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Acceptability

Health careers must be made acceptable

nursing and the allied fields to men.

medicine more attractive to women; Stabilization of our health manpower pool

requires an active program to eradicate the popular conception that medicine is for men and all other areas of health care are poorly compensated women's work. The efforts of the federal government to encourage former servicemen who have been given training in these areas is a forward step but is handicapped by the prevailing image referred to a moment ago.

Accessibility

Shortages of competent

The problem of accessibility is amenable to solution. personnel are most acute in rural areas. Aggressive recruitment of students who have grown up in a rural environment should result in an increased percentage of graduates returning to a familiar setting.

More adequate support in the form of traineeships must be made available. Such traineeships should provide for all costs including travel, tuition, housing and maintenance. The availability of such aid will be an attractive incentive for service, particularly to youths from rural or distressed areas. Their counselors must be thoroughly orientated. Traineeships must be made available to the high school graduate who wishes to complete four or more years at a college or university awarding a baccalaureate and/or higher degrees, whose potential is that of educator, administrator, researcher or highly skilled technologist in one of the emerging health specialties.

The rationale for restricting such aid to those already committed to the field is understandable but such a policy excludes or eliminates a large number of capable and interested high school graduates who just don't have the funds to get started and consequently drift into other areas of employment. Proper safeguards in the form of screening techniques and grade requirements could be

fomulated to insure against abuse or waste of government funds.

Although not accessible to many, we have an adequate number of educational institutions offering baccalaureate programs in the allied health services to meet prcected demands for personnel, if these programs were properly coordinated and if resources in terms of space, faculty and equipment were properly exploited. Many colleges and universities including Saint Louis University, given

Lial assistance to expand faculty, laboratories and space, could substantially Increase their enrollment. In 1969, one-hundred and eighty-six students were elled in the five allied health programs offered by the School of Nursing and Allied Health Professions of Saint Louis University. This represented a slight increase (67) from the previous year. A similar increase is anticipated for the school year.

If justified by an increased demand that could be generated by expanding the acneeship program, an additional fifty students could be accepted with the

ment of five full time faculty members and an increase of 15,000 square

feet of laboratory and classroom space.

Thirty-five years ago Saint Louis University became the first college or university in the United States to sponsor a school that included a baccalaureate angram for nurses and four allied health programs. A private university, it is not accessible to many because of necessary tuition charges. Located in an area that offers unlimited potential in terms of clinical facilities, expansion and Experimentation have been impeded by lack of funds.

paration

The degree of preparation for each of the identifiable allied health profesuns varies -- for some a two-year program may be adequate; others require more intensive preparation, involving not only the acquisition of technical skills,

but a knowledge of subjective influence of illness and its impact upon a given personality. The teacher, administrator, researcher and the technologist specialist require training beyond the baccalaureate level and it is in this area our greatest shortage will exist.

In common with medicine and nursing, allied health professionals - in the course of their preparation - must be exposed to patient contact in actual work situations under supervision of competent faculty. Faculty supervision must be

on a personal basis, both in the laboratory and in the care of patients; consequently the ratio of faculty to students requires maintenance of a large teaching staff

with attendant expense.

This desirable educational experience can best be offered in a university medical center complex whose resources include a medical school, hospitals and a school of nursing and allied health professions with access to a full range of related disciplines, i.e., education, basic sciences, administration, etc., but where the administrative structure with its coordinating processes are in existence.

Government Assistance

The allied health programs at Saint Louis University and in other schools with similar programs would be severely handicapped or perhaps discontinued if assistance in the form of basic improvement grants were not made available over the past five years. I would encourage this committee to strongly support legislation continuing this form of assistance in an increased amount and with less rigid requirements for annual increase in enrollment.

As with all programs designed to meet a growing need, there exists the danger of over proliferation. New and innovative programs should be encouraged but it is conceivable that we will so fragment our delivery of health care with specialists that manpower in terms of efficiency and effectiveness will be dissipated. needs of the public might best be served by exploring the feasibility of preparing

The

personnel with capabilities in more than one area, rather than encouraging the continued development of technicians and/or technologists with expertise in but one specialty. The majority of our hospitals are small; the majority of consumers live in areas that cannot support, in terms of demand, the many speura't es that exist.

Besearch on the contribution of each specialty, evaluated in terms of

ping technology and feasibility of application, should be conducted by a selected number of Institutions with the resources to conduct such a study. To meet the needs of various sections of the country, perhaps more than one such could be subsidized to work with curriculum development, evolution of new and experimentation with existing programs.

aps one example of the need for such research is the emergence of the 's Assistant. The concept is valid; the terminology may be unfortunate. Several programs designed to prepare personnel qualified to assume routine responsibilities of the physician have been initiated, but objectives and standards seem to lack uniformity.

For the protection of consumers and the medical profession, the role of the Physician's Assistant must be clearly defined. As a consumer, I would expect person with the title of Physician's Assistant to have a basic orientation to

alth care. This orientation can best be provided in a medical center complex.

Thank you.

Senator EAGLETON. We now have Dr. Oliver Duggins, Ph. D. It is refreshing to have a Ph. D. with us, after all of the M.D.'s. He is chairman of the Life Sciences Division, Forest Park Community College.

STATEMENT OF OLIVER H. DUGGINS, PH. D., CHAIRMAN, LIFE SCIENCES DIVISION, FOREST PARK COMMUNITY COLLEGE

Dr. DUGGINS. Dr. Cosand apologizes for having to leave. Senator EAGLETON. Yes, I would like the record to show he was with us for 2 or 3 hours waiting very patiently, and I know what his schedule problems are.

Dr. DUGGINS. He has asked that I represent him, and we appreciate this opportunity.

I'd like to make four or five very rapid comments on things that have been said so far.

I think probably the community colleges are in better position, or as good a position, as any other institution or type of institution to supply allied health personnel, and there are three or four reasons for this.

First of all, 42 percent of all the students who are in colleges today are in community colleges. The Junior College District of St. Louis in its very short existence is already the second largest college in the State of Missouri, and we anticipate or estimate that 60 percent of all students in college by 1975 will be in community colleges.

Secondly, community colleges are open-door colleges. We feel committed to meeting the needs of each individual student, as well as meeting the needs of the community.

Senator EAGLETON. Your open-door colleges are subject to the limits financially, aren't they?

Dr. DUGGINS. Well, we haven't been limited yet.

Senator EAGLETON. Federal City College, for instance, in Washington, D.C., yesterday turned down 2,500 students.

Dr. DUGGINS. We may have to do this; we haven't yet.
Senator EAGLETON. It is a real tragedy.

Dr. DUGGINS. Thirdly, technical or career training is one of the major emphases of the community college.

Fourthly, there are over 200 allied health programs, and most of these can be offered in 1 or 2 years which, of course, is the specialty of the community college.

The Junior College District of St. Louis at the present time has more than 600 students enrolled in allied health programs. There are eight allied health programs we are presently offering.

Senator EAGLETON. Would you supply for the record at a later date, Doctor, the titles of the programs, a brief description as to the type of training that provides, and the number of students enrolled in each?

Dr. DUGGINS. All right. I might just say that these are in eight programs and we have them listed here [indicating].

Senator EAGLETON. Oh.

Dr. DUGGINS. There are 34 in clinical lab technology, 74 in dental hygiene

Senator EAGLETON. That's all right. That will be in the record. I'm sorry.

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