Mr. HORTON. No further questions.

Dr. ALBERT. Does that answer your question?

Mr. HORTON. Yes.

Mr. SISK. I thank the gentleman from New York.

There are a number of questions that I would like to raise with regard to your statement, Mr. MaGee, but I think I will not take the time to go into it now.

I would like just to briefly go back to Dr. Dryden to establish generally the position, I believe I understand the position, of the medical profession and the ophthalmologists. I think that my friend from New York, Mr. Horton, has ably brought it out in the questioning of Mr. Magee.

Frankly it comes to a question of whether or not we recognize the practice of optometry as a profession, and whether or not they are entitled to professional status. I believe, Dr. Albert, you actually made a statement that you felt they should not be referred to as "doctors," isn't that right? I believe your statement says that. Dr. ALBERT. The present bill says that, too.

Mr. SISK. Says what?

Dr. ALBERT. That they should not be called doctor.

On page 7 of the bill, this is under section 7 the Commissioners are authorized to revoke the license, and so on, for the following reasons, and the first one:

The use of any title or any other word or abbreviation indicating that the licensee is engaged in the practice of medicine or surgery.

Now, further back in the bill

Mr. SISK. That does not have anything to do with what I noticed in your statement. As I said, it seemed to me that it went to some extent, if you will pardon the expression, to the guts of the issue. There seems to be some feeling on the part of Mr. Magee and the medical profession that the practice of optometry should not be recognized as a profession.

I note from your statement you indicated that you did not feel that optometrist should be referred to as doctors.

Dr. ALBERT. Unless they qualify it by the word "optometrist." And what we had in mind there was, eliminating such vagaries as eyesight specialist or eye specialist or vision specialist, as this confuses the public.

Mr. HORTON. Would you gentlemen yield?

Mr. SISK. Yes.

Mr. HORTON. On page 19 of the bill, subsection C of section 13, which has to do with the qualifications of an optometrist, it says that he shall be recognized as qualified to give expert evidence and testimony, but it says so only in respect to the practice of optometry. Now, do you find any objection to that, Dr. Albert?

Dr. ALBERT. Yes, as it is defined.

Mr. HORTON. He is not testifying as a qualified expert in respect to the practice of medicine or ophthalmology, but certainly he can testify as an expert in the practice of optometry.

Dr. ALBERT. Yes, but

Mr. HORTON. He is more than an optician.

Dr. ALBERT. No. The reason we object

Mr. HORTON Excuse me, will you, please answer my question.

He is more than an optician?

Dr. ALBERT. Yes.

Mr. HORTON I recognize that his qualifications do not put him in the same category as a doctor or an ophthalmologist, but he certainly is qualified or should be qualified if he has passed the requirements of this bill, he is certainly qualified to testify with respect to the practice of optometry.

Dr. ALBERT. What we object to is the definition of optometry. And we also object to the definition of optometry in this act. So if this bill were passed, then the practice of optometry, we would object to, according to this definition.

Mr. HORTON. Is that in your statement, too?

Dr. ALBERT. Yes.

Mr. HORTON. Well, as one who was in the field of optometry, do you take objection to the definition on page 2 of the bill, subsection 2; is that right?

Dr. ALBERT. That is right, sir.

Mr. HORTON. Is that a gross error in the definition?

Dr. ALBERT. To me the thing has its vagaries in it.

Mr. HORTON. Let's don't talk about vagaries. I would like to find out whether or not there is a misstatement of what the practice of optometry is.

Dr. ALBERT. The employment of any objective or subjective means for examining the human eye, that could be the use of drugs, surgery, or anything else.

Objective and subjective method is all-inclusive, and on the next page, the identification of any departure from the normal conditions or functions of the human eye, including its associated structures. That is medicine.

Mr. HORTON. I don't think it is the intent of the committee, at least of the sponsors of the bill, to define optometry so it includes the practice of medicine.

It

Dr. ALBERT. I hoped that it wasn't, sir. And I think that from these changes, if they are made, it would be very acceptable to us. seems like the current definition of optometry is a good one, the one that we are working under now, from 1924.

Mr. HORTON. Thank you, Mr. Chairman.

Mr. Sisk. Dr. Dryden, I would just like to ask a few brief questions here.

You are, of course, an ophthalmologist, I believe that is correct, Doctor?

Dr. DRYDEN. Yes, that is correct.

Mr. SISK. And you are an officer in the organization of the American Association of Ophthalmologists; is that correct?

Dr. DRYDEN. That is right.

Mr. SISK. What position do you hold?

Dr. DRYDEN. Vice president.

Mr. SISK. Is the American Association of Ophthalmologists an organization that at one time was called the National Medical Foundation for Eye Care?

Dr. DRYDEN. That is correct.

Mr. SISK. Did your organization publish this little booklet here, Doctor? It is called "Medicine, Optometry, and the Public Welfare." Dr. DRYDEN. Yes, sir.

Mr. SISK. Did you concur with everything in this booklet?

Dr. DRYDEN. So far as I know, yes. I haven't read it recently. That is an old publication.

Mr. SISK. I assumed that you would be familiar with it.

Dr. DRYDEN. Yes.

Mr. SISK. Are you acquainted with Resolution 77 of the house of delegates of the American Medical Association, adopted in June 1955? Are you at all familiar with that?

Dr. DRYDEN. If you will tell me what that regulation is, I will tell whether I am familiar with it, sir.

There were several adopted at that time. I am not sure which one. Mr. SISK. It was a resolution pertaining to optometry and the practice of optometry, and its recognition, or nonrecognition, stating the position of the American Medical Association. I do not happen to have an extra copy

Dr. DRYDEN. Yes; I am familiar with it, I believe. There were three of them passed at that time.

Mr. SISK. As far as you know, is that resolution still the position of the American Medical Association?

Dr. DRYDEN. I am not sure which one you are referring to. The one that you may be referring to, it is unethical for a physician to teach in a school of optometry, is that it?

Mr. SISK. I don't have the wording of the resolution in front of I think it is included in this.

me.

Dr. DRYDEN. If you would please clarify which one of the three you are talking about, if that is the one, I don't know what the other two were, at this time. You will have to clarify which one of the three resolutions you are referring to, because three were passed at that same session, and I don't know which one you are referring to. Mr. SISK. In other words, part of those have now been disavowed, is that right, and no longer are in effect? Part of the resolutions that were passed are no longer effective?

Dr. DRYDEN. Not if you are referring to the resolution I think you are referring to-it is still in effect.

Mr. SISK. Still in effect?

Dr. DRYDEN. If you are referring to the one I think you are, but you would have to identify which resolution you are referring to.

Mr. SISK. The reason, of course, for identifying this, Dr. Dryden, was to set out rather clearly the position of the American Association of Ophthalmology, on the practice of optometry, and I do not quarrel with your position, because this is the position that I am sure the association took in good conscience, and one which you have a perfect right to, but I attempt to bring this out, I think, to place in proper focus, that this is the position of your organization at this time on this legislation.

Dr. DRYDEN. I am not here speaking for the American Association of Ophthalmology. I am just here speaking solely for the District Medical Society.

Mr. Sisk. I appreciate that, Dr. Dryden. At the same time, I think you have reflected here, as I said, the general position of the American Association of Ophthalmology, as I read this booklet, and I simply want to clarify for the record the general position that you have taken, and in no way do we deprecate your testimony, but to indicate that I think it should be clarified as to your position on this particular piece of legislation.

Dr. DRYDEN. Well, I appreciate your bringing that in focus, because I think that it very definitely augments my statement and makes it more substantial, and I appreciate the fact that you did not overlook it, sir.

Mr. SISK. All right.

Mr. WHITENER. Dr. Dryden, I had a telephone call yesterday from some of our folks in North Carolina, bringing into question the use of North Carolina statistical data in your statement.

Dr. DRYDEN. Yes, sir.

Mr. WHITENER. And as I understand from them, their impression is that in some way these are not valid statistics and that they were used in some way in connection with legislation that was proposed in North Carolina, and that the General Assembly of North Carolina did not go along with that legislation. The party who talked with me didn't give me any clear-cut information about it, but I wonder if you know the history of this documentary data.

Dr. DRYDEN. I think the history, sir, is very well explained on the cover page that went with the documentary report. It showed how the North Carolina State Commission for the Blind set up this whole program through their medical advisory committee, consisting of four physicians and a professional social worker, Miss Ruth PennyI am sure you know her quite well. I had the pleasure of working with her many years ago, incidentally, and she has rendered a tremendous service to the State of North Carolina.

This commission was set up for the sole purpose of determining what was happening to these people. These reports were sent in by optometrists, under the provisions of this act which I quoted yesterday, and we have documented here 100 cases, we have recorded their visual acuity and what was done with them and what the optometric report said.

I think they are all self-explanatory. I didn't go into any details of each individual case, but it is all explained right here in the document. And I think the State of North Carolina should be commended for going into this, and I think every State in the Union will go into it now as a result of this statement, because this is exactly what we see happening in our offices right here in Washington, all over the country, day after day.

There are cases of pathology that come into our offices who have been going to optometrists for years, with late glaucoma, or they have been told, you have cataract, and when you get ready for surgery, I'll send you to a physician, and lo and behold, when they get in to a physician, they do have cataracts, but they have glaucoma, too, which, granted, the cataract surgery at that stage will do them no good. It is a deplorable situation. It is a situation which the medical profession has for years been trying to do something about, and we maintain that if optometry is practiced as optometry, as it is defined in our present act, and they don't attempt to go into the field of pathology, if they do a satisfactory job on the fitting of glasses we have no quarrel with this. But when they once attempt to practice medicine by establishing themselves as being able to diagnose cases as documented in this North Carolina report, then we run into trouble. That is the thing we are complaining about.

The medical society, and I made it clear in my statement yesterday, sir, that we take no issue with optometry's effort to improve

President and subsequently, Supreme Court Justice of the United States, wrote the famous landmark opinion of Ewing v. Goode, 78 F. 2d. 442 (1897). That was a glaucoma case where a doctor was sued on the theory that his treatment had caused the loss of sight in the eye. There was no medical testimony in that case substantiating the. complainant's claim.

Judge Taft said that in this field of treatment of the eye, in the eye field there is no other guide but medical testimony, no other guide.

Now that decision was rendered a long time ago, but our court of appeals has adopted this opinion, I have given you four cases from 1965 on back where they relied on Ewing v. Goode, so that this—the optometrist is not an expert.

May it please the committee, you cannot make them one by just saying he is, by a legislative fiat. I don't think the court will accept

this.

Now, our position on behalf of the medical society I think is a simple one, I am not going to read my statement, I am about finished, may it please you gentlemen.

Regulations, for example, take the State of Virginia-the optometrists tried to do in the State of Virginia precisely what they are trying to do before this committee; they tried to have their profession called a learned profession, and we see the same language in the beginning of that act as we see here coming from the American Optometric Association; optometry is a profession. But, the act stopped there.

The Virginia act permits advertising, permits commercial hiring of optometrists, and it does not give them the things they ask for in this act.

Now, I want to go into this antidiscrimination matter.

Oh, by the way, I might tell the court that the very latest decision

Mr. SISK. This is a legislative committee.

I appreciate the gentleman's remarks, he is testifying as a fine. lawyer, but if he will just stick to the bill here under consideration and complete his statement as quickly as possible, we would appreciate it.

Mr. MAGEE. Yes, sir. I merely want to refer to this matter of whether or not opticians can fit contact lenses under the direction of a physician, which has been litigated in Mississippi and recently decided in the case reported in the State Board of Optometry v. Charles Chester, 169 Southern Reporter 468, argued twice in the Court of Appeals of Mississippi, and here is what they said:

This court cited with approval High v. Ridgeway's Opticians, 129 Southeast Second 301, 1963, and states that the optician fitting the contact lenses under the doctor's prescription amounted to no more than a mechanical adjustment and he is practicing neither optometry nor medicine when he does this.

You gentlemen asked questions in regard to the antidiscrimination provisions in the act which we have recommended be deleted.

It want to leave with the committee an exhibit. This is an exhibit emanating from the optometrists. It came about in this fashion, I will summarize briefly what happened.

The optometrists were unable to get a provision in the Virginia bill providing against discrimination. The optometrists went to the attorney general of Virginia and the attorney general of Virginia