Lawmakers overreach in casting themselves as infectious-disease specialists
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I applaud the Globe for its support of Governor Baker’s veto of the Lyme disease treatment provisions in the recent budget (“Two votes on health: One wise, one emotional,” Editorial, Aug. 3). A sensible alternative bill proposed by the governor, which mandated that board-certified physicians specializing in infectious diseases, neurology, or rheumatology be consulted and accede to unusually long treatment for Lyme disease, was not adopted. Instead, and unfortunately, lawmakers overrode Baker’s veto.
It seems, therefore, that we have some new infectious-disease specialists in practice in Massachusetts. They are not physicians or other health professionals. They certainly are not trained in or board certified in infectious diseases, a process that takes at least five years after graduation from medical school. And, while they are not licensed to write any prescriptions, they seem to feel competent to mandate off-label prescribing for potent antimicrobial agents at a time when overprescribing antibiotics has resulted in widespread antimicrobial resistance.
Who are these unlicensed practitioners? They're our legislators.
Lyme disease and other tick-borne illnesses are serious, and it is imperative to treat them promptly, properly, and vigorously. Unfortunately, some practitioners have taken it upon themselves to treat Lyme disease in unproven ways. Study after study has shown such treatment to be no better than a placebo. Meanwhile, prolonged antibiotic treatment, besides promoting antibiotic resistance, can cause serious side effects while not having demonstrated efficacy.
Yes, additional research may be warranted as to why some patients experience prolonged symptoms after Lyme disease or other infections. But weeks or months of potent antibiotics are not the answer.
The Legislature seems to have been hijacked by an antiscience movement, armed with anecdote rather than data. I thank Baker for being clear-minded and courageous on this issue, for heeding science, and for listening to the Massachusetts Infectious Diseases Society. The Legislature, on the other hand, has acted unwisely. I hope that when lawmakers reconvene, they will reverse their stance.
The writer is the associate chief of the Infectious Diseases Service at Newton-Wellesley Hospital and a professor of medicine at Tufts University School of Medicine.