APPENDIX C

(MATERIAL SUBMITTED BY GENERAL PUBLIC)

HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA,

Congressman OREN HARRIS,

DEPARTMENT OF SURGERY, Philadelphia, Pa., June 10, 1957.

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D. C.

DEAR CONGRESSMAN HARRIS: I have just had the opportunity of reading H. R. 7841, a bill introduced in the House of Representatives last week by Congressman John E. Fogarty, of Rhode Island. This bill is of the greatest importance to the future of medical training in this country, and will be equally helpful to dental schools and schools of public health.

Legislation of the type provided in the bill is sorely needed. The physical plants of the medical schools of most of our schools are very inadequate, and, with the Federal Government paying at least a half of the cost of building new facilities, we shall be able to take a long step toward the solution of a very vexing problem. I do hope you will give your complete support to this bill.

Very sincerely,

I. S. RAVDIN, M. D.

MAY 23, 1958.

Dr. LEROY BURNEY,

Surgeon General, United States Public Health Service,

Department of Health, Education, and Welfare,

Washington, D. C.

DEAR DR. BURNEY: From a recent report (Washington News, J. A. M. A., vol. 167, No. 3, p. 26, May 10, 1958), I have learned that in testifying before the Health and Science Subcommittee, House Interstate Commerce Committee, holding hearings on bills providing for matching grants for expansion of teaching and training facilities in medical and dental schools, you opposed the inclusion in the bills of schools of podiatry on the grounds that higher priority needs were for school of medicine.

We would appreciate it very much if you could advise us upon what information and facts the determination of higher priority for medicine was made. To the best of our knowledge, this office, nor any of our officers, nor officials of our schools, nor our council on education were asked to supply data on this question. Attached is a copy of the statement made by myself on behalf of our association and professional schools at the hearing. In it, you will note that none of our schools are supported by any public funds. In view of this, and because the fewer than 8,000 chiropodists-podiatrists are only a small fraction of the number required to provide adequate foot-health care and service for the Nation, it would seem to us that our schools would rate the highest priority. It should also be pointed out that our schools would be receiving only a very small portion of the total funds made available for matching grants under this legislation.

In order that the subcommittee may have our thoughts on your "priority" contention, a copy of this letter is being sent to Congressman John Bell Williams. Sincerely,

A. RUBIN, D. S. C., Secretary.

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE,

PUBLIC HEALTH SERVICE, Washington, D. C., June 3, 1958.

Dr. ABE RUBIN,
American Podiatry Association,

Washington, D. C.

DEAR DR. RUBIN: I have your letter of May 23 regarding the omission of schools of podiatry from the recommended legislation to expand the present research construction grant program to include assistance for the construction of teaching facilities for schools of medicine, osteopathy, dentistry, and public health.

I regret that there seems to be some misunderstanding of the priority concept as used in developing our legislative recommendations. There are many allied health callings which, like the profession of podiatry or chiropody, make im

portant contributions to the Nation's health team. While we recognize their great importance to both preventive and curative health care, there are two principal reasons why none of the schools which train people for these allied professions has been included in the proposed construction aid program. First, in order to avoid appropriation authorizations of undue size and yet achieve maximum effectiveness, the program now proposed has been directed toward only those professions which contribute the broadest basic proficiency in health matters. This is important from the point of view of our requirements for health-research scientists and for the administration of basic public-health programs, as well as from the point of view of training future health workers and the provision of needed services.

Second, the basic categories of training institutions which have been included are also, in the main, those in which the instructional cost per student is exceptionally high as compared to other fields of higher education or other categories of professional training.

I trust that this explanation of our position will reassure you concerning our reasons for recommending the omission from this proposed legislation of schools of podiatry-as well as other institutions which train for these relatively limited fields of health service.

Sincerely yours,

JOHN D. PORTERFIELD,
Acting Surgeon General.

JUNE 10, 1958.

Dr. JOHN D. PORTERFIELD,

Acting Surgeon General, Public Health Service,
Department of Health, Education, and Welfare,

Washington, D. C.

DEAR DR. PORTERFIELD: Thank you very much for your letter of June 3, in which you outline the priority concept used by the Department of Health, Education, and Welfare, Public Health Service, in developing legislative recommendations.

The Honorable John Bell Williams has asked me if I would supply him with a copy of your reply to my letter of May 23, 1958, addressed to the Surgeon General of the United States Public Health Service. He wishes this for the records of the subcommittee which held hearings on the bills providing for the expansion of teaching and training faciilties in medical and dental schools. I am, therefore, taking the liberty of sending him a copy of your letter, and a copy of this letter.

I should like to point out that, by your definition, our schools would fall within your higher priority concept. First of all, that portion of the appropriation that would, or could be, earmarked for our schools would be relatively small compared to the overall appropriation being considered. I should also like to point out that our schools (whose accrediting agency is recognized by the Office of Education of the Department of Health, Education, and Welfare) do provide the same broad "basic proficiency in health matters" as do schools of medicine, osteopathy, dentistry, and public health. The same basic sciences are taught in our schools as are taught in these schools. Certainly, a similar amount of knowledge of medical science is necessary for the adequate training of people to care for the human foot as is required of people trained to care for the teeth, and perhaps, more.

Secondly, I think a closer study would show that the instruction cost per student in our schools approaches that of the training institutions which thę Department of Health, Education, and Welfare recommends for matching grants. As a point of fact, the cost in our schools would be considerably higher if we were to calculate into the cost an appropriate salary for instructional hours now being provided to schools gratis by members of the profession. It would seem to me that this second part of your concept tends to be punitive toward institutions that are keeping costs down.

Thank you again for your explanation. I hope these few words of mine will erase any apprehension the Department might have should the subcommittee, the full committee, and the Congress provide for the inclusion of podiatrychiropody schools in the proposed legislation.

Sincerely,

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A. RUBIN, D. S. C., Secretary.

MINNEAPOLIS, MINN., April 28, 1958.

JOHN BELL WILLIAMS,

Chairman, Committee on Interstate and Foreign Commerce,

United States House of Representatives, Washington, D. C.:

Urge favorable consideration of H. R. 7841 with addition of appropriate provisions for support of graduate programs in nursing as recommended by American Nurses Association.

Hon. JOHN BELL WILLIAMS,

KATHRYN J. DENSFORD,

Director, School of Nursing,
University of Minnesota.

NEW YORK STATE NURSES ASSOCIATION,
Albany, N. Y., April 24, 1958.

Chairman, Subcommittee on Health and Science,

House Committee on Interstate and Foreign Commerce,
Washington, D. C.

DEAR MR. WILLIAMS: The New York State Nurses Association urges your sympathetic consideration of the recommendation contained in a statement made by Miss Julia Thompson, Washington representative of the American Nurses Association, before the Subcommittee on Health and Science of the House Committee on Interstate and Foreign Commerce in regard to H. R. 7841 (Fogarty).

We know from actual experience in New York State that we are sadly in need of expanded educational facilities for advanced study in nursing, particularly in view of the projected increase in demand for nursing services.

I feel that we need not repeat what Miss Thompson has made so abundantly clear in her testimony. We do, however, ask you again, as constituents of the American Nurses Association, to support this piece of important legislation. Sincerely,

KATHERINE E. REHDER, R. N.,

Executive Director.

Hon. JOHN B. WILLIAMS,

UNIVERSITY OF MINNESOTA,
THE MEDICAL SCHOOL, Minneapolis

April 25, 1958.

Chairman, House Commerce Committee, Health and Science Subcommittee, House of Representatives, Washington, D. C.

This

MY DEAR REPRESENTATIVE WILLIAMS: The financial plight of the Nations' medical schools is, I am sure, well known to you. Costs of medical education are rising at a rate more rapid than that of the cost of living. It is generally agreed that simply to maintain current standards of medical care we will have to graduate annually a much larger number of physicians by 1970 than we do now. will require new facilities and remodeling of old facilities, and plans for these facilities must be begun now since there is a very long lag period between conception of plans for a medical school and graduation of the first class of M. D.'s. As an example of the magnitude of the need, I cite our situation here at the University of Minnesota Medical School. We are currently making plans to increase the size of our classes in Medical School from a basic 125 to 150. The class which enters in September 1959 will be of the latter size, and thus by 1963 our entire student body will have been increased by 20 percent. The Minnesota State Legislature has really been quite generous in providing funds for the enlargement of basic science facilities to accommodate this increase. Yet to provide facilities which we consider adequate to teach these enlarged classes, we estimate an additional need for approximately $2 million for further construction during the next 5 years, and it appears most unlikely that our legislature will be able to provide this amount. The Nation over, the need for funds for construction of facilities for medical education exceeds $200 million.

I should like to point out, too, that research and teaching facilities are equally urgent needs, because in medical education teaching and research are so intimately related that they cannot be regarded as separate functions.

Members of the administrative committee of the College of Medical Sciences of the University of Minnesota, meeting on April 24, 1958, expressed the unanimous hope that legislation will be passed during the current year which will

provide funds in support of construction of medical teaching and research facilities, and they directed me to write you urging your support of such legislation. We understand that the following three bills bear on this subject: H. R. 6874 (Harris, Arkansas); H. R. 6875 (Wolverton, New Jersey); and H. R. 7841 (Fogarty, Rhode Island). Being unfamiliar with the precise details of these bills, we are unable to express a preference for one over the others. We do, then, urge your favorable consideration of this most important matter. With thanks, I am

Sincerely yours,

ROBERT B. HOWARD, M. D., Associate Dean.

AMERICAN COUNCIL ON EDUCATION,
Washington, D. C., March 24, 1958.

Hon. OREN HARRIS,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D. C.

DEAR CONGRESSMAN HARRIS: The committee on relationships of higher education to the Federal Government of the American Council on Education on March 18 received a report from the Association of American Medical Colleges in support of a continuation of the Federal program of matching grants to medical and dental schools for construction of research facilities, and also in support of legislation authorizing grants for medical and dental teaching facilities.

It was pointed out that, in accordance with a recommendation by President Eisenhower transmitted to Congress on April 10, 1957, bills embodying the proposals were subsequently introduced in both the Senate (S. 1917) and the House (H. R. 6874 and H. R. 6875), though no action was taken in 1957, and the bills are still before Congress. The President in his 1959 budget message again recommended support of this legislation.

The council's committee, being aware that there is a serious and continuing need for Federal support of programs to improve and expand medical and dental facilities for both research and teaching, voted unanimously to approve the bills designed for this purpose, including S. 1917 which is now under consideration by the Senate Committee on Labor and Public Welfare.

I am authorized to submit this statement of the action of the council's committee with the request that it be made a part of the record of any hearings that may be held on this legislation.

Sincerely yours,

Mr. JOHN BELL WILLIAMS,

ARTHUR S. ADAMS.

ST. JOHN'S UNIVERSITY, DEPARTMENT OF NURSING EDUCATION, Brooklyn, N. Y., April 22, 1958.

Chairman, Subcommittee on Health and Science, Committee on Interstate and Foreign Commerce, House of Representatives, Washington, D. C. DEAR MR. WILLIAMS: The faculty and student body of the department of nursing education, St. John's University, New York, wish to express their strong support of the action of the American Nurses Association on H. R. 7841, to authorize a 5-year program of grants for construction of medical, dental, and public health educational and research facilities, and for other purposes.

Sincerely,

(Mrs.) MARY E. REAP,
Administrative Chairman,

Department of Nursing Education.

AMERICAN CONGRESS OF PHYSICAL MEDICINE AND REHABILITATION,
Chicago, Ill., May 1, 1958.

Hon. JOHN BELL WILLIAMS,

Chairman, Health and Science Subcommittee, Committee on Interstate and
Foreign Commerce, House Office Building, Washington, D. C.

DEAR CONGRESSMAN WILLIAMS: The members of the American Congress of Physical Medicine and Rehabilitation are deeply concerned with any measures which will promote the health and welfare of the people of this country. An