It would be deeply appreciated if you would make this letter a part of the record of your committee's hearings on H.R. 12. Sincerely yours, AUSTIN SMITH, M.D. Re H.R. 12. Hon. OREN HARRIS, STATE OF CALIFORNIA, DEPARTMENT OF PUBLIC HEALTH, Chairman, Interstate and Foreign Commerce Committee, DEAR CONGRESSMAN HARRIS: As director of public health for the State of California, I would like to urge favorable action of your committee on H.R. 12. Extensive studies in California have shown the great need for more physicians, dentists, and public health personnel. During the next 10 years, the supply of our physicians must be doubled to meet the needs of our rapidly increasing population. This statement is based on the assumption that physicians will continue to come to California to practice at the same rates that they are now coming. A similar need for the training of dentists and public health personnel exists. We, in public health, are particularly concerned with the existing shortages of public health personnel. With the increasing realization of the value of preventive medicine and public health and with the addition of very complex public health problems resulting from our “exploding population," the need for public health personnel is particularly great. Recruitment and training must be increased to meet these urgent needs. Enactment of H.R. 12, would be of major benefit in stimulating and aiding the development of the necessary additional educational facilities for the training of the seriously needed health personnel. Chairman, Committee on Interstate and Foreign Commerce, DEAR CONGRESSMAN HARRIS: H.R. 12, now before the House Committee on Interstate and Foreign Commerce, would provide valuable assistance in the training of personnel in medicine, dentistry, nursing, and other public health professions. Many of our problems in all areas of medical care and public health stem mainly from a serious shortage of personnel and the imbalance of the public demand for medical services and the available personnel to meet this demand. It eventually becomes a personal tragedy to individual human beings, on all levels of our American society, that the richest country in the world cannot meet the demand for medical and health services, which such an affluent country requires. In sending us their medical graduates as hospital interns, Turkey, Iran, the Philippines, and many other less developed countries are in fact carrying out a "foreign aid program" for the United States. I am certain that you will derive deserving gratification from your support of this measure, and ask that you be kind enough to give this bill your active endorsement. Respectfully yours, Hon. OREN HARRIS, J. ALLEN YAGER, M.D., M.P.H., BALTIMORE CITY HEALTH Department, February 11, 1963. Chairman, Committee on Interstate and Foreign Commerce, House of Representatives, Washington, D.C. DEAR Mr. CHAIRMAN: This letter is in support of bill H.R. 12 which I understand is having hearings before your committee. There is no doubt that there is a serious lack of trained personnel in medicine, dentistry, nursing, and other public health professions. In the various programs of the Baltimore City Health Department, we are constantly hampered because of unfilled positions in essential posts. It was thought that part of this problem might lie in inadequate salaries; but even since the salaries have been raised, we are finding that there are no personnel available. From my discussions with other health officers and physicians from all over the Nation, I find that this problem is universal. This shortage, while very acute at the present time, will become disastrous in the future. As a result of medical research and technical advances, there will be increasing need for trained health personnel to bring these new knowledges to the public. Our medical schools and other training facilities, however, have not been expanding at the same rate that medical technology has. The only realistic prospect of correcting these various deficiencies can be by congressional action such as H.R. 12; and therefore, I urge your full support for this vital bill. I thank you for your consideration of this matter. ROBERT E. FARBER, M.D., UNIVERSITY OF CALIFORNIA, SCHOOL OF PUBLIC HEALTH, Hon. OREN HARRIS, Chairman, Interstate and Foreign Commerce Committee, DEAR CONGRESSMAN HARRIS: May I add my strong support for H.R. 12 on which you held hearings this week. Our university was most ably represented by Vice Chancellor Stafford Warren and by coordinator of Medical and Health Sciences, John Porterfield. Also, our schools of public health had the representation of Dean Stebbins. I should be very grateful if you include this letter in the record of the hearings. Having served on the Surgeon General's Consultant Group on Medical Education which also included brief consideration of the needs for dental education, I am acutely aware of the pressing need for passage of H.R. 12 to aid in the building of more medical and dental schools and to provide loan funds for medical students. It is so essential that the facilities for research must be complemented by construction of teaching facilities to prepare research workers and both are needed to provide medical and dental services (including future public health leaders) for our burgeoning population. In our own State of California we must expand the two already nearly completed tax-supported medical schools with from three to five more in order to maintain the medical services of our State's population at their present level. The need is just as great if not greater for the expanding dental schools. It is my privilege to serve also on the statewide advisory committee for medical and health sciences and we are constantly impressed with the tremendous need for this essential support. Among the schools of public health these needs are just as acute, if not even more so. While each of the five State-supported accredited graduate schools of public health has its individual problems with respect to its unmet space requirements, they share common difficulties in solving them. All of our schools of public health, private and tax-supported are national and because of fellowships of A.I.D. and W.H.O., "international" schools, as well. Especially since the passage of the U.S. Public Health Service Traineeship Act in 1956 and the resultant stimulus to national public health recruitment, the State taxpayers who support the State schools have been carrying a disproportionate share of a national responsibility. The enactment of the Hill-Rhodes Public Law 86-720 providing Federal aid to these national and international schools of public health for assistance in teaching these expanded classes has brought a degree of alleviation to the schools and some equalization for the taxpayers of Statesupported schools. No comparable support exists for medical and dental schools. However, in our schools of public health the concomitant augmentation of faculty and auxiliary teaching personnel has accentuated already existing deficiency in space. Our California State taxpayers already have provided basic building requirements. Thus in 1955 the school of public health at the University of 04933-63-25 California in Berkeley occupied its new Public Health Building, Earl Warren Hall, with 43,000 square feet. While this met our needs in 1955, now our graduate student body has more than doubled. Some of our faculty are forced to double up in occupancy of rooms and we are forced to resort increasingly to rented space both for instruction and research. Indeed, there are teaching programs which we cannot provide because we cannot house them. The favorable consideration of H.R. 12 is a matter of major importance to all of us in the field of the health sciences. Sincerely yours, Charles E. SMITH, M.D., President, California State Board of Public Health. Hon. OREN HARRIS, OREGON PUBLIC HEALTH ASSOCIATION, Chairman, House Interstate and Foreign Commerce Committee, House of Representatives, Washington, D.C. DEAR MR. HARRIS: This letter concerns House bill 12, introduced on January 9, 1963, by you. The members of Oregon Public Health Association, an affiliate of the American Public Health Association, has voted favorable endorsement of this bill. As you know, the shortage of physicians, dentists, nurses, and other health personnel is a major problem for essentially all of the States. For many years Oregon has held an enviable position among Western States for advancement in the field of public health. However, during the more recent years it has become increasingly more difficult to obtain qualified professional presonnel to fill public health positions. This has been true whether the positions were newly created in order to keep pace with population growth and the addition of essential public health programs or merely to fill staff vacancies as they have occurred. While we realize that the passage of this bill would not totally solve Oregon's problem, it would certainly enhance the opportunity for us to continue to assure that we will be able to insure continued growth in Oregon's public health programs. In the interest of increasing enrollment of health personnel, now in such short supply, we thank you for your support of House bill 12. May we also please request that you send us by return mail 10 copies of this bill. Respectfully, Hon. OREN HARRIS, Mrs. VIVIAN E. RUNTE, President. OREGON NURSES ASSOCIATION, INC., Chairman, Committee on Interstate and Foreign Commerce, DEAR MR. HARRIS: The Oregon Nurses Association is very much interested in H.R. 12, health professions educational assistance bill. We have two collegiate schools of nursing in Oregon, including a program for graduate nurses desiring to specialize in public health nursing, teaching, or administration. These schools could admit more students if more adequate facilities were available. In common with most other States, Oregon has a critical gap between the number of nurses needed to staff hospitals, public health agencies, and other health facilities and the supply available. Even more serious, is the shortage of personnel prepared for teaching, supervision, and administration of a high quality. We request, therefore, that your committee give favorable consideration to this bill. We hope that it will be sent to the floor of the House with a recommendation that it be passed. Sincerely, Mrs. BERTHA G. BYRNE, Executive Secretary. LAFAYETTE, INDIANA, February 8, 1963. Re inclusion of this letter in hearings currently being held in relation to the alleged dental manpower shortage and the need for Federal aid to build new dental schools. HOUSE INTERSTATE AND FOREIGN COMMERCE COMMITTEE, DEAR SIRS: It is my understanding your committee is holding public hearings on the need for Federal funds for new dental schools. It has been widely stated and suggested that there is currently, and that there will be, a dental manpower shortage. I have spent some time investigating the alleged dental manpower shortage and can see no shortage of dentists. Neither do I see any urgency in resolving the question of Federal aid to dental schools. I am including in this letter a summary of the recent dental manpower history of the United States, and am requesting that it be included in the official record of the hearings of your committee. Sincerely yours, W. KELLEY CARR. A SUMMARY OF THE RECENT DENTAL MANPOWER HISTORY OF THE UNITED STATES This summary will list the important points involving the productivity of the dental manpower history of the United States since 1930. For briefness, all points will be listed. 1. In 1930, there were 58 dentists per 100,000 people in the United States, and in 1958 there were 49 active dentists per 100,000 people.' 2. In 1930, 20 to 25 percent of the population of our country were seeing their dentists at least once a year." 3. In 1958, 40 to 45 percent of the population of our country were seeing their dentists at least once a year." 4. During this 28-year period of declining numbers of dentists per 100,000 people, the productivity of the dental profession has increased over 100 percent.* 5. When the 100 percent productivity increase is divided by the 28 years in the period, a yearly average productivity increase of approximately 3.5 percent is obtained. 6. From 1950 to 1960, the dentists increased their productivity 42 percent.5 For this 10-year period, the average yearly productivity increase was 4.2 percent. 7. In 1960, 18 percent of the dentists said they needed more patients and 38 percent said they could handle more patients. It is obvious that there is no current dental manpower shortage, although there is a maldistribution of dentists in some areas. 8. The Surgeon-General's Office feels that 16,000 more dentists will be needed by 1975 to preserve present dentist population ratios.' 9. From 1930 to 1958, the dentist population ratio has gone from 1 : 1,724 to our present 1: 2,174. Even though the ratio is changing, we have more dental manpower than dental demand by the public (see point 7). There seems to be no justification for the establishment of a dentist population ratio at this time. 10. The Survey of Dentistry projects that 24,000 dentist equivalents will be produced by increased use of auxiliary personnel by dentists from 1960 to 1975.o In 1975 we will have approximately 120,000 dentists.10 The dentist equivalents will represent a 20 percent increase in dental productivity during this 15-year period. A little simple mathematics shows this to be a 1.33 percent yearly increase of dental productivity. 11. This 1.33 percent projected yearly increase of dental productivity (as suggested by the Survey of Dentistry) would more than fill the projected need for dental manpower by 1975. 12. If the 15-year period of 1960 to 1975 has the same yearly average productivity increase as existed in 1950 to 1960, then 75,000 dentist equivalents will be available in 1975 instead of the projected 24,000. Both the 24,000 figure and the 75,000 figure are higher than the projected need of 16,000 dentists. 13. The record of American dentists under the free enterprise system is a record of amazing productivity over these last 30 years. There seems little sound basis for questioning their ability or desire to continue to be more productive. The historical record of our profession, as it applies to increasing productivity, is clear and strong. 14. One can only conclude that there is no dental manpower shortage at present, and that the alleged dental manpower shortage of 1975 has been manufactured by people who do not understand the basic factors working to make dentists more productive. 15. These facts from The Survey of Dentistry and the Michigan Workshop on the Future Requirements of Dental Manpower and the Training and Utilization of Auxiliary Personnel should make clear to all that there is no urgency needed in resolving the question-“Should the Federal Government provide funds for building dental schools?" These facts should also convince you that there is no need for additional dental schools through Federal aid. Our present system is working well. 16. Those people who remain unconvinced as to the past or present ability of dentists to be productive should take a long hard look at the productivity ability of American farmers. Their productivity was underestimated by many Government officials. There seems to be no logical reason for feeling that private practicing dentists are any less intelligent than farmers, or that the dentists will be any less productive. 17. The record of American dentists is a clear-cut record of progressive action, ability, productivity, and providing for the dental demand of the public. BIBLIOGRAPHY 1. Hollinshead, B. D. "The Survey of Dentistry." One final report, Commission on the Survey of Dentistry in the United States. Washington, D.C., American Council on Education, 1961, p. 77. 2. Ibid., p. 31. 3. Ibid. 4. Ibid., p. 85. 5. "Proceedings of the Workshop on the Future Requirements of Dental Manpower and the Training and Utilization of Auxiliary Personnel." The University of Michigan, W. K. Kellogg Foundation Institute Graduation and Postgraduate Dentistry, Jan. 15-19, 1962, p. 24. 6. Ibid., p. 19. 7. Hollinshead. Op. cit., pp. 78-79. W. KELLEY CARR, D.D.S. COLUMBUS, OHIO. Hon. OREN HARRIS, Chairman, Interstate and Foreign Commerce Committee, May I respectfully ask that our endorsement be recorded in favor of H.R. 12, "The Health Professions Education Assistance Act of 1963." State and local health departments have long been handicapped by a shortage of qualified health personnel. We consider the benefits provided in H.R. 12 to have vast potential toward resolving this barrier hindering the advance of many urgently needed public health programs. We trust that the Interstate and Foreign Commerce Committee will act favorably toward this legislation and would greatly appreciate having this telegram included in the record of the hearings just concluded. RALPH E. DWORK, M.D., Director, Ohio Department of Health. Hon. OREN HARRIS, THE OHIO STATE UNIVERSITY, House of Representatives, Washington, D.C. DEAR CONGRESSMAN HARRIS: It is my understanding that hearings are now underway before the House Interstate and Foreign Commerce Committee on H.R. 12, dealing with educational assistance to the health professions. One provision of the bill authorizes loans to students in medicine, osteopathy, and dentistry. |