Massachusetts College of Optometry, Boston, Mass.; Pennsylvania School of Optometry, Philadelphia, Pa.; Ohio University School of Optometry, Columbus. Ohio; Southern College of Optometry, Memphis, Tenn.; Illinois College of Optometry, Chicago, Ill.; Optometry Division of the University of Indiana, Bloomington, Ind.; School of Optometry, University of Houston, Houston, Tex.; Los Angeles College of Optometry, Los Angeles, Calif.; School of Optometry, University of California, Berkeley, Calif.; School of Optometry, Pacific University, Forest Grove, Oreg. There is a great need for new schools and colleges of optometry and plans are being formulated to established them. Some of these will be affiliated with existing universities and others will be institutions separate and apart from any existing college or university. While it is impossible to give any meaningful estimate as to the amount of expenditures for optometric purposes out of the funds which would be authorized by the various sections of S. 597, it is nevertheless of vital importance that the definition contained in part I of the bill be amended so as to specifically include optometry as one of the sciences related to health. There can be no question that this is a fact, but unfortunately, it is not always recognized as such by Federal administrative agencies. It is, therefore, both advisable and in the public interest that Congress make clear its intent by including the word "optometry" in the statute itself. We therefore recommend that on page 3, line 22 of the bill, the word "optometry" be inserted after the word "osteopathy." Assistant Secretary Dempsey in his testimony before the committee stated: "Today it is essential that personnel responsible for the operation and future planning of medical libraries have special training over and above traditional librarianship. This training must be related to the specialized communication problems of the medical community. They must be well grounded in the biomedical sciences." The Medical Department of the Air Force recently established a new Corps known as the Biomedical Sciences Corps. All of the optometry officers in the Air Force have been transferred from the Medical Service Corps to this new Biomedical Sciences Corps and comprise the largest single professional section. These optometry officers provide professional services in direct clinical patient care. Alfred N. Brandon, president of the Medical Library Association and director of the Welch Medical Library, Johns Hopkins University, in discussing the bill said: "Administered wisely, this provision (sec. 397) can in some way reach every aspect of the medical community: Student, researcher, and practitioner of all health professions." (Emphasis supplied.) On several occasions Congress has recognized the importance of optometry as one of the health professions. There is no question that the conservation and improvement of vision is one of the prime factors in our national security, as well as our economic prosperity. The adoption of the suggested amendment will not necessitate increasing the various authorizations contained in the bill. Under these circumstances, we strongly urge the adoption of the amendment. Respectfully submitted. Senator LISTER HILL, AMERICAN LIBRARY ASSOCIATION, Chairman, Subcommittee on Health, Committee on Labor and Public Welfare, U.S. Senate, Washington, D.C. DEAR SENATOR HILL: The American Library Association is interested in S. 597, the bill introduced by you, to provide a program of grants to assist in the need for adequate medical library services and facilities. We would appreciate it, therefore, if the attached statement in support of the measure could be incorporated in the record of the hearings. It is our belief that S. 597 is an important supplement to S. 600, the Higher Education Act of 1965, which includes significant provisions relating to college library resources and the training of all types of librarians. Sincerely yours, GERMAINE KRETTEK, Director, STATEMENT BY GERMAINE KRETTEK, ASSOCIATE EXECUTIVE DIRECTOR, AMERICAN LIBRARY ASSOCIATION The American Library Association supports the Medical Library Assistance Act of 1965 (S. 597) as essential in the national interest to insure the welfare and health of the United States. The association considers this proposed legislation as an important supplement to the pending Higher Education Act of 1965 (S. 600), which we think is basic and thus of first priority in helping to solve fundamental higher education problems and to provide the essential training for sorely needed professional librarians. The American Library Association, it might be added, is the oldest and larg est organization devoted to the development of libraries in the United States, and covers all facets of librarianship. It has among its consituent organizations two important ones: the Association of College and Research Libraries and the Association of Hospital and Institution Libraries, which, as their names indicate, represent higher education libraries and also libraries of medical, nursing, and other staffs in hospitals. Our organization has observed and has studied the various reports and documents compiled by medical libraries, societies, and committees relating to the existing deficiencies in medical library literature, library services, and library buildings in the fields of medical research, medical teaching, and medical practice. The shortcomings are serious. We believe that those interested in the development of adequate medical library services and facilities are justified in urging, among other things, Federal legislation for the construction of buildings for library purposes; the education of librarians for service in medical libraries; the conduct of research in the field of medical library science; the improvement and strengthening of library resources, including the processing of materials and retrieval of information; and the establishment of regional medical libraries. Recent reports bear out strongly the sad state of the relative amount of funds allotted by the Department of Health, Education, and Welfare to medical library service. For example, in 1964 the Department received in appropriations $55 billion, of which $36.1 million, approximately 0.65 of 1 percent, were devoted to scientific and technical information, but less than $1 million was assigned directly or indirectly to the support of medical library activities. Again, taking medical research alone, the growth in funds rose from $45 million in 1940 to $148 million in 1950; to $715 million in 1960; and will rise to a projected $3 billion in 1970. This tremendous increase must be accompanied by similar growth in the amount spent for medical library book and periodical resources, services, and buildings to support such a program vital to the health and welfare of the Nation. But this has not been the case. Research in medicine and allied fields must be bulwarked by a sound foundation in library resources and the quick retrieval of the information stored. The magnitude of the problem may be comprehended somewhat when we realize that there are some 4,000 libraries maintained by medical schools, hospitals, medical societies, schools of nursing, pharmacy, veterinary medicine, and osteopathy, public health, and other segments of the medical and health community. These libraries and their importance to the Nation have a justifiable claim for assistance from the Federal Government. The American Library Association, therefore, endorses the Medical Library Assistance Act of 1965, and urges the favorable consideration of it by this committee. STATEMENT OF THE NEW YORK ACADEMY OF MEDICINE The great medical library collections in this country have in the past been built and maintained by medical societies. The greatest of these are the collections of the Boston Medical Library, the College of Physicians of Philadelphia, the Medical Society of the County of Kings, in Brooklyn, and the New York Academy of Medicine, in Manhattan. The pressures of 20th century science have now compelled private organizations to look for support in collecting resources and servic ing them to the best advantage for the use of research scientists, practicing physicians, biomedical scientists in related fields, and students who will be the scientists and physicians of tomorrow. The proliferation of scientific literature, the tremendous increase in indexes and abstract journals which new automative processes have made possible, the rising costs of publication, and the greater needs of research have put the acquisition of necessary resources beyond the means of a group of private individuals. The New York Academy of Medicine Library which is supported by the Fellowship of the Academy, a group of 2,500 members, has already assumed a financial burden for the library of an annual budget of $437,360, and this despite a regrettable limitation of its acquisitions program. Even with the expenditure of these funds, the collection cannot be maintained with the high standards of the past. Such a library serving the community shares its resources with other libraries and welcomes the varied clientele seeking information. This clientele represents all those in the health professions, and those in other professional disciplines, as well as the general public and the important student population of this area. To meet the increasing demands for resources and services, financial support is urgently required. READERS IN THE LIBRARY Surveys of readers in the library have been made in November 1957, in March 1958, March 1963, and March 1965. There is remarkably little change from year to year, but there have been a few very gradual differences in the type of readers using the library in person. The percentage of use by fellows remains at approximately 15 percent; use by physicians who are not fellows has dropped a few points, and the use by scientists other than physicians increased. Use by students (other than medical, dental, or nursing) was 12.6 percent in March 1958, but by March 1963 has risen to 21.5 percent, just about what it was in 1965. Fellows, physicians, representatives of health professions, scien 1 Graduate, 8.5; college, 8.8; high school, 3.6. The latter are chiefly from the excellent High School for Science in the Bronx. 2 The category "Miscellaneous" includes engineers, advertising men, lawyers, professors, teachers, artists, musicians, accountants, editors, writers, newspapermen, philologists, historians. 3 Laity covers a number of readers who said that they were using the library for "research,' but would not clarify. There was a policeman (reading about narcotics), a fireman, a graphologist, and one who insisted that he was a bartender, although he uses the library fairly often and was obviously being facetious. We take the word of the readers, so there are, no doubt, some errors in our totals. Hon. LISTER HILL, MEDICAL LIBRARY ASSOCIATION, Chairman, Senate Committee on Labor and Public Welfare, June 11, 1965. DEAR SENATOR HILL: Enclosed is a statement on Senate bill 597, the Medical Library Assistance Act. We understand that hearings are being held on this bill during the week of June 14 and ask that the enclosed statement of the New York Regional Group of the Medical Library Association be made part of the official record. Thank you very much for your courtesy. Respectfully, ELEONOR E. PASMIK, Chairman, New York University Medical Center Library. STATEMENT ON THE MEDICAL LIBRARY ASSISTANCE ACT The New York Regional Group of the Medical Library Association draws its 250 members from medical libraries in the Greater New York area which includes New Jersey and parts of Connecticut. These 3 States include 65 hospitals, 12 medical schools, 9 academy and medical societies, 9 pharmaceutical companies, 6 State and city health departments, 3 pharmacy colleges, 3 nursing schools, 2 dental colleges, 1 veterinary college and 12 science voluntary health agencies, commercial, podiatry and research institute libraries. (1) As librarians we are dedicated to serving readers. What we seek in respectfully asking for a favorable recommendation on S. 597 is the means of improving our profession and our libraries so that we may better serve not only our researchers but paramedical personnel, medical, dental, and nursing students, and the busy practicing physicians who conscientiously try to keep up-to-date on new therapies and techniques. The needs of these latter groups should not be overlooked. The demands made by the heavy concentration of medical teaching, research and patient care personnel coupled with the proliferation of medical and scientific literature, rising book and periodical prices, higher processing costs, inadequate equipment, lack of bookshelf space, shortage of trained personnel and inadequate budgets have created acute problems in libraries in the New York area. Current statistics show that Federal support of medical and health-related research has grown from $105 million in 1951 to an estimated $1.3 billion in 1965 (2). National Institutes of Health research grants supported 1,695 projects in 1951 (3). By 1964 NIH granted funds for 15,242 projects (4). Of the total national public and private expenditures for health-related research in 1964 the Federal Government provided 65 percent, industry 23 percent, and other non-Federal sources 12 percent of the funds (5). In 1964 the Public Health Service made grants to over 100 institutions and organizations in New York City (6). All of the researchers in these institutions need and use libraries. The Federal Government provides two-thirds of the support for medical research and should rightly be concerned with seeing to it that the scientists performing this work have available to them needed tools and equipment including adequate libraries. The terms of research grants heretofore have provided a certain percentage for overhead. Libraries have sometimes received a portion of such funds. The number of professional workers engaged in medical and health-related research rose from 19,000 in 1954 to almost 40,000 in 1960 (7). By 1970 the number of researchers is estimated to be 77,000 (8). More research being done automatically means more articles being published with a resulting publications explosion. The vital education role of libraries has been recognized by organizations such as the Joint Commission on Accreditation of Hospitals, the American Nurses Association, the American Medical Association, the American Dental Association, and the Association of American Medical Colleges, each of which requires the existence of a library meeting minimum standards for accreditation of an institution by the respective association. The recommendations in the "Guidelines for Medical School Libraries," published in January 1965 by the Association of American Medical Colleges, is expected to have wide influence in raising the standards in medical school libraries (9). Proposed library standards for a developing medical school recommend a collection of 100,000 volumes and 1,600 current scientific journals (10). Of 86 medical school libraries only 14 have collections of 100,00 or more, 22 schools receive more than 1,600 journals (11). The average price of American medical books has risen from $8.20 in 1957-59 to $11.22 in 1964 (12). There were a total of 1,211 medical books published in 1964 of which 876 were new books and 336 new editions (13). Medical libraries are also finding that they must acquire new books in the physical, biological, and behavioral sciences. A survey by the Association of American Medical Colleges published in April 1965 reports that 79 medical schools libraries need an average of 32,000 additional square feet of space, an average of 18,000 additional volumes and periodicals, and an average of $132,000 for cataloging, binding, and other equipment or instructional media (14). Steps must be taken to assist school and other types of medical libraries so that they will come up to satisfactory standards of quality. In the area of regional cooperation between New York medical libraries there have been studies and some progress. A New York State survey several years ago presented recommendations for the improvement of medical library service based upon two reservoir libraries and the strengthening of individual medical libraries. Unfortunately the plan has not been implemented due to lack of funds. The survey of medical library resources of Greater New York, a 3-year study which began in September 1963, has as its purpose "to delineate the present and future library needs of the research community of New York and, from the knowledge thus gained, to develop a plan for the programing of existing facilities toward meeting those needs; to study the use of machines as tools in the implementation of certain needs of the programing." One phase of this study, interlibrary loan requests of 217 libraries, is nearing completion. It may be that excellent and constructive recommendations will result from this survey but unless funds are available to put these suggestions into practice we will have just another survey on the shelf. The Medical Library Center of New York, which began actual operation in January 1964, represents a cooperative measure supported by 10 New York City medical institutions. The center houses the older, less used materials deposited with it by these 10 libraries and provides ready access through a daily delivery service. This has eased the overcrowding to some extent but in most libraries there is still a serious space problem. The union catalog of medical periodicals, a part of the medical library center, is a computer-produced composite record of the medical and paramedical periodical and serial holdings of some 70 libraries in the New York metropolitan area. This enables a borrowing library to quickly locate a periodical needed on interlibrary loan. The medical library center and union catalog of medical periodicals have proven a boon but the $10,000 which sponsoring libraries are assesed annually is a great burden on limited budgets. Funds are urgently needed for new construction and expansion of existing facilities to bolster inadequate library collections, to train medical ilbrarians, to conduct research in new techniques such as the application of automation to libraries, and for the establishment of regional medical libraries and branches of the National Library of Medicine. Without Federal assistance the country's medical libraries cannot hope to keep up with the demands made on them. The inevitable result will be poorer service to the physicians who treat us and to the researchers who hope to conquer our major killing and crippling diseases. In the words of the late President Kennedy. "The accumulation of knowledge is of little avail if it is not brought within the reach of those who can use it. Faster and more complete communication from scientist to scientist is needed, so that their research efforts reinforce and complement each other, from researchers to practicing physician, so that new knowledge can save lives as swiftly as possible; and from the health professions to the public, so that people may act to protect their own health." REFERENCES (1) Medical Library Association Directory, 1961. (2) U.S. National Institutes of Health. Resources Analysis Branch. Resources for Medical Research. Report No. 5, October 1964. Table I, p. 3, app. table I, p. 17. (3) J. Med. Educ. 38: 147, 1963. (4) U.S. National Institutes of Health. Division of Research Grants. Public Health Service Grants and Awards, Fiscal Year 1964 Funds. Part I. Research Grants. Table I, p. 1. (5) U.S. National Institutes of Health. Resources Analysis Branch. Resources for Medical Research. Report No. 5. October 1964. Chart 2, p. 2. (6) U.S. National Institutes of Health. Division of Research Grants. Public Health Service Grants and Awards, Fiscal Year 1964 Funds. Part I. Research Grants. (7) U.S. National Institutes of Health. Resources Analysis Branch. Resources for Medical Research. Report No. 3. January 1963, table 9, p. 8. (8) Ibid., table 15, p. 15. (9) J. Med. Educ. 40(1) part I, January 1965. (10) U.S. Public Health Service. Medical Education Facilities, 1964, p. 34. (11) JAMA 190: 614, November 16, 1964. (12) Pub. Weekly 187 82, January 18, 1965. (13) Ibid., p. 56. (14) Assn. Amer. Med. Coll., Datagrams 6, No. 10, April 1965. |