colleges and community colleges are entering more and more into this training, and this would not encourage them. Mr. ROGERS of Florida. This would not help their situation or encourage them to increase their capacity to turn out these needed people? D.r MANN. That is right. Mr. ROGERS of Florida. How many colleges, is it 16 dental colleges? Dr. MANN. Dental schools? Mr. ROGERS. Dental schools. Dr. MANN. There are 50 of them. Mr. ROGERS of Florida. About how many dentists do you turn out a year? Dr. MANN. I will ask Mr. Miller to answer that. Mr. MILLER. About 3,400. Dr. MANN. Yes. Mr. ROGERS of Florida. What do you estimate the actual need is for dentists? Mr. MILLER. A number of estimates have been made of need, not only for today but for up to 1970 and 1980. I think the figure that was pretty generally agreed upon, was that by 1975 or 1980 we should just about double the number of the present output of the dental schools. Mr. ROGERS of Florida. What are the prospects for meeting that goal? Mr. MILLER. I think currently there are some very good prospects as the result of the Health Professions Educational Assistance Act. Many of our schools are currently expanding their enrollments. Several new schools are now either in planning for new construction or about to begin construction. Mr. ROGERS of Florida. This is encouraging. Mr. MILLER. Yes, it is. Dr. MANN. I think Mr. Rogers, H.R. 12 has been most helpful. My own school is in the process of expanding. We will take 53 percent, 54 percent more students, jumping from 97 to 150. Mr. ROGERS of Florida. Many of the medical schools have not been able to take very many new people. I think it would be helpful for the record if you could supply what the dental schools have done as a result of that legislation then and how we would meet the goal? Dr. MANN. We will be glad to supply that. (The information requested follows:) At the end of the current fiscal year 14 applications from new or existing dental schools will have been funded under the Health Professions Educational Assistance Act program. These facilities will provide 426 new places for dental students. It is estimated that if the full amounts authorized are appropriated during the next 3 years a total of 700 new places will have been added. Mr. ROGERS of Florida. Would you agree then that it would be well to have this legislation apply to, say, junior colleges where the 2-year schools can benefit from this construction program? Dr. MANN. If I were writing this I would make it apply to the 2-year dental hygiene programs which would include many dental schools, junior colleges, community colleges, and I would not insist that these people who are being effectively trained in 2 years necessarily now be trained over a 4-year period. Mr. ROGERS of Florida. Because you have found that sufficient in many areas? Dr. MANN. Yes. Mr. ROGERS of Florida. Thank you. You have been most helpful. Mr. ROGERS of Texas. Mr. Broyhill. Mr. BROYHILL. I agree with the gentlemen from Florida this is a very excellent statement which you gentlemen have given us. I know that a lot of us have been very much concerned over the need for physicians and dentists and of course the health professions go along with these professional people. I am very impressed with your statement that you felt that this legislation we are considering here makes some contribution to these needs. But, as I gather the thrust of your statement, it is that then it really does not go very far toward meeting these needs. Dr. MANN. We feel it falls short. Mr. BROYHILL. How many do you feel that will be trained under this program in the field of dental hygiene? Dr. MANN. I did not understand your question. Mr. BROYHILL. How many do you feel will be trained under this program, additional personnel, for your profession of dental hygiene? Dr. MANN. The number being trained in existing facilities probably would remain quite nearly the same. We do not think that existing facilities could absorb many more students. We feel that perhaps five or six schools might be inclined to move toward 4 year, initiate 4 year baccalaureate degree programs. So this would probably mean 100 to 150 students a year increase. Mr. BROYHILL. That would take, of course, some years? Dr. MANN. It would. And that is a small number. We are now graduating each year about 1,500. We feel that probably that number should be doubled as quickly as possible. Mr. BROYHILL. Thank you very much, Mr. Chairman. Mr. KORNEGAY. Thank you, Mr. Chairman. Dr. Rovelstad, thank you for your fine statement this morning. I know that you and your colleagues will be interested in hearing, if you don't already know, that a junior college and technical institute in my home county in North Carolina, received the first grant under the Manpower Development and Retraining Act 2 or 3 weeks ago for dental hygienists. The program calls for training 60 dental hygienists. They have already within 2 weeks recruited or had 40 applicants for it. I portend a great future in this particular area. I appreciate your statement. Mr. ROGERS of Florida. Will you yield? Mr. KORNEGAY. Yes. Mr. ROGERS of Florida. Don't you think it would be perhaps wise to consider amending this bill by adding an additional section to assist junior colleges and hospitals in the training of allied health personnel rather than to have to wait and anticipate another act coming up? Dr. MANN. We would have no objection to that. Mr. ROGERS of Florida. Thank you. Mr. ROGERS of Texas. Mr. Satterfield. Mr. SATTERFIELD. No questions. Mr. ROGERS of Texas. Mr. Mackay. Mr. MACKAY. No questions, Mr. Chairman. Mr. ROGERS of Texas. Mr. Gilligan. Mr. GILLIGAN. Mr. Chairman, I have no questions. Off the record, I would like to comment. (Discussion off the record.) Mr. ROGERS of Texas. Mr. Adams. Mr. ADAMS. Dr. Mann, on page 2 you refer to three categories. I thought the dental hygienists included all the ladies in white that wander around the office. Dr. MANN. That is not true. Mr. ADAMS. Who trains the assistants and the dental laboratory technicians as opposed to the dental hygienists? Dr. MANN. The dental assistants are largely trained on the job, in dental offices. This is something which is changing and the dental profession is doing everything in its power to change. It is developing and we are encouraging the development of formal programs of training, either 1 or 2 years in length, and primarily developing in junior colleges. This again would even be something that to us would be a great help, some possibility of assisting junior colleges and community colleges, to prepare these people with a formal education to become dental assistants in their own home localities where they will eventually work. But right now most of the training is going on in the dental office. Mr. ADAMS. In these 1- and 2-year technical training programs, who is there to tell these young ladies what they are going to do? Dr. MANN. Usually a local dentist. Mr. ADAMS. A local dentist goes in rather than a 4- or 6-year dental hygienist coming back and telling them how to do it? Dr. MANN. A dental hygienist does not, ordinarily. Their duties are different from those of a dental assistant. Her education is not necessarily preparing to be a teacher of dental assistants. A dentist with some experience, and dental assistants are usually doing the teaching in these programs. Mr. ADAMS. A laboratory technician, now you mentioned there are only five of those schools in the country. Who is telling the dental technician how to perform his functions? Is this again somebody with a 5- or 6-year college education? Dr. MANN. Generally the program would be headed by a dentist again and helped by a technician, a skilled technician. The reason I keep saying these programs are headed by dentists is that not only do we think this is ethically proper but so many times it is hard to find the dental assistant with the academic background necessary for appointments in our junior colleges and so forth. Mr. ADAMS. In other words, these programs to train the categories of the people, with the exception of the dental hygienists, which I will come back to in a minute, but the people who are actually working in the office at the lower level-type activities are trained by others who are in the field and not necessarily by educators who have been through a full 6- or 5-year college program? Dr. MANN. That is right. Mr. ADAMS. In other words, one of the other witnesses this morning talked about practical nurses helping people at home. Most of her education is from another practical nurse who has done it and is telling another one how to do it rather than an elaborate educational program? Dr. MANN. Yes. Mr. ADAMS. And therefore if we simply train more people for 4 and 5 years both at the baccalaureate and masters level we may well drain away some people who would otherwise stay in offices and work? Dr. MANN. Yes. As far as dentistry is concerned you would help to some extent with the further education of the dental hygienist and to no other extent other than the preparation of teachers for dental hygienists and dental assistants. You would not increase the supply appreciably. Mr. ADAMS. Is there some other type of examination or accrediting system for dental assistants and dental laboratory technicians? Dr. MANN. There is an accreditation program for training. Mr. ADAMS. If somebody comes out to be a dental laboratory technician, in X city does it vary State by State and county by county as to whether or not he can go to work? Dr. MANN. If you will permit me I would like to ask Mr. Miller, who works in this field daily, to answer that. Mr. MILLER. There are two certification programs for the dental auxiliaries, for the dental assistants and for the dental laboratory technician. However, these are voluntary certification programs and they are not conditions of employment. They would indicate competence and skill beyond the average dental assistant or dental laboratory technician if a person were certified. There are national certifying boards for both auxiliaries. Dr. MANN. If somebody is trained either in junior college or community college or by a dentist to be a dental assistant and goes to a dentist's office and says I am a dental assistant and can perform, there is no board to be passed or no particular license. No compulsory requirement. Mr. ADAMS. Thank you, Mr. Chairman. I have no further questions. Mr. ROGERS of Texas. Thank you, gentlemen. Dr. ROVELSTAD. Thank you, Mr. Chairman. Mr. ROGERS of Texas. The next witness is Miss Ruth Hovde, Division of Medical Technology of the College of Medical Sciences of the University of Minnesota, representing the American Society of Medical Technologists. Miss Hovde, it is nice to have you before the committee and you may proceed. STATEMENT OF MISS RUTH HOVDE, PROFESSOR AND DIRECTOR, THE DIVISION OF MEDICAL TECHNOLOGY, COLLEGE OF MEDICAL SCIENCES, THE UNIVERSITY OF MINNESOTA, ON BEHALF OF THE AMERICAN SOCIETY OF MEDICAL TECHNOLOGISTS Miss HOVDE. Mr. Chairman and members of the committee, my name is Ruth F. Hovde. I am professor and director of the Division of Medical Technology in the Department of Laboratory Medicine of the College of Medical Sciences at the University of Minnesota. As a past president of the American Society of Medical Technolo gists, I am appearing on behalf of this organization whose active membership consists of 10,000 professional medical technologists whose standards of education and certification meet the requirements of the Council on Medical Education of the American Medical Association as well as the National Commission on Accrediting. A medical technologist has an educational background of 4 years of academic and professional study in basic sciences related to health. Three of these years are in college with the final year in a hospital laboratory approved for clinical training. As an educator for the past 20 years in medical technology, I am pleased to appear here in support of this bill (H.R. 13196) which provides for improvement of the quality of educational programs and increase in educational opportunities for students in the allied health professions. You are all well aware of the overall factors involved in the tremendous task of providing total health care to the people of this Nation and of the major problems of an adequate supply of qualified personnel, and adequate facilities for service, education, and research. I am here today to speak specifically about only one of the allied health professions, medical technology, which can be defined briefly as "the application of principles of natural, physical, and biological sciences to the performance of laboratory procedures which aid in the prevention, diagnosis, and treatment of disease." In the last 15 to 20 years the amount of knowledge in all basic sciences related to health and disease has expanded at an incredible rate. Even without the impact of medicare and the regional medical complexes, it has been estimated that the utilization of laboratory services has been increasing between 10 and 30 percent annually. This increase in service is not merely an increase in numbers of existing procedures but reflects also the introduction of new methodology and instrumentation making possible more precise and accurate determinations in less time. Contrary to popular opinion such methods and instruments require more, not less, scientific education. The critical shortage of medical technologists has developed primarily because of lack of sound educational programs under good instruction, lack of adequate facilities for classrooms and laboratories, and lack of financial support for educational opportunities in medieal technology. The early development of laboratory services relied on personnel with on-the-job or apprenticeship training. Now with the increasing sophistication of modern science in methodology and utilization, this pattern of training is outmoded, inefficient, and inept. To meet today's and, indeed, future needs, educational programs for medical technology require emphasis on sound academic curriculums properly balanced with clinical experience to prepare the graduate for demands being made of him. The quality of any medical laboratory service depends on the quality of the personnel. First and foremost, of course, is the individual who must possess the intelligence, the devotion, and the integrity to do the job. But this individual, however otherwise qualified, must also have the basic scientific knowledge and skills with which to work. This is obtained through a strong academic and professional prounder the best instructors available. But no matter how excellent a program may be in content and instruction, it must also be gram |