Writing in the "Journal of the American Medical Association" (JAMA) in 1993, Steere and colleagues stated that Lyme disease had become "overdiagnosed" and overtreated. This statement became a rallying point for what advocacy groups call the Lyme disease controversy. In the face of some elements of mainstream medical opinion, some doctors and patient advocacy groups claim that Lyme disease can develop into a chronic disease requiring high doses of antibiotics over long periods of time. However aside from the issue of terminology, some mainstream medical opinion goes as far as to say that some Lyme disease cases can become "difficult to treat" if not quickly diagnosed.