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.

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. It 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 Eve 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

their education or to improve their standing or discipline its members, and I would like to reiterate again that the Medical Society of the District of Columbia does not object to any rule or regulation that will regulate the commercial practice of optometry and control the advertising, I made the statement, I didn't think this law was necessary, because I had been advised by legal counsel that the District Commissioners now had authority to control advertising. If in the opinion of this committee it don't have such authority, and this committee sees fit to pass laws that will control it, the medical society, as I said here yesterday, will go along with that and help to support it. Mr. WHITENER. Getting back to the North Carolina statement, I wonder if it will be possible for you to get some explanatory statement from the North Carolina Commission on the Blind.

Dr. DRYDEN. I will make every attempt to do so, sir.

Mr. WHITENER. I think we are entitled, as a committee, to know whether the contention made by you folks is correct, or the contention made by those who called yesterday in behalf of the North Carolina Optometric Society.

Dr. DRYDEN. Did you read the cover letter on that report?

Mr. WHITENER. Yes, I read that, but that is from Dr. Rankin, down in Concord.

Dr. DRYDEN. I should think he would be in position to answer any questions you might want to put to him.

Mr. WHITENER. I think in order to resolve this dispute, I am not saying whether the dispute is groundless or not, if you had something from the North Carolina Commission for the Blind, to explain it, because, after all, these statistics were back in 1962. We don't know why they were gotten up, or anything else. It would be helpful. I know you may not be able to get it, but

Dr. DRYDEN. I will write a letter and ask.

Now, may I clarify that by asking you exactly what you would like to have answered?

Mr. WHITENER. Just a statement about how the study came about, what its purpose was, and whether these statistics are correct. Dr. DRYDEN. All right, sir, I will do that.

Mr. WHITENER. Now, Mr. Magee, you have apparently taken the legal position, that if this bill is enacted there will be some restrictions placed upon ophthalmologists, as far as their office service is concerned, such as using nurses and technicians and others. But is it not true that under the Healing Arts Act of the District of Columbia, that it is specifically provided that that can be done?

Mr. MAGEE. Yes, they have a right, and the Corporation Counsel is well aware of this.

Mr. WHITENER. This would not in any way repeal that part of the Healing Arts Act?

Mr. MAGEE. We have attempted to make that very clear, and an amendment has been suggested so that it does not in any way revoke the right of a doctor to use technicians or nurses in this field. The act was not quite clear, but the amendment that was suggested by the medical society would make it clear. And it takes doctors, just as the prior act does; it takes doctors, their technicians and aids, out of the Optometric Act.

Mr. HARSHA. Will the gentleman yield?

Mr. WHITENER. Yes.