The Lyme disease controversy. Social and financial costs of misdiagnosis and mismanagement.

Since it was first described, Lyme disease has emerged as a major public health concern, complicated by an emerging body of beliefs often at odds with scientifically established facts. Disagreement between the belief systems has led to confusion and anxiety, resulting in an alternative, but unproved, approach to management. When Lyme disease is incorrectly diagnosed, the debility related to the true, underlying problems remains unaddressed. The financial cost of the overdiagnosis and overtreatment of Lyme disease includes expenses related to testing and therapy and those of side effects and toxic effects of these treatments. Harder to estimate are the emotional costs to society of incorrectly burdening patients with the diagnosis of a chronic, incurable illness, with attendant assumption of a sick role and a disabled self-image. Better education is a major component of the solution to the problems of misdiagnosis and mistreatment of Lyme disease.