SECTION 396. RESEARCH AND DEVELOPMENT IN MEDICAL LIBRARY SCIENCE AND RELATED FIELDS Section 396 provides for grants for projects of research and investigation in the field of medical library science and for "the development of new techniques, systems and equipment, for processing, storing, and retrieving and distributing information pertaining to sciences related to health." We believe this section to be of particular importance. Since emphasis is usually placed on space, budget, and library holdings, the important aspect of utilization is often overlooked. The critical factor in the value of a medical library is, after all, the question of how effectively its stored information is made available to the learner in response to his need. The largest and most magnificent library is of little value until its storehouse of information is actually in use. New methods of meeting the requirements of the learner more quickly and efficiently are badly needed, and we strongly support this section which is intended to develop such new methods. SECTION 397. GRANTS FOR IMPROVING AND EXPANDING BASIC RESOURCES OF LIBRARIES This section would provide the means for libraries to improve their holdings of books, journals, et cetera, and thus strengthen their basic resources and facilities. The provisions permitting acquisition of films, projectors, duplicating devices, and new technologic equipment are particularly valuable since most medical libraries are deficient in these areas. The AMA supports this section of the bill. SECTION 398. GRANTS FOR ESTABLISHMENT OF REGIONAL MEDICAL The concept of having a strong medical library in each region of the country to serve as a source of support for other libraries in the area appears to be a reasonable one under present conditions. The purpose of this section would seem to be best fulfilled by strengthening existing medical libraries in strategic locations to serve as regional libraries. Except in the unusual circumstances where a geographic area is completely lacking in library resources, new and separate regional libraries need not be established. SECTION 395. ASSISTANCE TO SPECIAL SCIENTIFIC PROJECTS, AND SECTION 399. FINANCIAL SUPPORT OF BIOMEDICAL PUBLICATIONS We make no specific comment as to sections 395 and 399. However, the need for these provisions is less apparent to us. Mr. Chairman and members of the subcommittee, the American Medical Association appreciates this opportunity of presenting its views on this important legislation. We will be pleased to attempt to answer any questions the committee may have. The CHAIRMAN. Doctor, thank you very much. I wonder if Dr. Ruhe or Mr. Donelan have any further comments to make. 63-762-65--6 Mr. DONELAN. No, sir. Dr. RUHE. No, sir. The CHAIRMAN. Are there any questions among members of the committee? Mr. MACDONALD. Mr. Chairman. I have listened to your very fine statement, and I am glad to see that you support the legislation, as I do. I was just wondering if AMA did not feel this would be Federal interference with the practice of medicine and research. Dr. SODEMAN. I believe the AMA believes that this is sound support for the health of the country. Mr. MACDONALD. Obviously this would not be leading to socialized medicine, would it? Dr. SODEMAN. I don't see how it can, sir. Mr. MACDONALD. Because sometimes I have difficulty following the mental processes of the AMA. They support some things that the Federal Government does in the field of health. Other times they take a rather, shall we say, a drastic point of opposition to things that we in the Congress try to do to help the field of medicine. Dr. SODEMAN. This bill would give support to each and every physician and researcher in sharpening his knowledge and the depth of his knowledge in medical science, and this is very important. Mr. MACDONALD. I take it in that area the AMA gives it full support. Dr. SODEMAN. There is full support. Mr. MACDONALD. While in other areas they do not. The CHAIRMAN. Are there any further questions? Dr. Sodeman, thank you very much for your very fine statement. We are pleased to have you gentlemen here in support of this legislation. Dr. SODEMAN. Thank you. The CHAIRMAN. The next witness will be in behalf of the Association of American Medical Colleges, Dr. John Parks, George Washington University, in Washington, D.C., and Dr. Robert C. Berson, the executive director of the association. Gentlemen, we are glad to have you. We shall be pleased to have your statement. STATEMENT OF DR. JOHN PARKS, DEAN OF MEDICAL SCHOOL, GEORGE WASHINGTON UNIVERSITY, WASHINGTON, D.C.; AND DR. ROBERT C. BERSON, EXECUTIVE DIRECTOR, ASSOCIATION OF AMERICAN MEDICAL COLLEGES Dr. PARKS. Mr. Chairman and members of the committee, I am Dr. John Parks, dean of the George Washington School of Medicine and a member of the Executive Council of the Association of American Medical Colleges. This is Dr. Robert C. Berson, executive director of the association. We are pleased to have this privilege to speak in behalf of this proposed bill. Speaking for all the 87 medical schools in this country who constitute the institutional membership of the Association of American Medical Colleges, I want to express enthusiastic and unqualified support for all provisions of this legislation and urge its passage at an early date. While the major medical libraries in this country are located in medical school centers, large research complexes, and the medical societies of a few metropolitan areas, there are over 6,000 medical libraries serving smaller medical societies and community hospitals throughout the Nation. For a number of years responsible reports have indicated that the medical libraries of the Nation are in a serious state of disrepair. It has been impossible for librarians to keep pace with the growing volume of scientific literature which is of such great importance to medicine. Productive medical research is dependent on access to the relevant literature. Each research project usually results in one or more published articles or periodicals and as the number of research projects underway in this and other countries has increased, the volume of published literature has grown at an astonishing rate. The protection of our national investment in research requires adequate provision for making the published results available to investigators. Medical libraries play a very important role in the education of medical students, dental students, students of public health and veterinary medicine, other students in the health disciplines, interns, and residents. For health care everywhere it is of greatest importance that practicing physicians have access to appropriate parts of the published literature in order to keep abreast of new developments in the study and care of their patients. This triple role of the medical library in providing a service basic to research, education, and patient care has made it difficult for existing national programs to meet the needs of medical libraries. One of the most important traditions of science has always been the free exchange of knowledge between scientists wherever located. It can truly be said that the literature of medical science as well as the problems it attempts to solve transcends national boundaries. At the present time a considerable percent of the important new periodicals in medical literature are printed in languages other than English. There is a very active exchange of literature between our country and Russia, Germany, Italy and other countries all over the world. It is far more efficient to provide translating, abstracting, and bibliographic services to serve the entire English-speaking world rather than for each library to attempt this type of technical work. There are unparalleled opportunities for strong leadership at the national level through the National Library of Medicine. The more than 6,000 medical libraries in this country reflect the efforts that have been made through hospitals, research institutes, professional societies, and medical schools to provide library services. It has been estimated that the present investment in medical libraries in this country is something over $300 million, essentially all of which has come from private, local, or State resources. The Medical Library Assistance Act of 1965 recognizes that these local sources will continue to carry most of the library expenses. It also recognizes that Federal funds should be provided to augment these local funds and to strengthen the role of leadership of the National Library of Medicine in matters that can be handled effectively on a national basis. Medical libraries are thought centers for medical scientists and physicians. Better medical library facilities are urgently needed to support the expanding educational and health programs of our Nation. The Association of American Medical Colleges strongly endorses the Medical Library Assistance Act of 1965 and looks forward to its early adoption. That is our testimony, gentlemen. We shall be pleased to answer any questions. The CHAIRMAN. Thank you very much, Dr. Parks. Dr. Berson, do you have any further comment? Dr. BERSON. No, sir. We shall be glad to attempt to answer any questions. The CHAIRMAN. Are there any questions by any members of the committee? I would like to make this suggestion for those of you who are very cooperative in making the record-I think I will start with Dr. Dempsey. I believe this record should show information to support the estimated expenditures. I would like more positive information as to what the estimates are. I know the bill proposes to utilize so much money for various purposes, but I do not see in any of your statements that have been presented yet any information as to what those requirements actually are going to be. As an example, you testified for the need of certain construction. The Bureau of the Budget asked that this program be deferred, and I think with some merit, for at least a year in order that plans can be developed to provide more information. What I would like to know, Dr. Dempsey, is the justification for the amounts proposed for construction. We know that $10 million is estimated to be the amount that should be authorized. But maybe it should be $5 million or maybe it should be $15 million. There is no information here yet to indicate what the requirements will be. So, I would like to ask you, Dr. Dempsey, if you will give us more detailed information for the record to go along with your statement on what your estimated requirements will be for each of the budgetary items. Dr. DEMPSEY. I will be delighted to furnish that. The CHAIRMAN. For 1966, for 1967 and during the 5-year proposed program, so that we will have a record of what would be needed. (The information requested follows:) MR. JAMES M. MENGER, PROFESSIONAL STAFF MEMBER, HOUSE INTERSTATE AND FOREIGN COMMERCE COMMITTEE Mr. Menger, in response to Chairman Harris' request, we are transmitting herewith, two statements of appropriations requirements together with our justifications for the Medical Library Assistance Act. The first of the statements is based on the authorization as set forth in the bill: The second embodies our recommendations for authorizations which could provide for maximum flexibility and efficiency of administration. You will note that the 5-year totals are $117.5 million in each case. Appropriations authorizations recommended by Department of Health, Education, and Welfare to carry out the proposed Medical Library Assistance Act of 1965 (H.R. 3142) [In millions of dollars] Alternative method of authorizing appropriations to carry out H.R. 3142 SECTION 393. ASSISTANCE FOR CONSTRUCTION OF FACILITIES Based on information obtained from various health professional organizations, from governmental agencies, and by its own resources, the National Library of Medicine has determined that an amount of $50 million made available over a period of 4 years will make a significant impact in reducing the backlog of construction and renovation needs of health science libraries. Since there has been very little new construction of health science libraries in recent years, it appears that the larger need is for new construction rather than for renovation of existing facilities. This is confirmed in the case of the study of medical school libraries conducted by the Association of American Medical Colleges in 1964. This study disclosed that 80 established medical schools required $87,217,062 for planned library construction. In addition new construction for freestanding medical libraries and those in other health professions such as dentistry, public health, osteopathy, and optometry will require an additional $10 million. At the 75percent matching rate allowed in the bill, these projects would require somewhat more than $72 million. SECTION 394. GRANTS FOR TRAINING IN MEDICAL LIBRARY SCIENCES The manpower deficit in the medical library field is evident when one considers that there are about 6,000 functioning medical libraries in the country but only about 3,000 librarians with specialized training or experience. It is not suggested that all these libraries need be manned by highly trained professional librarians. Many of the smaller ones could be operated by library technicians. At the present time less than 50 new medical librarians are being added to the manpower pool per year. The appropriation authorization ($1 million) contained in H.R. 3142, section 394, would permit the support of approximately 200 individuals per year for training in biomedical information work. Since not all of these would be in 1-year programs, it is estimated that between 125 and 150 new personnel could be added to the manpower force annually. During the 5-year period of this program, approximately 750 information personnel will be trained at 20 academically based training centers. |