At the same time, it should be understood that the registered pharmacists active in the related health fields mentioned do not satisfy the numerical requirements for pharmacists in those areas, either. The demand for pharmacists in such areas far exceeds the available supply. Over the past 30 years, very little preparation of any kind was made to meet what have become the substantial needs for trained pharmacists in such associated fields of interest.

As one informed observer of the pharmaceutical scene has reported: *** the current shortage of pharmacists seems certain to become even more pronounced in the years ahead. ***More than 160,000 registered pharmacists will be required 15 years from now to satisfy the needs stemming from continued population growth only, assuming that current ratio of availability of pharmacists can be termed adequate. Of this number, an estimated 10,000 will be needed in hospital pharmacies and another 2,000 to meet what are probably the minimum requirements for teaching and research. For the most part, the others will be engaged in retail pharmacy and allied health fields, as is the case today. (See table B.)

In planning to meet the needs for pharmacists in the future, attention must be given also to the rapidly developing trend in retail pharmacy toward the 8-hour day and the 5-day week. Even now, the smaller retail pharmacist is sorely pressed to provide his customers with professional pharmaceutical services throughout the 14-16 hours of his daily operations. Bear in mind that 40 percent of all drugstores operate with only one pharmacist and another 45 percent are serviced by only two. Once retail pharmacy generally adopts the 40-hour week enjoyed by the other health professions, a substantial increase in the supply of pharmacists will be required. The alternative would be a deterioration in the quality and convenience of pharmaceutical service.

These observations concerning current and future shortages in pharmacy manpower find confirmation, I believe, in the 1959 report of the Surgeon General's Consultant Group on Medical Education, entitled "Physicians for a Growing America." According to the Consultant Group

shortages of trained people [exist] in practically every one of the many professional and technical careers in the health field. Intensive recruitment of young people for these many essential health services, including medicine, is imperative.

The desirability of coupling the problem of medicine with those in the related health professions was recognized by the Consultant Group. *** Physicians cannot carry their load of responsibility without competent and well-trained teammates and associates.

There is increasing recognition of interrelated responsibility of health workers with a variety of skills and educational preparations. One evidence of this is the development of university-based health centers with closely related schools of medicine, dentistry, nursing, and other health professions.

** * In 1900, for every physician in practice there was one other professional health practitioner; today, there are four such persons for every physician. After outlining our pharmacy manpower requirements, our task is to meet them. To achieve even our minimum goals in the supply of registered pharmacists will require much larger pharmacy school enrollments and graduations. That being the case, pharmacy school facilities will have to be substantially enlarged and teaching staffs correspondingly increased to take care of the additional students to

be enrolled, all without reducing the present high quality of pharmaceutical education. For success in this important undertaking, some Federal assistance will be required by the pharmacy schools just as with the medical and dental schools.

In view of these considerations, the NARD feels justified in asking that H.R. 12 be amended to make pharmacy students eligible for the scholarship funds that the bill would offer medical, dental, and public health students. Practical justice for American pharmacy would seem to require that the needs of the health professions be met in a comprehensive and nondiscriminatory manner.

(The tables referred to in Mr. Jehle's testimony follow:)

and December, 1961.

Source: Bulletin of the National Association of Boards of Pharmacy, vol. 12, No. 12. October, November,

1 Submitted by Senator Hubert H. Humphrey to the Senate Labor and Public Welfare Committee during public hearings last year on S. 1072, a companion measure to H.R. 4999.

NOTES

(a) Based on series 2 figures from Bureau of Census.

(b) Factor of 3.5 percent supplied by the National Association of Boards of Pharmacy. (c) Represents pharmacy school graduates.

The CHAIRMAN. Are there any questions? If not, Mr. Jehle, we appreciate your appearance and testimony.

Mr. JEHLE. Thank you, Mr. Chairman.

The CHAIRMAN. This will conclude the hearings today and the committee will adjourn until 10 in the morning.

(Whereupon, at 4 p.m., the committee recessed, to reconvene at 10 a.m., Thursday, February 7, 1963.)

1

*.. 14: Jou presently contemplating the establishment of new nooi..

American Medical Association has a serious interest of long mintaining the nigi, quality of medical education in the Sizes, without which there cannot be high-quality medical re over a century, the American Medical Association has been an effectively engaged in the improvement of medical edu1. ca: now be said, with assurance, that medical education in oumer i superior to that found anywhere else in the world. It convergence that improved standards of medical care in the century saw the elimination of substandard medical schools ...om mils" wich hat been turning out graduates in large Ta improvement in medical education is the direct result igorous efforts of this association and other interested

g the problem in the field of medical education, the Medica Association for the past several years has endorsed Federa program of aid to medical school.

(

1952. the American Medical Association supported the 2..100 construction provisions contained in H.R. 4743, 64th introduced by the late chairman of this committee, Mr.

1958, the association favored the construction provisions sath Congress, introduced by the committee's current A Harris.

1960. the association supported the construction pro16906. 86th Congress, introduced by Mr. Fogarty of

ind the opportunity to appear before this committee ant of the AMA, urging passage of that portion of Congress, designed to authorize matching grants for replacement, or rehabilitation of medical schools, Ironleet by Mr. Harria.

a take this opportunity on behalf of the American tion to respectfully subunit for your consideration our provisions of H.R. 12, 88th Congress, which is now

nding that this bill would amend the Public at provide:

ant for the construction, replacement, or rehabiliDental and osteopathic schools, and for schools naullary services.

on of sums to establish a loan fund for medical. are students.

of the research facilities construction program. deanssion to those sections of the bill providing for Se the construction, replacement, or rehabilitation

ads of medical education are to be maintained. st be given to the adequacy of physical facilof qualified instructors, and the availability of for the clinical phases of medical

e number of medical students

without regard to these conditions will result in a lowering of the standards of medical education. At this time, priority should be given, in our opinion, to an increase and improvement in the physical facilities available for medical education.

We believe that there is need for assistance in the expansion, construction, and remodeling of the physical facilities of medical schools and, therefore, a one-time expenditure of Federal funds on a matching basis is justified, where maximum freedom of the school from Federal control is assured.

The support by the AMA of these provisions in H.R. 12, 88th Congress, is based on the action of our house of delegates taken initially in June 1951, and reaffirmed frequently since that time.

We would also urge that the National Advisory Council on Education for Health Professions, suggested in the bill, be composed of persons skilled in the broad aspects of engineering, education, finance, architecture, as well as those concerned with training in medicine, osteopathy, dentistry, or the other named ancillary services.

When I appeared before this committee on January 26, 1962, to present the comments of the American Medical Association on H.R. 4999, 87th Congress, the predecessor of H.R. 12, I referred briefly to the AMA's student loan program. At that time the program was still in the final planning stages, and Dr. McKittrick, Dr. Wiggins, and I, in response to the committee's questions, were able only to estimate the probable effect of the project. As of December 31, 1962, the program had been in effect only 10 months; however, we can now transform the estimates into actual data. We believe these initial results to be dramatic.

The American Medical Association Education and Research Foundation has prepared two brochures which may be of significant interest to the members of this committee. I ask that these, one entitled "Medical Education Loan Guarantee Program," and the other a "Progress Report Through December 31, 1962," be received and incorporated in the record of these proceedings.

The AMA's medical education loan guarantee program, designed to alleviate the financial difficulties of medical students and to encourage career decisions in favor of medicine, utilizes the principle of a security fund, functioning as a surety agency, to make available unsecured personal loans at a relatively low rate of interest to medical students, interns, and residents. Administrative costs are paid by the American Medical Association-Education and Research Foundation. The loans, which have been available since March of last year to medical students, interns, and residents, provide each borrower with as much as $10,000 over a 7-year borrowing period.

The growth and success of the AMA-ERF medical education loan guarantee program can be best described as phenomenal. In the 10 short months since it was initiated, nearly 1 in every 10 medical students in the country now has borrowed money under this program. Through December 31, 1962, a total of 4,694 individuals (2,890 medical students, 672 interns, 1,132 residents) received 5,299 loans or $6,111,400 in principal amount. Ten percent of the borrowers applied for and received more than one loan. The borrowers are in training in 83 medical schools and 462 hospitals in 46 States and possessions.

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