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Car: M. Cobb indicated that the cost annually to educate a medical student approx

$1,000. At Saint Louis University a student paying full tuition at the

present time pays approximately 1/5 of that amount; the remainder must be derived from other sources. We have a very modest endowment, the income from which covers less than 1/10 of the annual cost referred to above. Therefore we are very dependent upon other sources of income including amounts received annually from corporations, foundations, interested individuals, and other donors. I do not believe

our situation is basically very different from that of many other medical centers. imperative that additional financial support must come from other sources if attempt is to be made to increase appreciably the number of trained health profem.anals.

If we in this country are to continue to try to satisfy the increasing demand for more and better quality health care, all segments of the community must not any recognize the seriousness of the problem but must be prepared to cooperate trying to solve it.

There are a number of areas in which more effective use can be made of the

ly trained professionals, such as physicians and registered nurses, and this ere our American ingenuity must be utilized. A number of people far more knowledgeable than I have suggested the development of a class of physicians'

stants, paramedics, trained as the hospital corpmen have been trained by our armed forces. These could, under proper guidance, serve to meet many of the needs of the population thus reserving for the more experienced physicians and nurses services for which theirmore intensive training has prepared them. I am informed

that some headway has been made in this matter particularly at Queen's Medical Center in Honolulu. One Operating Room Technician program covers a six month period which prepares high school graduates to work in the operating room under the direct supervision of a surgeon or a registered nurse. The second program is intended to establish a group of non-professional surgical assistants to supplement or substitute for surgical residents or interns in most types of surgery. Applicants for this latter program (Trained Surgical Assistant program) must have had prior training as a military corpsman or must have completed a certified Operating Room Technician course.

Increased emphasis on the advantages of group practice also offers an opportunity for better utilization of our present health professionals. These are but a few of the areas that must be carefully and objectively explored if we are to meet the ever increasing needs of our consumer population.

In closing, may I again thank you for this opportunity to testify before this committee. Hearings such as you are having here today encourage me in my conviction that the problems facing all of us are not only capable of solution but are receiving careful consideration and study.

If there are any questions you have, I will attempt to answer them.

Senator EAGLETON. Our next witness is one of my favorite indivials, I must say, and really a distinguished clergyman and a great

versity president. I am privileged to introduce for this presenta1. Paul C. Reinert, S.J., president of St. Louis University.

STATEMENT OF REV. PAUL C. REINERT, S.J., PRESIDENT, ST. LOUIS UNIVERSITY

Father REINERT. Thank you, Mr. Chairman.

Senator and Congresman Symington and gentlemen, as president. f St. Louis University, I want to make five brief statements which present the position of St. Louis University and its trustees in regard to our involvement in the field of health education, health rearch, and health service.

No. 1, St. Louis University places a very high priority on its medialter as it is presently constituted. That includes the school of 1. e, the school of nursing and allied health professions, and the versity hospitals. During the past 2 years the trustees of the unihave been carefully reviewing the many diversified educatal programs sponsored by the university and have been determingwhat our priorities should be. In doing so, they have made a firm

mitment to maintain the medical center with the schools that I Lave just enumerated. This commitment obligates the university to *.d be to exert every conceivable effort to secure the resources necessary, both for the center's annual operational budget and for capital exgen i:tures,

No. 2, through its medical center programs, the university is parlarly interested in and dedicated to the training of personnel for elivery of health care and for the improvement of the mechanisms w bring medical services to the sick and the needy. We are coned that we possess special abilities in this field because of the

phy espoused by this institution and its faculty and because fr location in a large metropolitan area where our concern for the e needs of the community has long been recognized.

No. 3, in spite of the sincerity of its commitment, the university is periencing serious problems in achieving its objectives for the medial enter. In common, first of all, with all private universities, we

secure most of our operational budget from two sources, tuition aft Yet, in the medical school, for example, our relatively high 1. of $2,250 covers only about one-fifth of the gross cost per dent in educating a doctor, the figure that Mr. Jackson pointed earlier. Then, as regards our second chief source, gifts, the St. Lcommunity, including corporations, friends, alumni, and others, ave been quite generous in their support, but in a period of inflation auertain business conditions the amount of annual giving to the

rsity is certainly in danger of leveling off, if not diminishing. Moreover, we face a special problem by reason of the fact that we Acated in the State of Missouri. Most private medical schools sewhere are receiving some form of direct or indirect financial assist

from the State, either through scholarships for their medical tients or through special grants or contracts for the education of alth personnel. As a matter of fact, according to the best information I have been able to gather, there are only six private accredited

medical schools in the entire United States that are not receiving some form of State aid. Two of them are in the District of Columbia and, therefore, obviously are not getting State aid, George Washington and Georgetown. The other four are Tulane in New Orleans, Creighton in Omaha, and Washington and St. Louis Universities, so two of the six unaided private medical schools are in the State of Missouri.

No. 4, committed as it is to serve our local community first and foremost, the university wishes to make a special contribution by enhancing the number of black physicians, nurses and other health personnel to meet the needs of this specific metropolitan area. Such an objective is impossible of achievement without substantial financial assistance from resources that are not now available.

From our special assistance programs for the disadvantaged at the undergraduate collegiate level, we know from experience that to prepare a young man or woman from a disadvantaged family to qualify for admission to a medical school demands an expenditure in money and time that is substantially larger than in the average situation. Hence, it is inconceivable that any substantial number of black students can complete their undergraduate premedical education and then proceed to the costly process of medical education itself without massive assistance, either to the student himself or to the institution. that is educating him.

No. 5, finally, St. Louis University is dedicated to the philosophy of integrated education for health professionals. Although other types of educational institutions can certainly make a substantial contribution, we are convinced that a medical center such as ours, with all of the resources of its schools and hospitals, can best provide an integrated program for the education and the early experience of all personnel who are involved in the medical and the paramedical professions.

Thank you very much.

Senator EAGLETON. Thank you, Father Reinert.

At this time I am sorry to announce that both Senator Symington and Congressman Symington will have to leave for other engagements. Before leaving, do you wish to make a statement, Senator?

Senator SYMINGTON. Thank you. I always avail myself of the opportunity of listening to Father Reinert because, Mr. Chairman, I never do listen to him that I don't learn something constructive.

I am late for another engagement. The chairman had said he would be kind enough to put me on as the first witness, but I became interested in Mr. Jackson and I stayed a little longer.

I want you to know, Father, that I agree with every word you said in that statement. If the chairman doesn't put it in the Congressional Record, I would like to put it in the Congressional Record. I think the situation here is very serious and I am very proud of the fact my colleague, Senator Eagleton, is looking into this matter in this way. You can be assured that I will join him, and we, in turn, will attempt to get others to join us in solving the problem that you have presented so well this morning.

Mr. Chairman, again, my appreciation.

Senator EAGLETON. Jim?

Mr. SYMINGTON. No, thank you, Mr. Chairman.

Senator EAGLETON. My thanks to both Senator Symington and Congressman Symington.

Next we will hear from Father E. J. Drummond, the vice president 4te Medical Center of St. Louis University, a member of the Ntoral Advisory Allied Health Professions Council of the Depart

t of Health, Education, and Welfare, a member of the Council on Ma power and Education of the American Hospital Association, and *ber of the board of directors of the National League for

Father Drummond?

STATEMENT OF EDWARD J. DRUMMOND, S.J., VICE PRESIDENT, ST. LOUIS UNIVERSITY MEDICAL CENTER

Father DRUMMOND, Mr. Chairman, like my colleagues, I appreciate

of portunity to speak about health manpower problems. As vice ient of this institution and one who is involved in a number of atal health boards and committees, I am very pleased to speak at our medical center.

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Iere will be enrolled here this fall, to put this in something of the metic of size, about 1,450 students in our center in the various a professions. Of these, about 525 will be studying to be doctors nedicine. Others will be in nursing, hospital administration, and health related programs.

Apart from our contribution to society in the direct delivery of th care in the ways that have been described relating to various - tals in the community, through the direct service we offer in own hospitals, and apart from our work in health research, this ter, in terms of manpower production, is an important resource e community, the State, and the Nation. Mere numbers show that, 1. Its strong and effective continuance, to which various im*** ant national leaders and our own university president, the chairsz. of our medical center and the trustees have spoken requires Gov

ent assistance.

Let me show this in some brief detail. In fiscal 1970, this center at an operational deficit of almost $1,700,000 for the year, and has rred this kind of deficit over the past several years. Moreover, extenditure of capital funds, exclusive of Federal money, has the past years amounted to about $4,500,000. These operational and capital spending have been funded partly from gifts but have also been funded by using of our very limited fiscal reThis process is a little like that of a dog chewing its tail, as - mas described. "Subjectively, the dog is eating: objectively, the being eaten.”

e center has, of course, been aided by Federal funds. Most re***y there were the matching funds of almost $9.8 million that more awarded for capital construction.

I, too, want to add my appreciation and that of all of us to you, - Carman, and to the other Senators and Congressmen who have ℗ so much to help obtain this grant. We are very conscious of it. For operations, besides the Federal funding for capital affairs, we » received training and research grants in various health pro1- well as some student aid in scholarships and loans. We rerio State subvention, ns Father Reinert, our president, has indiWe are, however, endeavoring, along with Washington Univer**y az d 'he two colleges of osteopathy in the State, to try to work out

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