Dr. CHAPMAN. No. Mr. ROGERS of Florida. We will file his statement, then. (Dr. Kitchell's statement in full follows.) STATEMENT OF FRANK M. KITCHELL, O.D. Mr. Chairman and members of the committee, my name is Frank M. Kitchell. I am a licensed optometrist, engaged in private practice in Hempstead, N.Y., and am senior vice president of the American Optometric Foundation. The foundation is a nonprofit organization, organized in 1947, and composed of approximately 2,600 optometrists throughout the United States. Its founders had several objectives. The most important and most urgent was to sponsor research in optometry. The profession realized then, as it does today, that the advancement of this profession will rest to a large extent upon research. Vision care is and must be a dynamic science; it cannot stand still; it deals with man's most valuable possession-his ability to see which largely enables him to be a dynamic part of his civilization. Over the past 16 years, the foundation has awarded numerous fellowships to deserving students; most of them receiving their Ph. D. and now engage in teaching and research. These fellowships were paid for solely through voluntary contributions made by optometrists. The individuals who received those grants were not the only deserving applicants. There were many others. But foundation funds were and are limited. Lack of funds has hampered our progress in optometry. And it has prevented us from adding to those in our profession who have earned a Ph. D. Their number is far from sufficient for the needs of the profession itself and of American industry. We do not begrudge industry its share of our Ph. D.'s. In fact, we are glad that our profession can and does make a contribution to industrial safety and efficiency. But we must have sufficient men with advanced degrees to do research and teach in our schools. Parenthetically, it is only the graduate schools of the major universities with optometric training programs which supply teachers and researchers with the advanced degrees in physiological optics. These Ph. D.'s are found not only in industry but also in military installations and health service clinics. They oecupy teaching positions in various departments of universities-medicine, physiology, psychology, and physics. To train these men, to give them an opportunity to obtain the highest degree in our profession, is a costly undertaking for the schools-and for the students. Optometry has supported its own all along to the limit of its capabilities. But the limit is far short of our requirements. The demand for trained men in all health fields is rapidly, even alarmingly, increasing. I have represented the American Optometric Association at the National Health Council meetings for the past 3 years-and the statistics they gave us at those meetings gathered from 50 health professions, certainly demonstrated graphically that growing demand. What is true for the other health professions is true of optometry: We must have more researchers, teachers, and-since everything must start with a source students. It is quite difficult for a good many students to finance even their undergraduate professional study. This problem becomes vastly more difficult when they attempt to obtain a doctorate. They have to be willing to make great sacrifices to obtain advanced degrees: they must be dedicated men and women. It takes the candidate 7 or 8 years to earn a Ph. D.; meanwhile he may be married, have a family, and yet must live on a pittance, for he can rarely afford to take enough time off from studying to earn money at an outside job. Even the man who goes into optometric practice after finishing the 5- or 6-year course depending on the school he attends-has a much harder time financially than the medical doctor who at least earns some money right away during his internship. The optometrist establishing himself in his own practice cannot count on a particular income; in fact his income for the first 2 years is likely to be no more than $5,000. Meanwhile he has quite an investment in equipment, and the rent has to be paid. At this moment, we have eight applications for fellowships. Our funds allow us to give out only three. And this at a moment in history when we badly need more educators. During the past 4 years the foundation has expended approximately $10,000 annually in grants to its applicants. Small amounts, surely, for a big job. Small amounts when you consider the urgent need for more highly trained men. Now, there was an article in the Optical Journal-Review recently concerning eye research. It reported the findings of a survey conducted under sponsorship of Research to Prevent Elindness, Inc., a voluntary, medical research foundation, by Dr. Thomas D. Duane, head of the department of opthalnology at Jefferson Medical College in Philadelphia. Dr. Duane says that the number of scientists engaged in eye research must be increased by 75 percent in the near future, the number of supporting personnel by 65 percent. There must be a large expansion in laboratory space 415 percent according to Dr. Duane's survey--which will cost some $15 million. A minimum investment figure for new equipment: $10 million. And the number of electron microscopes must be doubled. These are the suggestions Dr. Duane put before the Labor, Health, Education, and Welfare Subcommittee on Appropriations of the House of Representatives, calling on the Federal Government to double its support of eye research. Of course research is important. But so is trained manpower. Optometry is aware of its responsibility to do research to further the cause of vision care. But it is also aware of the fact that you must have a steady-and increasingbody of students from which pool you can eventually draw researchers and educators. There is no river without its source; there is no profession without its students who will be tomorrow's teachers, practitioners, and researchers. And I am proud to tell this committee that there is no dearth of applicants for optometric college training nor of interest on the part of young people in optometry. For example, in April 1964 alone, the American Optometric Association received 305 requests for information; while during the period May 1963 to May 1964, it received a total of 2,196 such requests. And we know that there are far more applicants in every college and university than-barring financial aid for the student-they can possibly accept. For example, by early May of this year, Southern College of Optometry of Memphis, Tenn., had already 400 applications for the 1964 winter semester. In recent years, Southern's acceptance ratio has been 1 out of 3 student applicants; last year the ratio increased to 1 out of 4, and with rising numbers of applicants, the college reports this ratio will again increase this year. What is particularly sad about this situation is that students with promise have to be turned away. Most of those who are not accepted are not turned down for scholastic reasons. It is simply a question of dollars and cents; dollars and cents unavailable to either the student or the educational institution. The American Optometric Foundation views such a state of affairs with grave misgivings. Our profession is desperately in need of additional high-caliber teachers; our profession is in need of more researchers. And here we are turning away high-caliber students who could help to fill those needs. I mentioned earlier that the foundation had to limit its fellowships because of lack of funds. Again, the human potential-the research potential was there, but we could not put it all to work. Yet, like the optometric profession as a whole, we have gone forward, regardless of financial and other obstacles. The foundation is now engaged in a 3-year study at Indiana University School of Optometry to determine the factors involved in night driving, including not only the visual skills required, but automobile design and environmental factors as they affect safe night driving. Recently the foundation made a grant to a young Ph. D. at Pennsylvania State College of Optometry to develop an improved tonometer, an instrument that detects glaucoma. This will eventually be available in general practice. We are proud of our accomplishments. We shall continue to meet the challenges of research to the limit of our resources. I think that, looking at the entire field of optometry, it is amazing how much has been accomplished in the field of vision care and its advancement without the aid of outside funds. But the cost of education in all the health professions is high and probably will go higher; this is true of optometry. Considering our small amount of available loan funds, much more could be accomplished if the existing law is amended to make Federal loan funds available to optometry scholars and colleges. The enhancement and preservation of the priceless gift of vision is the primary concern of the American Optometric Foundation, whose officers and directors serve without material compensation. Their only reward is the knowledge that their efforts will eventually play a part in the improvement of the vision-and the vision care of all of our people, and of people far beyond the confines of our country. I hope that the members of this committee will report favorably on this proposed expansion of the student loan fund provided by Public Law 88–129. By doing so you will help insure a greater supply of future well trained optometrists. both men and women, from among whose numbers organizations such as ours will be able to secure the researchers who will make the optometric discoveries of tomorrow. Thank you for the opportunity to present the foundation's views. In closing let me say that optometry is eager to meet its increasing challenges in the space space and to continue to provide the finest vision care in the world for our citizens. The loan funds now under consideration will go a long way to help to make that hope come true. Mr. ROGERS of Florida. Are there any other witnesses that you have? Dr. CHAPMAN. No, sir. There are no further witnesses from our association. I would like to suggest if any of you gentlemen have recorded questions which you would like to ask any of those who have previously testified, this might well be the time to do that, but I would-whatever procedure you follow will be all right with us. Mr. ROGERS of Florida. All right. Mr. SCHENCK. Mr. Chairman, I have only one question and that is that I think Dr. Ewalt mentioned additional studies were being made on the matter of filters of one kind or another, and I wonder where and when, that study is going to be completed and where the information will be available. Dr. CHAPMAN. Mr. Schenck, I do not-well, I will turn it over to Dr. Ewalt. Dr. EWALT. I am not able to answer when they will be completed, but I will certainly make an effort to get the information for you from members of our profession serving on these committees, and so forth. Mr. SCHENCK. Thank you so much. Dr. EWALT. On the filters for this fog and Dr. CHAPMAN. It is at Indiana University, I think primarily, isn't that right, Gordon? Dr. HEATH. Yes, one of my colleagues, Dr. Merrill Allen at Indiana University is one of the country's leading researchers in the matter of driver's vision and visibility and illumination from vehicles. He is presently engaged in a study of filters and of foglights specifically. Mr. SCHENCK. Well, recently there was some company-I do not recall now-who manufactured yellow colored lens for, I think, primarily trapshooters but who also felt that that was a valuable filter for fog. I know nothing about it. Mr. ROGERS of Florida. Any questions at all? Mr. BROTZMAN. Permit me to proceed out of order, if these gentlement will indulge me one question. I have another hearing at 11:30. I just want to get one thing straightened out in my mind. I will direct this to any member of the panel, which I thought was a very effective one, I might say, but since we are talking about schools and education, will someone draw the line for me and define optometry, ophthalmology, I believe, and then there is another term, oculist. I do not quite have these things specifically in my mind as to which is which and which will be produced as a result of the education process assuming this particular measure is enacted into law by the Congress. Dr. CHAPMAN. In answer to Mr. Brotzman's question, one which constantly comes up in these discussions, Congressman, because of the similarity of the names, it make it very difficult on the part of lay people to understand the differences. I will be pleased to try and do that for you in as basic terminology as I can, and you will have to understand that it is really more extensive than I am going to outline for you now. An ophthalmologist is not an optometrist. An ophthalmologist is a medical practitioner who has in most instances taken additional training in the treatment of eye disease and the handling of eye surgery. He at the same time includes in his practice in most instances the handling of vision problems and the prescribing of glasses. The optometrist is a nonmedical practitioner in the sense that we are not concerned with the treatment or the surgery or the use of medicine in the handling of our patients. We are specialists in vision. Our first major concern is to determine the health of the eye. If it is deemed that this eye is healthy, and by the way, 98 percent of these eyes which will be seen will be healthy eyes, the optometrist then proceeds to utilize the various methods and techniques and proceduers to make this pair of eyes a comfortable, efficient seeing pair of eyes. In the course of that examination, if I discovered the need for surgical investigation, or further investigation from a pathological or from a health standpoint for treatment, then I immediately refer that patient to the proper physician for it, the proper medical practitioner. The term oculist is not now-I want to say the right word here it is not used nearly so much. The term is fast going out of vogue. It generally described back in its important day the medical practitioner who did eye, ear, nose, and throat, and quite often he would call himself an oculist. He rarely, however, went beyond his normal medical training for specialized work in the eye particularly as treatment or surgical requirements might demand. He generally specialized by his own interests in this field in the area of eye examination, prescribing of glasses, et cetera. You see that term very rarely now. not very often. It still exists in some spots but There is one other that you did not mention which is important in this whole scheme and really with the exclusion of the oculist term, now, you come to three, and the third is the optician, and his name is so similar, too, that it is also confusing. And I think the easiest way to remember his performance is to think of him in terms of a pharamacist in the sense that he can take a prescription from an ophthalmologist or an optometrist and fabricate a pair of glasses from it, but he is not trained or licensed or equipped to examine the human eye at all. You may take your prescription there and have it filled; your prescription from the ophthalmologist or optometrist. Is that helpful to you? Mr. BROTZMAN. Very helpful. Mr. ROGERS of Florida. Thank you very much. STATEMENT OF JOSEPH P. ADAMS, REPRESENTING THE Mr. ROGERS of Florida. At this time, then, there being no questions, thank you very much for an excellent presentation. Any other Mr. ADAMS. My name is Joseph P. Adams. I am the Washington representative of the International Chiropractors Association, and I would like to request permission to file a statement. Mr. ROGERS of Florida. That will be permitted, and without objection it will be made a part of the record at that point. (The material referred to follows:) Hon. PAUL G. ROGERS, WASHINGTON, D.C., June 2, 1964. Subcommittee of Public Health and Safety, Interstate and Foreign Commerce Committee, House of Representatives, Washington, D.C. DEAR MR. ROGERS; It was a pleasure and a privilege to attend the hearing conducted by you and the Subcommittee on Public Health and Safety of the House Interstate and Foreign Commerce Committee on Tuesday, May 26, on H.R. 8546, a bill to include optometry students in H.R. 12 under the student loan sections. You authorized me to submit a statement on behalf of the International Chiropractors Association and the statement follows: Chairman Rogers and distinguished members of the Subcommittee on Public Health and Safety, I am privileged to present this statement on behalf of the International Chiropractors Association of 741 Brady Street, Davenport, Iowa. My position with the association is that of Washington, D.C. counsel. The International Chiropractors Association is active and represents member chiropractors in all States of the Union. It is dedicated to the public welfare and to the promotion and preservation of high professional standards. It maintains that all citizens are entitled to freedom of choice of doctor for their personal health care. There are compelling reasons why the science of chiropractic should be included in any consideration of H.R. 8546, by amendment. Chiropractic today is the second largest healing profession in the United States, and has earned, and deserves your consideration for its inclusion in legislation now the subject of this committee's study. Research and development in the chiropractic colleges of this country will probably afford the greatest dollar's worth of value purchasable in the entire health field today while at the same time increasing the output of doctors whose training will be made possible by the student loan section of the act. To refuse chiropractors inclusion in this amendment is to prohibit thousands of young people the right to attend a college of their choice, but most of all it will deny the public the right to choose their own doctor because the present school system finds it difficult to meet attrition rate through its graduating classes alone. This is a worthy cause and it for our own citizens and our own young people. Help the chiropractic colleges help themselves by including them in this bill. CLEVELAND CHIROPRACTIC College President, C. S. Cleveland, Jr., B.S., D.C., Ph. C. "Every effort should be exerted to assure the inclusion of chiropractic in any consideration of the Health Professions Education Assistance Act of 1963 by appropriate amendment. "The enrollment of Cleveland Chiropractic College, Kansas City, Mo., is growing, and we need more classrooms, more laboratories, and more equipment and facilities. |