be used, we would certainly attempt to do that. But the pressure is not upon the optometrist, because we feel if he does his job and does it well, takes care of these people who come in, eventually, we are going to build a practice and a following that will take care of his salary and the salaries of the other persons involved.

Mr. SISK. What would be your policy if, through your advertising methods, you were able to pull in a great number of people, say 30 people a day? What would be your policy? Would you employ another optician, or would you

Dr. RowE. We would hire another optometrist.

Mr. SISK. Or would you expect him to speed up a little bit?
Dr. RowE. No, sir, we would hire another optometrist.

Mr. SISK. What is the maximum number of patients that an optometrist would see in one of your stores?

Mr. RowE. You are asking, of course, a question directly at me. I would say that I would feel that an optometrist should be able to take care of up to 20 patients a day. This is not going to hold true every day, because there will be days when there will be patients which will require more time. Some days he would only be able to take care of 10 patients. But under normal circumstances and without running into any unusual conditions, he should be able to see 20 patients a day, which is the normal number of patients most medical refractionists see in a day, or any other refractionist who is not engaged in the sale of eyeglasses.

Mr. SISK. Do you have any figures, percentagewise, of the number of referrals that your people make to medical doctors?

Dr. RowE. No, sir, I do not.

Mr. SISK. You have no idea of the number of referrals at all?

Dr. Rowe. No, we simply emphasize to the doctor that he must fulfill his obligation to the patient, and when he sees the necessity for referral, he should do this. We cannot dictate to him and say, you must refer so many.

Mr. SISK. I appreciate that, but I was wondering if you kept records as to the number of referrals.

Dr. RowE. I am sorry, I do not have those records.

Mr. SISK. Do you have any questions?

Mr. HARSHA. Yes.

Doctor, in Ohio, at least in my area in the southern part of the State, Sears, Roebuck and Montgomery Ward have their own stores; that is, their outlets take up the complete building. They are not in a shopping center. They utilize the entire space in any one building. Normally, there are no optometrists in that store. that case, when you are selling glasses through Montgomery Ward or Sears Roebuck, do you merely act in the same capacity as a drugstore? You merely fill a prescription of some optometrist, whoever he may be?

Dr. Rowe. Yes, sir, that is correct.

Mr. HARSHA. That is all I have.

Mr. SISK. That will be all, Dr. Rowe. Thank you very kindly. Dr. RowE. Thank you, Mr. Congressman.

Mr. SISK. The next witness we have today is Mr. McLeod.

STATEMENT OF WILLIAM N. McLEOD, JR., WASHINGTON, D.C. Mr. MCLEOD. Mr. Chairman, I have a statement in opposition to the bill.

Mr. SISK. Mr. McLeod, the committee will be glad to hear you. Mr. MCLEOD. I represent a group of optometrists and opticians. I think everything in it has been covered many, many times, and I would like to ask your permission to file my statement and have it put in the record at this time.

Mr. SISK. Very good.

Mr. MCLEOD. And I would ask permission, after I consult with the people I represent, to file with the subcommittee amendments to the bill. (These appear in the appendix, pp. 381-382.)

Mr. Sisk. Very good. We will keep the record open, I would say, for a week, and if you have time, go ahead and submit those. (The complete statement of Mr. McLeod follows:)

STATEMENT IN OPPOSITION TO THE BILL H.R. 12937

My name is William N. McLeod, Jr., and I am representing a group of optometrists and opticians in the District of Columbia who oppose the bill H.R. 12937 and several other identical bills which have been introduced. I am here to represent S. S. Hollander who operates the optical department of the Hecht Co., Dr. Ben Gainsburg who operates the optical department of Kann's Department Store, Kinsman Optical Co., Sterling Optical Co., and the Kay Jewelry Stores. This group is affiliated with the National Association of Optometrists and Opticians whose president, Dr. Galen E. Rowe, Jr., has testified previously.

This bill has been introduced in various forms in many States by people who wish to limit the practice of optometry and the sale of glasses for their own gain. The bill, if passed, would benefit a special group, would create monopolies, and would prevent the public from obtaining eye care in many places where it is now obtainable and at much lower cost than would prevail if this bill were enacted. The bill defines optometry as a profession. Courts in the District of Columbia have held to the contrary. Several years ago a group of licensed optometrists filed suit against Lansburgh's Department Store to restrain the corporation from employing a registered optometrist to render services to its customers in its extensive optical department. The plaintiffs in that suit sought to restrain Lansburgh's from directly or indirectly engaging in the practice of optometry in the District of Columbia. The request for an injunction was based on the allegation that optometry was a "learned profession." In the trial of the issue in the district court and finally on review in the U.S. Court of Appeals for the District, both courts found:

(1) That optometry is a mechnaical art which required skill and knowledge of the use of certain mechanical instruments to measure and record errors and deviations from normal found in the human eye; and (2) that "optometry" is not a learned profession.

Chief Justice Groner said in his opinion that the licensing statute for optometrists does not prevent a corporation from furnishing its customers or clients the services of a licensed optometrist, since the performance of optometry is not a "learned profession," but relates to the measurement and powers of vision and the adaptation of the lenses thereto. (Silver v. Lansburgh, 111 Federal (2d) 518.)

The bill attempts to dictate to the accredited schools of optometry what procedures the school should follow in graduating candidates for degrees in optometry. If candidates for degrees in optometry are being permitted to graduate without having the qualifications necessary for being licensed, it is the duty of the Optometric Society to see that the standards of the schools be raised so as to accomplish this purpose.

A person holding a license to practice by reciprocal agreement in the District of Columbia who failed to enter into practice after holding a license for 1 year would not be permitted to practice in the District. It is hard to understand why a person who is competent to practice would not be so for a period longer than 1 year.

Section 7(a), subsection 7, refers to conduct which disqualifies the licensee from practicing optometry with safety to the public. Without a clear-cut defini

tion of what constitutes such conduct, the possibility of abuse is left wide open. Section 7(a), subsection 8, prohibits the advertising, directly or indirectly, of the sale of ophthalmic or optical material. This would eliminate the advertising of eyeglass frames and lenses. In so doing, the bill fails to recognize the fact that eyeglass frames, in particular, are fashion accessories. This would force the buyer of glasses and frames to buy what the seller wanted him to purchase, rather than have free selection.

Section 7(a), subsection 9, would make it impossible for anyone to adjust a pair of frames, to adjust the earpieces of a frame, or perhaps even to clean the lens of glasses. This subsection would also prohibit the extension of credit to a person not able to pay for eye care at the time of an examination, and would force an individual to postpone needed service until able to pay cash.

Section 7(a), subsection 11, restricts the display of glasses, frames, goggles, lenses, etc., if visible from the street or public corridor of a building. This is an unfair restriction and again forces the buyer to take only what the seller wishes to sell.

Section 7(a), subsection 17, implies that ethical standards cannot be maintained because of the location of an office. This is an attempt to establish ethics by legislation, and it is a well-known fact that a person who has a high standard of ethics will maintain this standard regardless of the location. It is not the location of a business, but the manner in which it is conducted that is of importance. Section 7(a), subsection 19. The reference to "any other unprofessional conduct" is meaningless and leaves the door open for wrong interpretation.

Section 8(a), subsection 2, would eliminate corporate practice in the District of Columbia. There is no reason to believe that an individual would be more competent in the performance of his work in optometry as an individual rather than as a member of a company, association, corporation, etc. It is only reasonable to assume that a company, association, or corporation would be in a better position to render greater service and at a more reasonable cost.

Section 8(a), subsection 4, prevents a person from selling or offering to sell eyeglasses, spectacles, frames, mountings, or lenses, or to fit or duplicate lenses without a written prescription from a physician or optometrist licensed to practice in the District of Columbia. This would force a person who has a broken or cracked lens to return to a physician or optometrist for a prescription before the lens or lenses could be replaced. This would require much additional time and result in inconvenience as well as greater expense to the consumer.

Section 8(a), subsection 5, "would prohibit any person from advertising or causing to be advertised any optometric or ophthalmic material of any character which includes or contains any price, cost, or any reference thereto." This is a restriction on free trade and competitive enterprise. If optometrists and opticians are not permitted to advertise prices, the cost of optometric services to the public would increase substantially.

Section 8(a), subsection 8 would make it unlawful for any person other than an optometrist to utilize the service of another optometrist. This would prohibit any company, association, corporation, etc., from employing the services of a licensed optometrist. It would also prohibit an optician from continuing his business by employing the service of an optometrist. This subsection would prohibit a corporation such as Lansburgh's, the Hecht Co., Kann's, and many other businesses from employing a licensed and properly qualified optometrist to furnish its customers or clients with the service of a licensed optometrist.

Section 9(c), subsection 3. The limitation of 1 year in this subsection should be eliminated so as to permit a widow or widower of a deceased optometrist to continue the practice of optometry through the service of another optometrist. The enactment of this subsection would make the practice of a deceased optometrist practically valueless to his estate.

Section 10 places too much power in the hands of the Board of Commissioners of the District of Columbia. The authority which would be vested in the Board of Commissioners should be clearly defined.

Section 11. Serious thought should be given to the considerable appropriations which might be necessary in order to carry out the provisions of this section.

Section 13(c). This section would permit an optometrist licensed under this act to qualify as an expert witness in the courts of the District of Columbia. This is a matter of court procedure and should be determined by the court itself.

Mr. SISK. That concludes the public witnesses. We will hear now representatives of the District of Columbia government. Mr. Thomas Moyer, Dr. Frederick C. Heath and Mr. Lawrence E. DuVall.

Mr. Moyer, do you want to have Dr. Heath and Mr. Duvall testify with you?

STATEMENT OF THOMAS MOYER, ASSISTANT CORPORATION COUNSEL, ACCOMPANIED BY DR. FREDERICK C. HEATH, DEPUTY DIRECTOR, DEPARTMENT OF PUBLIC HEALTH, GOVERNMENT OF THE DISTRICT OF COLUMBIA

Mr. MOYER. Mr. Chairman, Mr. Duvall is at an appropriations hearing. We hope we can proceed without him. If any questions come up within his expertise, we hope we can submit answers to them at a later time.

Mr. SISK. Fine.

Mr. MOYER. Dr. Frederick Heath, Mr. Chairman, is the Deputy Director of the District Department of Public Health, and will accompany me today.

Mr. WHITENER. Before you start out, Mr. Moyer, let me ask this question. Is there any statute in the District of Columbia which prohibits a medical man or a physician holding an interest in or operating a drug-dispensing business?

Mr. MOYER. I shall have to refer you to Dr. Heath on that. I am not prepared on doctors holding interests in drugstores.

Dr. HEATH. I do not think it is true in practice. Whether there is a specific law or not, I am not sure at this point, but it is not the accepted practice.

Mr. WHITENER. I wonder if we could get you to give us a little statement on that in the record.

Mr. MOYER. I will certainly try to find out. I am not aware that there is such a statute. I shall do some research on it.

Mr. SISK. I would like, before you gentlemen proceed, to have made part of the record a letter on this proposed legislation directed to the chairman of the committee, Hon. John L. McMillan, from the Commissioners, signed by the President of the Board of Commissioners, Mr. Walter N. Tobriner.

(The letter referred to follows:)

GOVERNMENT OF THE DISTRICT OF COLUMBIA,

Hon. JOHN L. MCMILLAN,

Chairman, Committee on the District of Columbia,
U.S. House of Representatives, Washington, D.C.

EXECUTIVE OFFICE, Washington, March 18, 1966.

DEAR MR. MCMILLAN: The Commissioners of the District of Columbia have for report H. R. 12937, H. R. 13049, H. R. 13155, and H. R. 13176, 89th Congress, substantially similar bills, "To amend the Act of May 28, 1924, to revise existing law relating to the examination, licensure, registration, and regulation of optometrists in the District of Columbia, and for other purposes." Each of these bills amends in its entirety the Act entitled "An Act to regulate the practice of optometry in the District of Columbia," approved May 28, 1924 (43 Stat. 177; D.C. Code, sec. 2-501 et seq.; hereinafter, "the Act").

Initially, the Commissioners desire to note that on January 17, 1966, they forwarded to the Congress draft legislation "To revise and modernize procedures relating to the licensing by the District of Columbia of persons engaged in certain occupations, professions, businesses, trades, and callings, and for other purposes," introduced in the Senate on February 21, 1966, as S. 2953. A primary purpose of the Commissioners' proposed bill was to relieve the Congress of the constantly recurring necessity of amending 20 acts of Congress governing the licensing of more than that number of occupations, professions, businesses, trades and callings

(including the practice of optometry), by vesting in the Commissioners authority by regulation to revise and modernize these statutes. If the Commissioners' proposed bill should be enacted, it would be possible for them to establish higher standards in the practice of optometry, to the extent such action is indicated, and to take similar action with respect to the standards applicable to the other occupations, professions, businesses, trades and callings specified in the Commissioners' proposed bill, without the necessity for continual requests to the Congress respecting amendments to these various statutes. The Commissioners accordingly urge the enactment of their proposed District of Columbia Licensing Procedures Act.

However, in connection with the consideration by the committee of the desirability of enacting any of the subject bills amending the act relating to the practice of optometry, the Commissioners submit these comments respecting the merits of the various provisions of the bills.

The first section of each of the bills replaces the act with an act comprised of 15 sections. References in this report to a "proposed section" mean 1 of such 15 substitute sections.

The proposed section 1 gives the act the title "District of Columbia Optometry Act."

The proposed section 2 declares optometry to be a profession; states its practice affects the public health, welfare, and safety, thus requiring regulation; and declares that the practice of optometry should be limited to qualified persons, admitted to practice under provisions of the bills.

The proposed section 3 contains definitions, including the following:

“(2) practice of optometry' means any one, any combination, or all of the following acts or practices: the employment of any objective or subjective means for the examination of the human eye, including its associated structures; the measurement of the powers or range of human vision; the determination of the accommodative and refractive powers of the human eye; the determination of the scope of the functions of the human eye in general; the prescription, adaptation, use or furnishing of lenses, prisms, or frames for the aid thereof; the prescribing, directing the use of, or administering vision training or orthoptics, and the use of any optical device in connection therewith; the prescribing of contact lenses for, or the fitting or adaptation of contact lenses to the human eye; and the identification of any departure from the normal condition or function of the human eye, including its associated structures; ***”

Section 1 of the present act provides:

"The practice of optometry is defined to be the application of optical principles through technical methods and devices in the examination of the human eye for the purpose of determining visual defects, and the adaptation of lenses for the aid and relief thereof."

A reading of the substitute definition indicates a much broader scope than under the present act. The Commissioners believe that this proposed definition is too comprehensive and intrudes not only on the practice of medicine, but on long recognized functions of opticians and other persons, including officers and employees of the District of Columbia. The Commissioners understand that there will be offered to your committee expert medical testimony on this aspect of the bills.

The Commissioners recommend that if the committee accepts the broader definition of the practice of optometry, as contained in the bills, that at least simple visual screening procedures conducted by District teachers, school nurses, and others for the purpose of detecting eye trouble in children and adults be excepted from the definition "practice of optometry.'

The proposed section 4 sets out qualifications for licensure, requiring that applicants be 21 years of age or older; be of good moral character; mentally competent; possess the education equivalent to a high school education; complete a 2-year college preoptometric course; complete a 4-year course in a school or college of optometry; pass the examination; and pay all required fees.

Section 12 of the present act, in addition to setting a 21-year-age minimum and requiring good moral character of applicants for examination, authorizes the Commissioners to alter, amend, and otherwise change the educational standards at any time, provided they are not lowered.

The proposed section 5 provides for reciprocity with the States. However, there are requirements that an applicant for license by reciprocity must have practiced for at least 5 of the last 7 years and must practice in the District within 1 year of receiving the license by reciprocity. It occurs to the Commissioners that these provisions might work a hardship on a qualified optometrist who before