New Bill Targets Lyme Disease

The Vermont Senate gave preliminary approval to a bill that would protect medical professionals from prosecution by state regulators for prescribing long-term treatment for Lyme disease on Thursday, April 10.

The vote, 27-0 in favor of the legislation, followed a unanimous precursory vote by a Senate committee on Friday, April 4, which recommended the bill’s passage during the full Senate vote.

The decision follows a heated controversy over the use of long-term drugs — medication lasting longer than a month — antibiotics for curing symptoms of chronic Lyme disease, which has become a more viable option because of the bill. In the past, any health professional who wished to prescribe long-term antibiotics feared the risk of losing his or her medical license on account of professional conduct charges to the Medical Practice Board.

Though no such incidents have occurred in Vermont, these limitations have led Vermont citizens to seek treatments in other states. States such as Connecticut, Massachusetts, California and Rhode Island have approved similar legislation to protect doctors from such prosecution.

Lyme disease is  considered an epidemic in Vermont and can be found in every county in the state. Last October, the Center for Disease Control reported that the number of Lyme cases in Vermont has increased by over 1000 percent during the past eight years. Though the disease is fairly treatable when caught in its early stages, it can become severe if patients go a long time without being diagnosed, potentially leading serious neurological problems.

Dr. Stephen Phillips, who practices in Connecticut, treats many patients for Lyme and insisted there is “overwhelming evidence” that the Lyme bacteria can persist after short or moderate antibiotic treatment.

Ellen Read, a victim of chronic Lyme disease from St. Albans, Vt., shared her story, saying “My recovery was incomplete. I went on to develop debilitating neurological Lyme disease.”

Read discussed the impact of the disease on her life – as she was unable to work – by saying, “I estimate my lost earnings to be between $200,000 and $250,000.”

Though victims of long-term Lyme symptoms look hopefully to the new procedure, the treatment is still considered experimental, and has caused much debate between medical professionals over its necessity and effectiveness. Many doctors disapprove of the long-term antibiotic treatment because it involves an elaborate process, including intravenous administration and surgery. Moreover, there is no concrete evidence that the new technique is effective in curing symptoms of Lyme.

Represent George Till of Jericho, Vt., said during an interview that studies conducted by the National Institutes of Health had “not demonstrated any long-term benefit from long-term antibiotics”. Dr. Robert Wheeler, chief medical officer and vice president of Blue Cross Blue Shield of Vermont, asserted that repeated or long-term intravenous antibiotic therapy is “not medically necessary.”

Extensive use of antibiotics carries additional risks, such as widespread evolution of bacteria to develop increased resistance. Dr. Harry Chen, the Vermont Health Commissioner, has expressed concern that expanded use of antibiotics could create more “super-bugs”, impervious to current treatments.

Some people are objecting the government’s role in legislating medical decisions. Madeleine Mongan of the Vermont Medical Society openly opposed the bill, stating, “we don’t think it is appropriate for the legislature to be legislating the standard care.”

Karen Allen, a lawyer representing the Vermont Association of Justice, said, “I’m not saying this shouldn’t be treated with long-term antibiotics. I’m saying it shouldn’t be legislated. The Legislature is not the place to settle this medical science controversy.”

Allen argued at a panel in front of the House Health Care Committee in February, insisting that state law did not prevent doctors from issuing long-term antibiotics, and that they could not be prosecuted by the medical practice board for pursuing such treatment as long as they “are documenting it and have done due diligence.”

In contrast, many view the new bill as allowing health professionals greater freedom to decide the proper course of action for their patients. Susan Chinnock of Westford, Vt., a victim of Lyme disease, believes the bill gives doctors “the right to treat as they see fit.”

The bill outlines the necessary steps doctors must follow if they wish to treat their patients with long-term antibiotics, including documentation of diagnostic reasoning in addition to obtainment of patient consent prior to administering a Lyme disease diagnostic test or long-term treatment. The legislation also states that doctors can still be prosecuted if they are found to have violated professional standards in other ways.