Case Synopsis

Increasing cases of Lyme disease are creating public outcry. The Public Health Agency of Canada (PHAC) has been tasked with the surveillance and guidance for this tick-borne disease but has not seen additional funding. Evidence-based analysis has indicated the most impactful use of resources would be spent on prevention and awareness. Despite this information, the push for increasing the healthcare budget to allow for more Lyme disease funding is growing. A desire to increase resources for acute care in the hopes of better diagnostic testing, more freely prescribed antibiotics, and dedicated Lyme clinics is being put forward from advocacy groups. As climate change worsens, Lyme incidences rising in the foreseeable future is probable. As the president of PHAC, managing different stakeholders within and outside of the organization while managing expectations is crucial. The ability to engage and inform while maintaining a positive public perception is key, as this will lay the framework for other initiatives to launch in the future. Balancing this delicate situation while maintaining an evidence-based approach will take caution and strategic skills.

Case Objectives

  1. Decision-making thought process.
  2. Discussion around prioritization of resources.
  3. Leadership in difficult situations when there are no definitive right answers.
  • Creating competing interest groups will be beneficial in dividing the classroom for productive debate and conversation.

Case Study Questions

  1. Is it necessary to appease all parties?
  2. How should one prioritize decisions?
  3. When to discuss and when to decide?
  4. Do we truly understand the issue at hand? Are the right parties involved?
  5. What does the evidence indicate? What is our responsibility to the evidence gathered and what is our responsibility to the public in the immediate situation and the future?


Leadership, stakeholders, prioritization, evidence

Additional Author Information

Nitin Mohan, MD, MPH

Michel Deilgat, CD, MD, MPA, CCPE, Medical Advisor, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases

Ava John-Baptiste, MHSc, PhD, Assistant Professor



Recommended Citation

Mohan, N., Deilgat, M., John-Baptiste, S. (2018). Managing Expectations: Lyme Disease. in: McKinley, G. & Sibbald, S.L. [eds] Western Public Health Casebook 2018. London, ON: Public Health Casebook Publishing.