offered greater promise of benefiting the American people than does this effort to establish regional medical complexes throughout the country.

My purpose in appearing before this committee today is to lend

full and enthusiastic support behind the expression of interest in this program registered by the Milwaukee, Wis., area. In that connection, Mr. Chairman, I fully endorse the views presented here this afternoon by Dr. John S. Hirschboeck, vice president of the Marquette University Medical School, and Dr. Peter Eichman, dean of the University of Wisconsin Medical School.

The extensive planning and studies which have preceded their appearance here today and upon which Milwaukee's interest is based is indicative, I believe, of both the desire and need in Milwaukee and throughout the State. To their lasting credit the medical educators, hospital administrators, and responsible citizens of the Greater Milwaukee area have mobilized a broad-based front of cooperation dedicated to the extension of improved health facilities for the Milwaukee and Wisconsin area. It is upon this foundation of local initiative, expressing as it has a creative and organized plan matching local needs against local resources, that the proposed program of a regional medical complex could be based and genuinely thrive.

Forming the nucleus of such a medical center in the Milwaukee area would be the Marquette University Medical School, the University of Wisconsin Medical School, the Veterans Administration hospital, and the facilities of the Milwaukee County hospital. Cooperation in this latter connection has already been pledged by Milwaukee County officials. Further, the Hospital Area Planning Committee of Milwaukee has also recommended in its studies a regional medical complex. It is my belief, Mr. Chairman, that this legislation's stated objective of drawing together the medical education facilities and other health agencies into a concert of unified action against disease can be ideally accomplished within this spirit of cooperation which has characterized Milwaukee's efforts thus far. Only where there is communication can there be understanding; and only where there is understanding can there be a coordinated action. This converging of objectives and purposes on the basis of exhaustive planning keynotes the Milwaukee interest.

In addition to the many direct health benefits which would accrue to Milwaukee and Wisconsin through the eventual establishment of a medical center there would be the bolstering of medical education facilities at both Marquette University and the University of Wisconsin.

As the demand for the fruit of medical research, development, and treatment increases with a growing population we must be ready with the best trained physicians, medical researchers, and technicians.

Only to the extent that physicians, medical educators, hospitals, and other health agencies devote their individual resources and unique talents to this objective can it be accomplished.

The Milwaukee area has evidenced not only its willingness but its proven ability to work toward this goal and would continue to do so even more in the future under the planning grants provision of H.R. 3140.

It is for these many reasons, Mr. Chairman, that I sincerely hope your committee will report favorably this proposed legislation for early action on the floor.

Mr. STAGGERS. We appreciate your appearance and testimony, Mr. Zablocki.

Mr. ZABLOCKI. Thank you for the opportunity, Mr. Chairman.

Mr. STAGGERS. We have a distinguished group following these gentlemen, and they come from the State of Virginia. So, we have a member on this committee from Virginia, Mr. Satterfield, and I will call on Mr. Satterfield to identify the people from his district and from his State.

Mr. Satterfield is one of our able colleagues.

Mr. Satterfield.

STATEMENT OF HON. DAVID E. SATTERFIELD, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF VIRGINIA

Mr. SATTERFIELD. Mr. Chairman, I appreciate this opportunity to introduce two of the three members. I understand the third one is from Mr. Porter Hardy's district, and he is here to make that introduction.

Mr. Chairman, I would like to say at the outset that we in Virginia are proud of our two outstanding medical schools, one, a part of the University of Virginia at Charlottesville, and the other located in my district at Richmond, the Medical College of Virginia.

We are not only proud of their past record and the eminence that each has achieved in the profession, but we point with pride to the leadership that both are contributing to improved medical protection and to the techniques in treating disease.

It is a real privilege for me to introduce at this time Dr. Kenneth R. Crispell, dean of the University of Virginia School of Medicine, and Dr. Kinloch Nelson, dean of the Medical College of Virginia School of Medicine, in Richmond.

Mr. STAGGERS. At this time I would like to call on Porter Hardy, one of our distinguished colleages from the State of Virginia also, to introduce the gentleman from his area.

STATEMENT OF HON. PORTER HARDY, JR., A REPRESENTATIVE IN CONGRESS FROM THE STATE OF VIRGINIA

Mr. HARDY. Thank you, Mr. Chairman, it is a real pleasure for me to be here. I do not know what order these gentlemen are going to present their case for Virginia, but I am particularly pleased to have with me one of my leading medical constituents to present something of the Norfolk situation and its interest in this particular legislation. Mr. Chairman, if you would bear with me for just a minute, I would like to take this opportunity to point out a little of what Norfolk is doing in building a new city, in its accomplishments, the progress it has made in civic, economic, and education matters, its present effort toward substantial cultural improvement, and its approach to its needs from a medical standpoint."

Now, my district is in the middle of perhaps one of the biggest metropolitan areas in the United States that does not have a medical

college. So, just last year, the Virginia Legislature passed an authorizing act which resulted in the establishment of the Norfolk Area Medical Center Authority.

Now, that authority has some long-range planning for the establishment of a medical center in Norfolk, and the first phase of it is coming into being this fall. To show how fast they have been begun to operate on this, the rehabilitation center is the first phase, and it will be activated this fall.

The next phase is a cardiopulmonary laboratory which is already financed and which is expected to be under contract in the near future. Following that will be a research building, and, of course, along with all of this, they have the problem of assembling a staff which is pretty involved considering the magnitude of the undertaking.

And then comes a comprehensive medical health center, which will be a fourth major element in the plan.

And, finally, winding up with a complete medical school.

Now, it is our thought that this legislation could be extremely helpful in expediting the accomplishment of this much needed objective, and it is with that little background that I would like to mention just a few of Dr. Andrews' qualifications.

Dr. Mason Andrews is chairman of the Norfolk Area Medical Center Authority which I have just referred to. He is a past president of the Norfolk County Medical Society, a past president of the medical staff of the Norfolk General Hospital, and he has many other accomplishments, Mr. Chairman, including membership on the Norfolk City Planning Council. So, he is a leader among our civic and medical community, and I am delighted that he can be here and present on behalf of Norfolk our situation which I am sure the committee will receive with a considerable amount of interest.

I thank you very much for letting me present him.

Mr. STAGGERS. Glad to have you, Mr. Hardy, and I want to tell you gentlemen that you have two very distinguished Members of Congress in Porter Hardy and Dave Satterfield. They are not only distinguished in their own right for Virginia but they are renowned here in Congress and are great Americans.

Which one of you gentlemen wants to lead off?

STATEMENTS OF DR. KENNETH R. CRISPELL, DEAN, MEDICAL SCHOOL, UNIVERSITY OF VIRGINIA, CHARLOTTESVILLE, VA.; DR. KINLOCH NELSON, DEAN, MEDICAL COLLEGE OF VIRGINIA, RICHMOND, VA.; AND DR. MASON C. ANDREWS, CHAIRMAN, NORFOLK AREA MEDICAL CENTER AUTHORITY, NORFOLK, VA. Dr. CRISPELL. Mr. Chairman

Mr. STAGGERS. Proceed as you see fit; go right ahead.

Dr. CRISPELL. Thank you, Mr. Staggers.

We have a prepared statement which I would like to submit for the record, if I may.

Mr. STAGGERS. Fine. You may do so, and

Dr. CRISPELL. I would like to read from this, and then if time permits answer questions.

Mr. STAGGERS. All right.

Dr. CRISPELL. We are pleased to appear before this committee to discuss bill H.R. 3140. The enactment of this legislation can provide financial support and a unique administrative framework for university medical centers, practicing physicians, and community hospitals to work together in providing the best in patient care and research in the area of cancer, stroke, and heart disease, and other diseases.

This program will create new opportunities for the training of skilled specialists who are essential to the diagnosis and treatment of these diseases. The most appealing function of the complex concept of medical care is the opportunity it provides for creating new and exciting innovations for the continuing education of the practicing physician. The rapid advances in medical knowledge have made it mandatory for medical schools to provide such training programs. It is fair to say that, in general, these programs, except in rare instances, have not met with outstanding success. The opportunities provided by this legislation appear to provide the administrative framework for a sound program in continuing medical education. The well-informed physician, the fundamental element of good medical care, will be able to bring to his patient the latest and best in diagnosis and treatment of these crippling diseases. This will not be a one-way street, as medical educators will most certainly benefit by having an opportunity to maintain closer liaison with the man in the field, the practicing physician. They will be able to share the problems involved in total patient care.

This program, to become a reality, will require extremely careful planning. It is not intended to overturn established patterns of patient care but hopefully to provide the practicing physician with better tools and facilities for care of his patient. We, in the State of Virginia, hope to expand our postgraduate program on experiences which have been gained in previous attempts to carry out these purposes on a limited scale.

In anticipation of the enactment of this legislation we have held a series of meetings to lay groundwork for the planning of a regional medical complex in Virginia. Practicing physicians, hospital administrators, representatives from the Virginia Heart Association, Virginia Division of the American Cancer Society, the State medical society, the State health department, the Norfolk Medical Center Authority, and members of the faculty of the two existing medical schools have met on several occasions to discuss the concept, possibilities, and problems of such a complex. It is agreed that planning would be on a statewide basis, with the two existing medical schools, the Norfolk Medical Center Authority, and the State Health Department taking the leadership in the preliminary planning. An advisory composed of: the deans of the two medical schools, the State Commissioner of Health, a lay representative to be appointed by the Governor, and representatives from the Norfolk Medical Center Authority, the State medical society, and the Virginia Hospital Association have been established to implement further planning. It is the intention of this committee to apply for funds for planning if this legislation is enacted. This committee will work closely with the medical school faculties, the practicing physicians, hospital administrators, and representatives from the Heart Association and Cancer Society in initiating this planning grant.

We would like to point out that there is already in existence in the State of Virginia three medical centers or complexes which serve as diagnostic and treatment centers for a large number of patients. The two State medical schools with their hospitals at Charlottesville and Richmond and the Norfolk Medical Center Authority which is actively planning, as you have already been told, a third medical school which is to be privately endowed. These three centers can serve as the nucleus of a statewide medical complex which will have as its primary function the continuing education of the practicing physician. In our meetings several of the community hospitals in the State have indicated a strong interest in setting up diagnostic and treatment centers in their communities.

We are keenly aware of the problems of manpower if this program is to be satisfactorily implemented. Medical schools will certainly need financial assistance if they are to help provide this manpower. However, it is conceivable to us that careful planning will provide beter utilization of the present pool of medical talent.

We are also fully aware of the anxieties of the practicing physician should this program be implemented in his community. We sincerely believe that with careful planning we can provide the practicing physician with opportunities for continuing education that will make him feel that he is more of an integral part of a modern medical care team than now exists. Our previous experience makes us feel that this can be done without destroying the present doctor-patient relationship.

Perhaps, Mr. Chairman, with your permission, I would stop there and ask Dean Nelson of the Medical College to enlarge perhaps on the program that we have now in existence in the State and some of the things that we think are needed to make this plan even better. Dr. NELSON. Mr. Chairman, I wanted to say a word here about the program that we have had since World War II.

At this time, through the help of the Commonwealth Fund of New York, we began, in 1946, a program whereby we have representatives in a number of hospitals throughout the State and we send to these hospitals doctors of various types and specialties who hold meetings and conferences and make rounds and see patients in a teaching way.

We were joined in this by the University of Virginia Medical School, and we have continued this program now for almost 20 years. It has always failed to some degree in the hope we had for it, because of the lack of support, though we have some State support and we get support from the local hospital groups.

We believe this is the nucleus on which could be expanded the type of program that Dr. Crispell just outlined in carrying information developed in the medical schools into the hospitals, to the patients, to the physicians through the State. We are working now with 10 such hospitals scattered from the far eastern to the far western part of the State and from the northern to the southern part.

Along a somewhat different line, and in connection with the manpower problem, we are quite well aware of this in Richmond and have moved to increase our student body from 96 freshmen at the present time to 128. We are preparing to do this the year after next. We have increased from 84 to 96 in the past 2 years.

Along this same line, we are developing our house staff and resident training programs further, and these young men and young women