-Caveat Lector-
Debate rages over Lyme treatment
Doctors, patients divided on therapy for tick-borne disease
By Linda Carroll
SPECIAL TO MSNBC
PHILADELPHIA. Nov. 1 - Demonstrators invaded the normally staid and studious
atmosphere of a national medical meeting here Wednesday, carrying placards
and doling out leaflets intended to refute the teachings of a prominent Lyme
disease expert.
Post your views on MSNBC's Health Bulletin Board
THE FOCUS of their ire was Dr. Alan Steere, a renowned
rheumatologist who originally linked the disease with tick bites and named
it after the town in Connecticut where it was discovered.
Steere has become a lightning rod for angry patients who feel that
his prominence has given his opinion more weight in the ongoing medical
debate over whether Lyme is over- or under-treated. He, along with many
physicians, supports a short-term course of antibiotics while other doctors
disagree, saying that patients may need months, sometimes years, of
treatment.
Live chat today at 6 p.m. E.T.
At the annual meeting of the American College of Rheumatology, dozens
of patients gathered around the front door of the conference center, where
they could catch doctors drifting out for lunch. They said they were holding
a "teach-out" to counter what Steere told rheumatologists inside the
building in a morning session in which he had promised to teach "How to
treat and diagnose Lyme disease." Steere is a researcher at the Tufts
University School of Medicine in Boston.
ONGOING DEBATE
The demonstration is the latest salvo in an unusually acrimonious
academic argument. Patients say they are caught in the middle, that they
have trouble getting proper care and that insurance companies are loathe to
pay the high price of long-term intravenous antibiotic therapy when leading
experts like Steere say that such treatments are completely unnecessary.
Early signs of Lyme disease . Headache
. Neck stiffness
. Fever
. Muscle and joint pain
. Fatigue
. Forgetfulness
. Bull's-eye rash
Patients are particularly incensed by Steere's involvement in the
malpractice investigation of Dr. Joseph Natole of Saginaw, Mich., who had
been treating Lyme patients with intravenous antibiotics. Steere testified
against the Michigan doctor, and Natole lost his medical license for six
months.
Patients decided to fight back, by protesting against Steere when he
makes public appearances and by filing complaints against him in his home
state of Massachusetts. One of the Lyme support groups has been encouraging
disgruntled Steere patients to file complaints with the state's medical
board. Thus far, the medical board has received more than 50 complaint
letters concerning Steere, according to the Massachusetts Lyme Disease
Coalition.
As the patient groups have become increasingly vocal, Steere has
become more reclusive. He has refused press interviews, including interview
requests for this article.
Outside the meeting, patients talked about why they were targeting
Steere in particular. "He has been the most public," said Susan MacNamee,
43, of Perkasie, Pa. "He's the most well known. He even discovered it. So
doctors believe what he says."
Others suggested that Steere's vocal opposition to long-term
antibiotics have led insurance companies to refuse payment for these
treatments. "When he stands up and says we all are cured after four weeks of
antibiotics, we can't get treatment," says Gail Wallin, 50, of Holland, Pa.
PHYSICIANS ON BOTH SIDES OF DEBATE
Doctors, for the most part, hurried by the protestors, ignoring their
promises to "tell the truth about Lyme disease." Some physicians, like Dr.
H. Paul Lasky, stopped to spar with the protestors, attempting to convince
them that Steere's analysis of the disease is right.
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Lasky, a physician in private practice in Cornwall, N.Y., believes
that the patients who believe they have chronic Lyme disease have simply
been duped by the companies selling intravenous therapy.
But a Swiss doctor who stopped to talk was perplexed by all the
furor. There is no controversy over Lyme disease in Europe, said Dr. Fritz
Hasler, a physician in private practice in Chur, Switzerland. Doctors simply
treat patients with antibiotics until they get better, Hasler said.
Hasler said he attended Steere's presentation earlier in the day. "He
gave a very good talk about the American view," Hasler said. "He made it
clear that he thinks in Europe we may have different patient populations."
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