A HUGE GIFT TO THE PUBLIC

The current debate regarding medical care for the
aged seems to ignore the physician. The fact that
the nation's doctors annually give away a huge
amount of their medical services is usually over-
looked. What this amount comes to as well as a
number of other aspects of the free care that is
donated by physicians—is revealed by New Medical
Materia's latest study. The charts on this and the
next two pages give the details,

Special Feature

U. S. Doctors In Private Practice Donate
$658,000,000 Worth Of Free Medical Care

The CHAIRMAN. Now, with reference to your student loan program-and I want to commend the American Medical Association emphatically and forthrightly here today for its recognition of the need and its efforts to help meet it. It was never intended to be completely adequate to meet the needs, but only to help in filling the gap. Since these are public institutions, many of them, and nonprofit institutions, the application of a medical student is made to whom?

Dr. DORMAN. It is made to the AMA through the deans.

The CHAIRMAN. Through the dean of a particular school?

Dr. DORMAN. Of his school. We have to be sure that the individual is a bona fide student in good standing.

The CHAIRMAN. Who decides whether a particular application will be approved or disapproved?

Dr. DORMAN. Final decision is in the AMA headquarters office. The CHAIRMAN. And you make that decision on the basis of the information submitted to you by the institution?

Dr. DORMAN. On information, primarily supplied by the student, but we inquire further of the institution.

The CHAIRMAN. In other words, you make your own private investigation of each individual application?

Dr. DORMAN. If there is any question: yes, sir.

The CHAIRMAN. Now, in the various States, are there procedures set. up for determining who will be or will not be accepted as a medical student other than the registrar of the institution or the dean?

Dr. DORMAN. Certain of the State laws or regulations require definite premedical requisites. In order to qualify, the student has to pass certain premedical subjects, but the decision of accepting him is up to the dean of the medical school.

The CHAIRMAN. Suppose, for example, you were to get 100 applications and you have only 50 places available. Who would decide which of those 100 would be approved?

Dr. DORMAN. The committee on admissions at the school. Usually, this is the dean of admissions, and four or five other people on the medical faculty. The decision is theirs entirely.

The CHAIRMAN. The medical faculty of that particular school? Dr. DORMAN. The admissions committee of the faculty; yes, sir. The CHAIRMAN. Does the school have a screening committee that is not associated with the school in any way?

Dr. DORMAN. I believe not, sir.

The CHAIRMAN. Not that you know of?

Dr. DORMAN. Not that I know of. There are premedical advisory committees. A foreign student has to show adequate premedical training.

The CHAIRMAN. Are these procedures established by the individual States themselves, or is there a national pattern?

Dr. DORMAN. I believe that each State has its own requirements. Since the States license the individual physician, they have reserved unto themselves the right to make the regulations for education requirements for their license.

The CHAIRMAN. In other words, under the existing procedure, a State has the prerogative and is autonomous in establishing minimum standards for entrance to its medical schools, and this is done wholly within that State for its institutions.

Dr. DORMAN. Not quite, sir.

They have the right to set up their educational requirements. However, the AMA has published standards of education necessary to qualify a man for practice. We work with the American Association of American Colleges on this. We have established specialty boards which set standards of education and training for physicians who wish to go into specialties. There is an overall "control." But the individual licensing is by the States themselves.

The CHAIRMAN. You mean there is an overall control of the financing which the AMA provides to a given student?

Dr. DORMAN. Well, I think we are getting into financing and the educational requirements, sir, which are two different problems.

The CHAIRMAN. Do you mean to tell this committee that the AMA has any control whatsoever over the educational requirements of a given medical school?

Dr. DORMAN. No, sir.

We demand that the medical school have certain minimum standards, but the individual medical schools vary as to what they stress. They have to maintain their independence in order to be active, good educational institutions. We do not control that.

But there is some control as to who is coming into a medical school, based on standards accepted by each separate State, because the State is the licensing organization. At the end of the medical school the licensing is by the State, not by the medical school.

The CHAIRMAN. But those standards must meet national accreditation criteria?

Dr. DORMAN. More or less; yes, sir.

The CHAIRMAN. Like the National Association of Universities and Colleges, or whatever that organization is?

Dr. DORMAN. That type of thing.

The CHAIRMAN. I wanted to get that in the record.

Mr. ROGERS of Texas. Would the gentleman yield for one question? The CHAIRMAN. Yes.

Mr. ROGERS of Texas. Doctor, what is the office of the American Medical Association in regard to the activities of the educational institutions?

Dr. DORMAN. We have our Council on Medical Education and Hospitals, the chairman and the secretary of which are present, which coordinates this type of activity.

Mr. ROGERS of Texas. Is that an advisory capacity group or do you have any methods or weapons by which you can enforce your beliefs and feelings?

Dr. DORMAN. Could I have the secretary speak to this?

Mr. ROGERS of Texas. Yes. I think the record ought to be clear on this.