new techniques to successfully exploit the increase in published medical information.

These innovations have great potential in being applied to the nonmedical sector in our research libraries. Thus it is my conviction that the support and encouragement given to medical libraries will be multiplied many times by the application of these new techniques and service concept to general information needs.

Thank you, sir.

The CHAIRMAN. Thank you very much, gentlemen. We are very glad to have your statements.

Are there any questions?

Mr. MACDONALD. I want to compliment both of you on the restrained and educational statement. One question does come to my mind: How will this do what you say it will do, on page 3? I think one of the problems that the Federal Government is faced with is the increasing instances of needless duplication of research. It has always been a problem. NIH could not use the amount of money we gave it one year. It set a record in sending some money back.

Dr. LOGSDON. The thing we are faced with is the acceleration in the amount of research and publishing ahead of our being able to keep track of all the information that is reported. We do not always know what has already been done. It is precisely that kind of objective that these new levels and new concepts of information handling are designed to achieve. We will be more certain once we have a really thorough system of analysis of published literature, a proper subject heading systems, and improved machine handling of this subject and bibliographical information. We will be more certain of what has already been done so that current research can really be on the frontier and nonduplicating.

There is a frequently quoted story in research circles that it is often cheaper to repeat the research than to search the literature. This may be true in some cases but all too often large sums may be wasted or important data overlooked.

Mr. MACDONALD. My question is this: Would it not be more economical, instead of having 6,000 or whatever was suggested as the figure for construction, to have just one center in which this research would be put together and have the center send it out to the various hospitals and schools and the other places where it is needed instead of having regional centers all over the country?

Dr. LOGSDON. I think the basic work of analyzing the literature, being sure of what is in it, should be done in one place, and that is precisely what is developing with the medlar's program and the medlar's related program. But in order to bring this information quickly to the individual user at these various centers throughout the country we must have a local staff, the equipment to handle requests, and of course books and journals containing it. You have to provide the article or articles for the user locally.

The basic intellectual work of indexing, cataloging, and so on, can be done more efficiently at a central point. That is the wonderful contribution through the years of such publications as "Index Medicus," and now through the medlar's program. Does that answer your question?

Mr. MACDONALD. In some measure, thank

you.

Dr. LOGSDON. We must get this hard work centrally and we are moving very fast in that direction.

Mr. MACDONALD. You don't think it will be more economical to do it in place and have it distributed from that one place?

Dr. LOGSDON. Yes, I agree it is more economical to do some things centrally; but I think that is what we are working toward in present programs and in programs projected by this legislation. But doing these things centrally will not be a substitute for competent reference librarians at the local level. You need both.

Mr. MACDONALD. Thank you.

The CHAIRMAN. Are there further questions?

Thank you very much, gentlemen. We are pleased to have your

statement.

(Dr. Logsdon's statement follows:)

STATEMENT BY RICHARD H. LOGSDON, DIRECTOR OF LIBRARIES, COLUMBIA UNIVERSITY, REPRESENTING THE ASSOCIATION OF RESEARCH LIBRARIES

I am Richard H. Logsdon, director of libraries of Columbia University and former chairman of the Association of Research Libraries, the organization which I am representing today. Appearing with me is James E. Skipper, executive secretary of the association.

The Association of Research Libraries, established in 1932, comprises 74 institutional members, the larger academie, public, and special libraries which collect comperhensively in support of research. Sixty-one of the members are American university libraries, 47 of which operate medical schools and medical research centers. Our member institutions accordingly are carrying a substantial part of the total responsibility for nurturing biomedical research and medical education. They are similarly in a good position to assess present shortcomings of the whole information complex and in turn to assess also the opportunity offered to the Congress in this bill to strengthen medical library resources and services. This testimony is based not only on 17 years of direct experience in the administration and financing of library services to one of these medical research centers (the Columbia Presbyterian Medical Center including the College of Physicians and Surgeons) but also on knowledge of the pressures which are being felt by medical libraries generally.

The case for this bill can be stated briefly under four headings:

(1) Programs of education and research in medicine and the healthrelated fields will be effective only if supported by adequate library and information services.

(2) Medical library resources and services are not now adequate to the needs of the research community.

(3) The gap between present levels of support and adequacy is too large to be closed quickly if at all from nongovernmental sources.

(4) The program set forth in H.R. 3142 and H.R. 6001 is soundly conceived and would achieve a dramatic and balanced development of medical library resources.

One of the best guarantees that funds available for research will be spent effectively is through the provision of adequate library resources. Medical libraries form a vital link in the chain of communication of ideas and information in the health sciences. They serve as custodians of recorded knowledge; the recipients of a virtual torrent of publications reporting the results of current research; and as the principal means through which medical school teaching is kept up to date and research guided to new frontiers of discovery and understanding. Only through well-organized, comprehensive and readily available collections is it possible for the researcher to know what has been done in his field of specialization, the direction of current research and the areas needing further study. The findings of research must be reported and put to use if the original objectives of research grants are to be achieved.

The ultimate objective is, of course, better patient care and here, too, the library plays an important role by bridging the distance between the findings of research and the practicing physician.

That funds available for biomedical research have increased much faster than appropriations for medical libraries is, I believe, well established. Funds

from the Federal Government alone have risen from some $27 million in 1947 to an estimated $1.3 billion. This emphasis on the part of Government coupled with funds from nongovernmental sources has, in a real sense, created the library problem by generating the so-called explosion both in publication output and the number of users to be served. Similarly increasing specialization in research has brought demands for library and other information services of a much more sophisticated nature calling for subject analysis in depth and machine handling of bibliographical records. Taken together these influences call for a higher proportion of total funds for information services at a time when library support is almost certainly falling behind on a percentage basis.

The logic of Federal support for strengthening medical library services is, I believe, uncontestable. Not only is the gap so large as to preclude early correction from private sources but the Federal Government itself is likely to be the principal beneficiary. Improved information services will, as stressed earlier, increase the effectiveness of Federal funds for research and in addition, decrease the incidence of needless duplication of research. Time is, of course, important in that each year of delay risks the losses which can be generated by a poor communications network.

Those responsible for the drafting of this bill are to be commended for the care and appropriateness with which the several key aspects of a good medical library program are considered. I should now like to comment briefly on those separate provisions which deal particularly with medical library services.

CONSTRUCTION OF FACILITIES (SEC. 393)

It seems to be especially difficult to secure construction funds for library buildings. At Columbia, as is true of other privately supported institutions, the money must be sought from individual donors or foundations. A medical library area planned years ago for a relatively small collection and before the dramatic expansion in biomedical research is simply not meeting current needs for collections, staff activities, and services. While some funds are in hand for a new building, it may be several years before construction could begin from private funds alone. A matching grant, on the other hand, would make it possible to begin immediate construction. I am sure that this situation could be duplicated in dozens of other universities and medical libraries.

TRAINING IN THE MEDICAL LIBRARY SCIENCES (SEC. 394)

The shortage of library personnel generally and of persons qualified in specializations like medical librarianship has been a critical handicap in the maintenance of good library service. The investment in training provided for in section 394, including the program for information specialists, would be extremely helpful in recruiting the staff necessary for achieving high standards of service.

RESEARCH AND DEVELOPMENT IN MEDICAL LIBRARY SCIENCE (SEC. 396)

It is gratifying to see the emphasis given in this bill to research and development. Libraries have been so hard pressed through the years to provide the essentials in acquisitions, organization of collections and reference services that there has been all too little attention given to research in the nature of the library operation itself. The program here proposed would go a long way toward correcting this lack of emphasis in the past and would contribute to the improvement and efficiency of library operations not only in medical libraries but libraries generally.

IMPROVING AND EXPANDING THE BASIC RESOURCES (SEC. 397)

This section offers the promise of the kind of direct strengthening of resources and services at the local level which could bring immediate benefits to research programs. It should help to correct the present imbalance between the levels of local support for research and for medical libraries.

REGIONAL MEDICAL LIBRARIES (SEC. 398)

There is growing evidence and conviction that the total information needs of the society will finally be met only through the creation of a network of libraries each providing a level and quality of service appropriate to the geographical

area and clientele served. The program here envisaged would establish just that kind of pattern of interrelation between a local service, a more comprehensive backstop collection for a larger area and, of course, the capstone of the National Library of Medicine. Achieving this kind of network for biomedical literature would be a big step toward the ultimate goal.

REGIONAL BRANCHES OF THE NATIONAL LIBRARY OF MEDICINE (SEC. 378)

The proposal to amend the Public Health Service Act to enable the National Library of Medicine to establish regional branches similarly supports the idea of a network of medical library service mentioned above. The concept is con

sistent with emerging ideas of good library planning and deserves support.

CONCLUSION

Mr. Chairman and members of the committee, I appreciate this opportunity to appear before you in support of such a vital legislative proposal.

I wish to reemphasize the importance of this bill in correcting the imbalance which has been created by extensive Federal assistance to medical research without corresponding support for medical information. This imbalance threatens to become even greater under the recently enacted medicare program.

The purpose of the bill under consideration is to assure that doctors and medical scientists are provided with the essential knowledge which they require in doing their work. Information is an essential ingredient in medical progress and H.R. 3142 and H.R. 6001 will provide the support required.

Dr. LOGSDON. Thank you, Mr. Chairman.

The CHAIRMAN. Dr. Pearlman. Doctor, I believe you are here representing the American Dental Association and the American Association of Dental Schools.

STATEMENT OF DR. SHOLOM PEARLMAN, REPRESENTING THE AMERICAN DENTAL ASSOCIATION AND THE AMERICAN ASSOCIATION OF DENTAL SCHOOLS

Dr. PEARLMAN. That is correct, sir. For the record, to qualify myself, I am the secretary of the Council on Dental Research of the American Dental Association. I am also a member of the National Research Council and of the Advisory Committee on Scientific Publications of the National Library of Medicine.

It is my privilege to appear before you on behalf of the American Dental Association and the American Association of Dental Schools, to testify in support of this bill H.R. 3142. In addition to my oral comments I should like to file for the record a prepared statement which indicates the position of both organizations.

The CHAIRMAN. It may be included in the record.
Dr. PEARLMAN. Thank you sir.

(The statement follows:)

STATEMENT OF THE

AMERICAN DENTAL ASSOCIATION
ASSOCIATION OF DENTAL SCHOOLS

AND THE AMERICAN

INTRODUCTION

The American Dental Association, which represents 105,000 dentists, and the American Association of Dental Schools, which represents the 50 dental schools in the United States, are pleased to have this opportunity to record their support for H.R. 3142, a bill to amend the Public Health Service Act to provide for a program of grants to assist in meeting the need for adequate medical library services and facilities. In recording this support, the associations make a basic assumption that the intent of this legislation is to provide, within each of the programs authorized in the bill, assistance to all biomedical library and com

munication activities, including those related to dentistry and to the fundamental and applied sciences related thereto.

The chairman of the committee has once again demonstrated an informed interest and sensitivity to a major problem confronting the health professions of the country. As documented so convincingly in volume II of "A National Program To Conquer Heart Disease, Cancer, and Stroke," in the special report prepared by the Subcommittee on Facilities of the President's Commission, the development of a large-scale, coordinated, national program to improve communication and research in the biological and health sciences has come to be one of the most urgent needs confronting the public and private agencies concerned with our Nation's health. Although there is yet much to be done, the support which the Federal Government has given to the construction of hospital and health research facilities has aided immeasurably in achieving significant progress in the understanding, treatment, and prevention of disease. More recently, the Health Professions Educational Assistance Act of 1963 has encouraged the expansion of educational facilities for the preparation of professional health personnel. In addition to these programs oriented toward specific problems of health facilities and manpower, the National Institutes of Health has and continues to provide much-needed and expanded support for research and research training as evidenced by the more than $1 billion appropriated for these purposes during the last fiscal year.

As important and beneficial as these federally supported programs have been, however, relatively little has been accomplished in expanding and strengthening the vital lifeline of all of these developments-namely, the expansion and modernization of the systems needed to communicate biomedical literature to the community of health practitioners and research scientists. With the exception of the modestly supported program of the National Library of Medicine, there has been no concentrated effort to develop a cohesive and coordinated national program of biomedical communication commensurate with the greatly expanded demands which are placed on the health science libraries of today. With rare exception, those publicly or privately supported health centers which have been developed or which are now developing have not been able to incorporate within their plans the kind of communications systems and facilities which will be needed increasingly in the future. In the view of the associations, adoption of H.R. 3142 would be a major step in the direction of strengthening the communication of scientific knowledge—one of the weakest elements of the Nation's total health effort.

During the past 3 years, the American Association of Dental Schools and the American Dental Association have devoted extensive efforts to studying the ways and means of developing more effective continuing education programs for dental practitioners. Although the formats and techniques of providing continued professional education are many and varied, the overriding objective of any activity of this kind is to assist the dental practitioner in bringing to his patients the very best oral health care available. Through the cooperative efforts of dental schools, other educational institutions, State and local dental societies and study clubs, more than 35 percent of the Nation's active dental practitioners annually engage in some form of continuing education. This is indeed encouraging but we cannot and must not be satisfied until every practitioner finds it possible to keep abreast of the progress which is being made through dental research and through improved methods of oral health care. This goal, we firmly believe, will be more attainable if financial support such as that proposed in H.R. 3142 is made available for the construction of expanded dental library and other communication facilities, for the training of specialists in the communication sciences, for the support of research and development of new techniques and equipment related to the distribution of new information and for the expansion of published reviews, abstracts and bibliographies.

Before commenting on some of the specific needs of dental libraries, the associations would like to commend the chairman on the broadly based approach which has been proposed for solving the problems of biomedical communication. Although there are specific problems which relate uniquely to medicine, dentistry, public health, and the several biological and physical sciences related to health, it is increasingly apparent that real progress toward realizing total health care for all of our people will be achieved most effectively by an interdisciplinary approach to research, education, and the communication of new knowledge. It should be emphasized, therefore, that although we will comment primarily upon those activities which relate to dental education, research, and the communication of dental knowledge, these comments are intended to be within the compre