hensive frame of reference proposed by H.R. 3142 supporting the need for a greatly expanded system of communication among all of the sciences related to health.

LIBRARY FACILITY NEEDS OF THE DENTAL SCHOOLS

There are three basic types of libraries which serve dental schools today. One is an integral part of the dental school; the second is either a combined medicaldental library or a health science library and the third is a part of a main university library. At present, 21 of the 50 dental schools operate separate libraries. Of the remainder, most are conducted as medical-dental or health science facilities. There are, of course, advantages and disadvantages to each of these administrative arrangements, but irrespective of the organizationl pattern, the library is considered as an essential ingredient of any acceptable program of dental education.

According to a recent survey, the present average size of the library in those institutions which conduct a separate facility is 1,430 square feet. This same survey indicated that, were it posible to do so, these institutions would expand their existing facility to at least 9,000 square feet per institution, indicating that the present dental school library is operating at about 15 percent of the size that is considered desirable.

These estimates are reinforced by recent information submitted by dental schools now being planned in which the average amount of space projected for the library facility is about 9,000 square feet for an entering class size of 100 students. A space allocation of this amount represents between 5 and 6 percent of the total space planned for the dental educational program in new institutions presently under consideration—a modest allowance indeed when considering the multiple responsibilities of the modern health science library.

With reference to physical facilities, it is apparent that the majority of existing dental schools utilize library facilities which are a part of the total health center. As additional health center complexes are constructed, it seems likely that there will be an increasing trend toward the sharing of library and scientific communication facilities. In addition to the reasons already cited, such sharing will become increasingly important as more complex and sophisticated systems of information accumulation and retrieval are developed. As the committee recognizes, however, the cost of constructing, equipping, and maintaining multipurpose biomedical communication facilities will increase proportionately, thus it is urged that the suggested appropriations in H.R. 3142 be supported at the levels presented.

LIBRARY RESOURCE NEEDS OF DENTAL SCHOOLS

One of the measures of the adequacy of a dental library is the size and quality of its book and periodical collection. The average size of the book collection presently available in the 21 separate dental school libraries is 13,000 volumes. It has been estimated conservatively that the minimum need of a dental school library is at least 25,000 volumes, thus there is an average deficit of 12,000 volumes in each of these dental libraries at the present time. Based on an average acquisition cost of $13 per volume, it would be necessary for the 21 institutions which have separate dental libraries to invest over $3.25 million in order to bring their collections up to an acceptable standard.

In addition, each of the new dental schools now being planned or constructed can anticipate an expenditure of $325,000 in order to establish an acceptable library collection, based on the standards cited above. These estimates of expenditures are based only on text and reference book acquisition and do not provide for periodical subscriptions, the purchase and maintenance of microfilming equipment, and the use of the many information indexing and retrieval systems which are now available. It is apparent, therefore, that the dental school libraries presently in operation and those which are to be constructed and placed in operation within the next several years have an urgent need for the type of improvement and expansion grants proposed in section 397 of H.R. 3142. The American Association of Dental Schools is presently undertaking a comprehensive cost study of dental education which, when completed in November 1965, will provide explicit information on the various cost elements involved in conducting a dental educational program. Although the final figures from the cost study are not yet available, preliminary information indicates that dental school libraries are supported at the seriously inadequate level of approximately $25,000 per year in public institutions and at slightly less than $19.000 a year in privately supported schools. Cost figures cited previously in this

statement with respect to the funds needed to develop an adequate textbook collection indicate an average need of more than $150,000 in each of the 21 dental schools which maintain separate library facilities. There is no reason to believe that this need is not at least as great in those dental libraries which are a part of the health science centers of university complexes. It is apparent, therefore, that the library activity is in critical need of financial assistance far above the level which it has thus far been possible for the dental school to achieve. We urgently request the committee to place the highest possible priority on the legislation under consideration and, specifically, to seek the full authorization recommended for the improvement and expansion of basic resources of biomedical libraries.

DEVELOPMENT OF LIBRARY PERSONNEL

As is true in all aspects of dental education and research, the ultimate effectiveness of the activities of the dental library is determined by the availability of a sufficient number of highly qualified personnel. The science of medical librarianship, including all of the ramifications of scientific communication, is no less exacting and specialized than any other field or endeavor in the health professions. Although we do not have current statistics on the shortage of qualified medical and dental librarians, information that has been compiled by the National Library of Medicine indicates there is a net gain of only 40 trained medical librarians annually available to institutions engaged in health science education. This production must be expanded manifold if we are to have available the numbers and caliber of individuals already needed in our health educational institutions. The attrition of currently trained personnel and the addition of new institutions makes the demand for newly trained medical librarians even more acute.

RESEARCH AND DEVELOPMENT

One of the important objectives of H.R. 3142 is to make possible the implementation of modern automated systems of storing, processing, and retrieving information from publications related to biomedical sciences. The need for these systems is imperative if the public is to receive optimum benefit from research efforts which are being conducted in this field.

Today's inadequate storage and retrieval systems, which fail to make use of modern data processing techniques, force the conscientious researcher to spend needless hours, days, or even weeks searching for reports of related research. Even then a report containing valuable information may be unavailable or, because it is uncataloged, undetected. The phenomenal growth which has taken place during the past decade in biomedical research and the equally astounding progress which has been made in the fields of automatic information processing virtually demand that the prompt and extensive correlation of these concurrent developments be expedited. This is not, in the view of our associations, an attainment which can be realized without substantial assistance from the Federal Government. It is, of course, apparent to the committee that the application of modern information processing techniques in this field holds the potential not only for improving the amount and quality of scientific investigation but can also be expected to accomplish substantial economy in the saving of man-hours and physical space requirements. We endorse the contributions which H.R. 3142 would make toward the development of a modern information storage, cataloging, and retrieval systems for the literature of the biomedical sciences.

Finally, we urge support of a greatly expanded program of research and development in medical library science and related fields. The necessity for continuous study of improved techniques for communication is so obvious as to need no further support. It should be indicated, however, that the essential research and development which is needed in the science of communication in the health fields has not kept pace with the other important phases of health research, thus the modest contribution recommended in H.R. 3142 is particularly and urgently needed.

It is our understanding that the programs we are supporting will, as we have said, benefit medicine, dentistry, osteopathy, and public health. We have no doubt that this is the committee's understanding as well. Except with reference to section 394, however, this intention is not clear. Amendments directed

to this end, then, would be desirable. In particular, we believe that the term "medical library" and "medical library facilities" should be defined to include dental libraries and the term "physicians" should be defined to include dentists. In conclusion, the American Association of Dental Schools and the American Dental Association urge the committee to give prompt and full support to this important legislation in the interest of the improved health of the people of the United States and, indeed, of the entire world.

Dr. PEARLMAN. The overall purpose of this bill is to improve communication of health information, in the public interest.

Communication is the key to progress in dental health service and practice, in research, and in education. For service can be improved and broadened to meet the expanding needs of a growing population only to the extent that new understanding, new methods, and new approaches that are evolved through research are rapidly communicated to the practitioners and health administrators who can put them into effective practice.

In dentistry, as in other areas of health, our capability has already fallen behind the needs created by the growing demand for service and the rapid increase in the output of information from the continually expanding activity in dental research. We have been doing our best to cope with these needs, but we do need substantial assistance with respect to library space and facilities, resources, personnel, information services, and research and development.

Of the 48 existing dental schools, 21 now have separate libraries; 27 share a library with either a medical school or a medical complex. In addition there are five new dental schools now in process of development. Recent surveys show that the average size of dental libraries is approximately 1,430 square feet, although at least 9,000 square feet are required for optimal function.

We don't have, at this time, a precise estimate of the cost of upgrading these facilities to an adequate level. Our estimate roughly would be $350,000 to $400,000 each for the dental schools. I would estimate roughly in the neighborhood of $10 million in total will be required for this purpose.

I would like the privilege of submitting later a table which will provide to you more detailed estimates of the cost of construction.

The average size of the collections in the 21 separate dental libraries range broadly in size from a low of 3,700 volumes to a high of over 40,000, averaging approximately 13,000 volumes per library although 25,000 is a minimal recommendation.

Based on this average deficiency of 12,000 volumes for the 21 schools and an average cost of about $13 per volume, there is a need for $3.25 million in the existing schools alone just to build their collections to adequate size. Considering that the 27 dental libraries that are now shared with medical facilities need about the same, the total cost of raising existing collections to minimal levels of adequacy would be about $6.5 million. In addition each of the 5 new dental schools can expect to spend about $325,000 to acquire the basic 25,000 volumes, a total of approximately $1,625,000. Accordingly, it would take $8 million to establish minimally adequate dental library resources across the country.

These figures are exclusive of the cost of periodicals and serials, which in the dental field are continuing to increase both in number and in usage.

The shortage of library personnel will be alleviated substantially with the passage of this bill. Schools of library science are able to graduate only about 100 medical librarians per year. Sixty of these are already employed upon graduation, leaving only about 40 for whom medical and dental schools must compete. Each dental school should have at least two topnotch librarians. On that basis, the 21 existing schools plus the 5 new schools would absorb 31 of the available 40 immediately. Grants for training personnel would clearly be helpful. There is a steadily increasing demand for library services from students, research scientists, from dental practitioners in general, and from physicians and hospital staff who seek information about diseases of the oral structures. Research and development of better library techniques are essential for dramatic improvement of such service.

There is a great and important need for research in communication and the transfer of information. Research is needed also in indexing and cataloging; in storage and retrieval methods and service; in improvement of reproduction of materials and of the distribution or disseminative services.

There is a need for more extensive microfilming, to provide secondary storage of material, quick access for reproduction and distribution and, secondarily, a method of saving space on volumes that may be discarded and on copies of borrowed material.

Special bibliographies and selected packages of material are needed regularly for use in the continuing education of the dentist, for research investigators and for others who demand them. Every dental library faces these pressures.

In addition, it seems highly desirable to begin now to establish regional libraries in certain areas if it is not practical immediately to have full-scale independent libraries at each school in the area.

The objective of the dental profession, in supporting H.R. 3142, is to benefit the public by providing better health service. This can be achieved only by closing the gap between research and development and the provision of better service by the practitioner and public health agencies.

In conclusion, the American Dental Association and the American Association of Dental Schools are pleased to support this bill and the important programs it would make possible. I should like to make one important point, however. It is our understanding that this bill is intended to cover medicine, dentistry, osteopathy, and public health in each and all of its sections. It is believed, however, that with respect to sections of the bill other than section 394 this intent is not entirely clear, and clarifying amendments would be extremely desirable. In particular we believe that the terms "medical library" and "medical library facilities" should be defined to include dental libraries and the term "physicians" should be expanded to include dentists.

The timeliness and necessity of this bill are quite obvious and have been noted by others who have testified before you. There has been exceptional expansion of research during the past several decades. There is continuing growth in the number of schools, which places heavier demand upon the dental libraries in terms of both quantity and activity. And the dentist himself needs to keep in touch with new information as well as he can in the face of a growing population which places more and more demands upon his time.

Mr. Chairman and members of the committee, we believe this is desirable legislation and should be enacted.

I am at your disposal, Mr. Chairman, to reply to any questions you may have.

The CHAIRMAN. Thank you very much, Dr. Pearlman, for your presentation here in behalf of the American Dental Association and the American Association of Dental Schools. Are there any questions by members of the committee?

We are very glad to have

your statement.

Permit the Chair to inquire: Is there anybody here who is going to appear in opposition to this legislation?

If not, we will have Dr. Gordon Heath.

STATEMENT OF DR. GORDON G. HEATH, PROFESSOR OF OPTOMETRY, INDIANA UNIVERSITY, BLOOMINGTON, IND., REPRESENTING THE AMERICAN OPTOMETRIC ASSOCIATION

Dr. HEATH. Thank you, Mr. Chairman.

The CHAIRMAN. Dr. Heath, we are very glad to have your statement. I am going to suggest, however, as I have to the others, that your statement be filed for the record and you summarize it.

Dr. HEATH. I intend to do just that, Mr. Chairman. Thank you. The CHAIRMAN. Very well. You may proceed accordingly.

Dr. HEATH. Just to identify myself, I am a professor of optometry at Indiana University, and chairman of the graduate school program in physiological optics there. I am also serving on two committees for the American Optometric Association, which organization I represent today. One of these committees is the committee on new academic facilities.

So, we have been greatly concerned with the planning for, among other things, the library facilities at new prospective schools of optometry throughout the country.

I am also past president of the Association of Schools & Colleges of Optometry.

Now both of these organizations, the American Optometric Association and the Association of Schools & Colleges of Optometry, are concerned about the present wording of the bill. We support the bill, but we are concerned about the definition within the bill of "sciences related to health."

This definition states that it includes medicine, osteopathy, dentistry, public health, and fundamental and applied sciences when related thereto.

We do not believe that it was the intent of the authors of the bill to exclude optometry from any of the provisions of the bill, but interpretation of the present wording could omit this health care specialty, and therefore we respectfuly request that on page 3, section 391, line 22, after the word "dentistry" the word "optometry" be inserted. This amendment will in no way change the intent of the bill, but simply continues the precedent that Congress established in the Health Professions Educational Assistance Acts of 1963 and 1965.

Now libraries in the optometry schools and colleges are unique because they are so very interdisciplinary. The materials in these libraries are selected from a great many other disciplines, physics, mathematics, biological sciences, as well as the strictly optometric