LymeNet Newsletter Volume 4 Issue 02

Volume: 4
Issue: 02
Date: 12-Feb-96

Table of Contents:

I. LDF: CT Health Department Drops Charges Against Watsky II. LYMENET EDITORIAL: Groundless Watsky Charges Are A Tool For Misguided Political Intimidation III. J NEUROPSYCHIATRY CLIN NEUROSCI: Rapidly progressive frontal-type dementia associated with Lyme disease IV. About The LymeNet Newsletter

Newsletter:

*********************************************************************** * The National Lyme Disease Network * * LymeNet Newsletter * ***********************************************************************

IDX# Volume 4 - Number 02 - 2/12/96 IDX# INDEX IDX# IDX# I. LDF: CT Health Department Drops Charges Against Watsky IDX# II. LYMENET EDITORIAL: Groundless Watsky Charges Are A Tool IDX# For Misguided Political Intimidation IDX# III. J NEUROPSYCHIATRY CLIN NEUROSCI: Rapidly progressive IDX# frontal-type dementia associated with Lyme disease IDX# IV. About The LymeNet Newsletter IDX#

QUOTE OF THE WEEK:

"There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance."

-- Hippocrates, c. 460-377 B.C.

I. LDF: CT Health Department Drops Charges Against Watsky ------------------------------------------------------------ Sender: Thomas Forschner <[email protected]> Date: February 5, 1996 -- FOR IMMEDIATE RELEASE

CT Health Department Drops Charges Against Doctor Treating Chronic Lyme Disease

George Gunther, Chairman of the Public Health Committee telephoned Dr. Phil Watsky of Bristol, CT Wednesday night and informed that the charges brought against him by the State of Connecticut Dept. of Health (DOH) had been dropped. Dr. Watsky was denied participation into at least two managed care plans due to the charges.

Warren Wollschlager of the DOH called the Lyme Disease Foundation Thursday morning and confirmed that the department's proceedings against Dr. Phil Watsky have been stopped.

These charges originated because of a 1993 letter to the DOH written by a pediatrician accusing Dr. Watsky, a Board Certified Internist, of over diagnosing, over treating and profiteering from his Lyme disease patents. The letter stated that the charges were based on second hand information.

The DOH initiated an investigation this summer and requested the records of 2 specific patients (we do not know how they were selected) from Dr. Watsky. The profiteering charge and one of the two patients selected were immediately dropped (both patents are adults and neither patient had complained about their care). The remaining adult patient's records were sent out for review by a pediatrician recommended in the 1993 letter.

After an intense 2 1/2 hour meeting at the DOH on December 12, 1995, where Dr. Watsky was questioned about every aspect of this one patients care the DOH announced that they would request a second review of this patients records by another of their consultants.

In the last two weeks an outpouring of support in Connecticut and across the country from Dr. Watsky's colleagues, the Centers for Disease Control and from the public and was focused on the Governor, the Commissioner of Health, Chairman Gunther, and the Hospital administrators of the pediatrician who sent the original letter.

There are however some remaining issues:

* How did the DOH select the patient to be reviewed, was there a breach of confidentiality ? * Donna Brewer, Chief of the DOH's legal office in a letter to Watsky advised him that although the investigation was concluded, because they couldn't find sufficient evidence to support the claim against him the DOH is concerned about health dangers from long term IV antibiotic therapy. The letter also goes on to say that the DOH could "re-examine" the case if more information comes to light.

The Lyme Disease Foundation (LDF) supports the decision of the DOH to drop the case and urges all the parties involved to work together to address the problems of diagnosing and treating Lyme disease on a productive and not on a punitive basis. The medical atmosphere in the state had been chilled because of the allegations.

This unfortunate episode points out the very significant need for education, investigation and cooperation to try and deal with the very complicated and swiftly evolving areas of Chronic Lyme disease as well as other Tick-Borne disorders.

The Lyme Disease Foundation is actively working to address the issues of Chronic Lyme disease: (contact LDF Medical Director Martina Ziska, MD for more information).

* The LDF is conducting an international conference on Chronic Lyme Disease on April 19 & 20 in Boston Ma. * The LDF is also seeking support for a study to address the issue of treatment of Chronic Lyme disease. Answers are at least one year away if full funding ($250,000) is obtained.

The Lyme Disease Foundation is a Connecticut based national voluntary health organization dedicated to making Lyme and other Tick-Borne illnesses non-risks. Research, education and advocacy are all used to achieve this goal. The Foundation was founded in 1988 to address the emerging epidemic of Lyme disease throughout the Untied States and around the world. For more information on Lyme and other Tick-borne disorders, call the National Hotline at 800-886-LYME (5963).

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II. LYMENET EDITORIAL: Groundless Watsky Charges Are A Tool For Misguided Political Intimidation ----------------------------------------------------------------- Sender: The LymeNet Editorial Team

witch-hunt: n. An investigation carried out ostensibly to uncover subversive activities but actually used to harass and undermine those with differing views.

After an extensive inquiry, charges against Dr. Phil Watsky, a family physician in Bristol, Connecticut, were dropped last week by the Connecticut Medical Board of Examiners. Dr. Watsky was under investigation for the alleged overdiagnosis and overtreatment of Lyme disease. In addition, he had been accused of "profiteering" from "unnecessary" therapies.

The investigation was launched on the basis of a complaint filed in 1993 by Dr. Lawrence Zemel, Director of Pediatric Rheumatology at Newington Children's Hospital. No patient or ex-patient of Dr. Watsky participated in the investigation or in any way suggested that he or she received anything less than satisfactory care.

Dr. Watsky, like many other front line clinicians in the Lyme disease arena, is caught in a vice between medical orthodoxy and his Hippocratic duty to treat his patients to the best of his ability according to his best medical judgment. Despite numerous studies -- microbiological, clinical and pathologic -- that expose the poverty of the current Lyme disease model, the ideologues who control the Lyme disease debate have been relentless in their refusal to let go of their dogmas and have continued their campaign of harassment against the heretics who dare to challenge their views.

In Lyme disease, the "standard of care" as defined by the academicians who wage war against clinicians like Watsky is hopelessly outdated in the areas of both diagnosis and treatment. Claims that patients with Lyme disease invariably test positive on serologic tests have been repeatedly proved false by culture isolation of Borrelia burgdorferi, the Lyme disease spirochete, from seronegative, clinically ill patients. Likewise, while medical convention holds that the Lyme disease agent yields to short term antibiotic therapy, there are scores of cases in the peer-reviewed medical literature (and thousands of patients across the country) that prove otherwise. How many cases -- and how much suffering -- will it take before dogma finally yields to data?

The uncomfortable truth about the clinical management of Lyme disease in this era is that it is often virtually impossible to tell whether the spirochetal infection persists in a still-symptomatic patient who has been treated under the currently recommended protocols. In the absence of compelling evidence one way or another, the clinician has little more to go on than his experience, his clinical judgment, and the patient's response to treatment. While it is understandable that this sort of uncertainty makes some physicians uncomfortable, the solution should not be the imposition of arbitrary, flawed treatment guidelines that are divorced from reality and do not serve the patient's best interest. The standards should serve the patient, not the other way around.

Unlike AIDS, where medical science has few effective weapons in its armamentarium, there are treatments that work in some cases of chronic Lyme disease. Simple antibiotic therapy, though not always curative, is often palliative and can control the infection and prevent or minimize progressive organ damage and relieve suffering associated with chronic Lyme disease. We are appalled by the continued campaign of harassment against physicians like Dr. Watsky who opt for extended treatment when they feel it best serves the needs of their patients. Furthermore, the charge of "profiteering" was completely without foundation, as Dr. Watsky has no relationship with any home infusion company.

In carrying out the investigation of Dr. Watsky, the Connecticut Department of Health has allowed itself to be used as a tool to maintain the status quo at the very time when change in the standard of care for Lyme disease is desperately needed. Through intimidation, ridicule, collusion with insurers and as informers to the DOH, physicians affiliated with Yale University and the University of Connecticut exert a strangle-hold on thought in Connecticut, the power center of the insurance industry. Meanwhile, the DOH turns a blind eye to the far more egregious collaboration between academic physicians and health insurers in denying reasonable requests for treatment of individuals seriously ill with Lyme disease.

These physicians also attempt to interfere with payouts for patients for disability occasioned by Lyme disease and its aftermath. Surely a profitable enterprise for both insurers and consultants, it leaves patients stranded and desperate, their lives in a shambles, deprived of the financial support they both need and deserve and for which they have dutifully paid years of disability and health insurance premiums. The morally repugnant symbiosis between the health insurance industry and the academic physicians who serve as their "consultants" for Lyme disease cases is far more deserving of state examination than the actions of a family practice physician simply trying to do the best he can for his patients.

There are legitimate scientific questions surrounding the issues of diagnosis and treatment in Lyme disease, but they should be dealt with in a scientific arena, not a political one. Having lost out in the marketplace of ideas, Dr. Zemel resorted to provoking State intervention into what should have been a private and confidential matter between Dr. Watsky and his patients. In suspending its investigation of Dr. Watsky, the Department of Health appears to have implicitly acknowledged the groundlessness of the accusations. Still, the DOH has released no public statement on the matter, not has it issued an apology to Dr. Watsky. (Dr. Watsky's attorney has received a letter from the DOH, but has refused to accept its wording.) While the action against Dr. Watsky has apparently fizzled out, it is unlikely that the campaign of innuendo and intimidation against Lyme disease clinicians is over.

The chill wind still blows -- which is exactly what the ideologues want.

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III. J NEUROPSYCHIATRY CLIN NEUROSCI: Rapidly progressive frontal- type dementia associated with Lyme disease ------------------------------------------------------------------- AUTHORS: Waniek C, Prohovnik I, Kaufman MA, Dwork AJ ORGANIZATION: New York State Psychiatric Institute, NY 10032 REFERENCE: J Neuropsychiatry Clin Neurosci 1995 Summer;7(3):345-7 ABSTRACT:

The authors report a case of fatal neuropsychiatric Lyme disease (LD) that was expressed clinically by progressive frontal lobe dementia and pathologically by severe subcortical degeneration. Antibiotic treatment resulted in transient improvement, but the patient relapsed after the antibiotics were discontinued. LD must be considered even in cases with purely psychiatric presentation, and prolonged antibiotic therapy may be necessary.

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