Lyme doctor ruled guilty

Jemsek's practice to face conditions

The N.C. Medical Board on Thursday suspended a Mecklenburg County physician's license for one year after finding he departed from prevailing methods of treating Lyme disease.

The 12-member board also concluded Dr. Joseph Jemsek didn't adequately inform patients that his approach, which includes keeping patients on intravenous antibiotics for months or years, is unorthodox.

Dr. Robert Moffatt, the medical board's president, said the board would immediately stay the suspension, which will allow Jemsek to continue practicing. The board will place conditions on how Jemsek conducts his work during the one-year suspension when it meets in July.

The decision affects hundreds of patients who say Jemsek's treatments spared them from lives of daily agony. Hundreds wrote letters praising him, and scores turned up at the two-day hearing to show support. Many had feared the board might strip Jemsek of his medical license or put him on active suspension, which would stop him from practicing.

"In a way, I feel the board recognized he's serving the community in a good way," said Beth Jordan, who was treated for Lyme by Jemsek and is president of the N.C. Lyme Disease Foundation. "They gave him the lesser penalty."

Jemsek, 57, didn't make it hard for the board to convict him.

He testified repeatedly that he is the only physician in the state who routinely diagnoses patients with chronic Lyme even if they do not test positive when screened with standard laboratory tests.

Jemsek also said he is alone in attacking the tick-borne disease with long-term antibiotic therapy. Most doctors require positive test results and believe Lyme should be treated with no more than two four-week courses.

Jemsek acknowledged that he and his staff did not always clearly explain the different standards of care to patients.

"I should have," Jemsek said. "I think I do with most of them."

The Huntersville doctor was adamant about the soundness of his approach.

He argued that his methods represent the cutting edge in a field where much remains unknown and standard diagnostic tools are mediocre at best.

Dr. Brian Fallon, a Columbia University psychiatrist and Lyme disease researcher, mentioned a study funded by the National Institutes of Health that sent blood samples from patients with well-documented Lyme disease to three diagnostic laboratories and got three different results.

One laboratory identified 56 percent of the patients as positive for Lyme, Fallon said. The lab with the most positive results found 83 percent.

'Probable' Lyme

The medical board's case did not debate the merits of Jemsek's approach.

The board's lead prosecutor, Marcus Jimison, argued that Jemsek's methods were out of step with accepted standards and harmed patients, some of whom developed infections and other side effects.

Five patients, including the widower of a woman who died of morphine poisoning while under Jemsek's care, testified for the prosecution.

Jimison got both of the defense's expert witnesses to make statements that aided the prosecution.

Fallon acknowledged that he considers patients who lack conclusive test results to have "probable" Lyme disease. Jimison jumped on the point, using it to challenge Jemsek that he frequently told patients they definitely had Lyme disease when in fact it was an educated guess.

Jemsek fired back that doctors make treatment decisions based on assumptions and experience every day.

Dr. Steven Phillips, a Connecticut doctor whose entire practice is dedicated to the treatment of Lyme, said that Jemsek is hardly alone among physicians nationally in his approach to the disease. Phillips said he treats patients with antibiotics for many months and often accepts referrals from other doctors who also do.

Phillips reviewed the 10 patient files on which the board based its case. He said he agreed with Jemsek's diagnosis, including his decision to treat with long-term antibiotics, in every one. But he said he did not agree with every aspect of Jemsek's care.

Phillips said he rarely uses IV antibiotics. He said he would end treatment and remove the IV port implanted in the patient's body if an infection developed around it.

Infections

Heather Jenkins, a former patient of Jemsek who testified that she grew more ill under his care, said that she developed five infections over a year and a half of daily infusions.

The final infection put Jenkins, 32, in a hospital intensive-care unit for days. She appeared pleased when Moffatt read out the board's decision, squeezing her husband's hand as the board president said the word "guilty."

Jemsek told the board his treatment has evolved so that it is now much shorter and gives patients frequent breaks between active therapy. He said patients treated with IV antibiotics today now receive it for an average of 70 days spread over many months.

Jemsek also said his clinic staff is more cautious about infections. Patients are taken off IV therapy if they develop more than one infection.

"We have definitely tightened that up," Jemsek said.