint be placed on doctor or patient choices for the treatment of Lyme disease. As Blumenthal himself has expressed, the law is not concerning itself with the science, but with the legal and ethical process: In today's healthcare system, clinical practice guidelines have tremendous influence on the marketing of medical services and products, insurance reimbursements and treatment decisions. As a result, medical societies that publish such guidelines have a legal and moral duty to use exacting safeguards and scientific standards.[1]

Perhaps the state where Lyme disease first raised its ugly head could also be the state that hosts the beginning of working toward a consensus in the Lyme medical community, helping to ensure that all credible research be considered in order to fully inform physicians treating and patients suffering from this disease. At the very least, the light is shining on this process; what happens next is now in the hands of the new panel, and those who are watching from the wings.


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