I went to med school in a place where Lyme disease was endemic. So when I was on my Medicine rotation and one of my co-students complained about feeling tired and achy for a few days, our attending immediately said to him, “Get tested for Lyme disease.” The student was reluctant. He didn’t have a rash. Our student health plan was crappy with a huge deductible, so he would have had to pay for the test out of pocket. Also, I pointed out (from a personal Lyme scare) that he could get a false negative this early on. “Well, if you don’t want to get the test,” the attending said, “I’ll write you a prescription for doxycycline and you can just treat it.” And then we saw another attending, who totally agreed with this. Even years later, I still find this offensive. The course of treatment for Lyme is 10-21 days of antibiotics. Would you really give someone up to THREE WEEKS of antibiotics because they were tired and achy a few days? I took doxycycline and it made me throw up… not something I’d personally be excited to take for weeks for no reason. And… hello, antibiotic resistance? I’d like to believe that the attendings were just over-treating because it was a colleague and not something they recommend to all their patients. Source
