This disagreement, may also spill over to insurance coverage for that diagnosis, too. That would be a huge factor in people electing to not get treated.

Lyme is still a contentious subject and I guess the people are not coming in from Google on our forum here. We seem to get many many Google visitors and other search engine new members on many other forums here.

For what it is worth, I never saw many RXs either for long term oral antibiotics for Lyme. Many are IV however, but still many oral (those on IVs would go thru home care facilities not retail).
We had a very prominent infectious disease doctor in our area, and mostly he was writing for antivirals, and antifungals. I didn't see much Lyme oral treatment from him either.

This arguing between various doctors about Lyme is similar to the frictions about using T3 for functional hypothyroid. The controversy there is hot always. The holistic doctors using high dose iodine and T3, and the endocrinologists debunking it all and saying levothyroxine T4 is the best way to treat. This controversy has been quite ongoing here for at least a decade.