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. Public (4) U.S. National Institutes of Health. Division of Research Grants. Health Service Grants and Awards, Fiscal Year 1964 Funds. Part I. Research Grants. Table I, p. 1. 2. p. 2. (5) U.S. National Institutes of Health. Resources Analysis Branch. Resources for Medical Research. Report No. 5. October 1964. Chart (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. Re (7) U.S. National Institutes of Health. Resources Analysis Branch. sources 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. Hon. LISTER HILL, AMERICAN MEDICAL WRITERS' ASSOCIATION, April 20, 1965. U.S. Senate,, Washington, D.C. DEAR SENATOR HILL: The executive committee of the American Medical Writers' Association has asked me to convey to you its approval and support of the principles and purposes embodied in Senate bill 597, "To provide for a program of grants to assist in meeting the need for adequate medical library services and facilities." I am confident that in this expression we truly reflect the views of the great majority of the 1,800 members of our association. The development of our medical library system has not kept pace with the growth of medical literature. The resulting problems in medical communications present a very real threat to the quality of medical research and to the teaching and practice of modern medicine. The medical library is, of course, the heart of medical communication. During the past two decades, the Federal Government has spent more than $10 billion for medical research and the Nation as a whole has spent nearly $100 billion for health and medical services. But the medical libraries have been largely ignored. In 1964, less than $1 million of Federal funds accrued directly or indirectly to the support of medical libraries. Yet the past two decades have witnessed a veritable explosion of new medical information to be published, cataloged, indexed, stored, and, hopefully, made readily retrievable through modern methods of library operation and information science. There are at present only about 3,000 trained medical librarians available to serve the more than 6,000 medical libraries in the United States. Medical school libraries are reported to be suffering from an average deficit of 23,000 volumes, representing about one-fourth of the recognized minimum requirement of 100,000 volumes. Most medical libraries cannot subscribe to more than onesixth of the recognized periodicals in the field. We earnestly hope that your committee will give favorable consideration to the medical libraries bill now before you. We shall be glad to make ourselves available for further comment if you so desire. Sincerely yours, Hon. PAUL FANNIN, U.S. Senate, Washington, D.C. EDWARD C. ROSENOW, Jr., M.D., President. THE UNIVERSITY OF ARIZONA, DEAR SENATOR FANNIN: On Tuesday, January 19, Senator Lister Hill introduced Senate bill 597. It has since been read twice and referred to the Committee on Labor and Public Welfare. This legislation is known as the Medical Library Assistance Act of 1965 and is designed to assist in meeting the need for adequate medical library services and facilities. It is a good bill and can be stoutly defended without fear of opposition. I have reason to believe that the American Medical Association's board of trustees will endorse this bill; the Association of American Medical Colleges already has. The American Heart Association, the Society of University Surgeons, and other private and professional agencies have either already endorsed the legislation or will shortly. In the State of Arizona, a new college of medicine is being developed on the campus of the University of Arizona in Tucson. This is the first college of medicine to be developed in our State. As you have doubtless heard, an eminently successful fundraising campaign has produced in excess of $2,600,000 for the purpose of building the basic medical sciences building of this college of medicine. Under Public Law 88-129 it will be possible for us to secure some Federal participation in the construction of all aspects of this building. Unfortunately, although it is essential that we include a medical library in the building, the medical library is not matchable under the Health Professions Research Facilities Act. In order to accommodate to this need, Senate bill 597 was introduced. All of us here will be very grateful to you if you will keep Arizona's interests in mind when you are considering this legislation. Its successful passage is of some consequence to our State. Very sincerely yours, MERLIN K. DUVAL, Jr., M.D., Dean. Senator LISTER HILL, THE UNIVERSITY OF CALIFORNIA, New Senate Office Building, Washington, D.C. DEAR SENATOR HILL: The deans of the University of California Schools of Dentistry, Medicine, Nursing, and Pharmacy, and the Health Sciences Graduate Divisions wish to join with me in conveying to you our enthusiastic support of S. 597 and H.R. 3142. We are most pleased with the effort you are making to remedy the alarming deficiency which exists in our Nation's medical libraries. The President's Commission Report on Heart Disease, Cancer, and Stroke, aptly describes the situation in saying that, "unless major attention is directed to improvement of our national medical library base, the continued and accelerated generation of scientific knowledge will become increasingly an exercise in futility." The passage of your well-designed bills will preserve our scientific efforts and make them available for the greater benefit of all mankind. Sincerely yours, CLARK KERR, President. Hon. LISTER HILL, UNIVERSITY OF CALIFORNIA, Chairman, Senate Committee on Labor and Public Welfare, Washington, D.C. DEAR SENATOR HILL: I strongly support your bill, Medical Library Assistance Act of 1965, S. 597. As dean of the UCLA School of Public Health, I can attest to the demands being made on medical library facilities by community health leaders, research, and teaching faculty and students. With medical and public health advances of the next decade will come increasing demands on facilities and library science in general. As in the past, I wish to express my personal appreciation for your leadership in forwarding the health aims and objectives of our Nation. Sincerely, Hon. LISTER HILL, L. S. GOERKE, M.D., Dean. UNIVERSITY OF CALIFORNIA, Los Angeles, Calif., February 24, 1965. Chairman, Senate Committee on Labor and Public Welfare, Senate Office Building, Washington, D.C. DEAR SENATOR HILL: I am writing to tell you that I believe that your bill, Medical Library Assistance Act of 1965, S. 597, is excellently designed to meet our country's critical need for adequate medical library services and facilities. Schools of nursing across the country are largely dependent upon medical library services and facilities for the urgently needed expansion and development of their undergraduate and graduate nursing programs. Moreover, investigations leading to improved patient care of the Nation's sick and handicapped can continue to accelerate only if the rapidly accumulating scientific information in nursing, medicine, and other health fields can be made readily accessible. I want to take this opportunity to tell you how much my colleagues and I have appreciated your continued and material support to medical libraries during the past several years. Very sincerely yours, LULU WOLF HASSENPLUG, Dean. UNIVERSITY OF CALIFORNIA, SAN DIEGO, SCHOOL OF MEDICINE, Hon. LISTER HILL, U.S. Senate, Washington, D.C. DEAR SENATOR HILL: I should like to indicate my strong support of the Medical Library Assistance Act of 1965, which you introduced to the Senate as S. 597, on Tuesday, January 19, 1965. I can appreciate very well the special problem of medical libraries from my position as dean of a developing school of medicine. It is perfectly clear that we must improve our methods of information storage and retrieval in order to meet the needs of medical research, education, and practice. Yours very truly, JOSEPH STOKES III, M.D., Dean. STANFORD UNIVERSITY SCHOOL OF MEDICINE, Re bill S. 597. Hon. LISTER HILL, Senate Office Building, Washington, D.C. DEAR SENATOR HILL: I became aware recently of bill S. 597 which you have introduced into the Senate, and which proposes to establish Federal aid for the building and development of medical libraries. This is, of course, a subject of great concern to schools of medicine for reasons which extend beyond their deans and faculties to the medical profession generally, for such libraries serve as major service facilities, usually without charge, for physicians who practice within a wide radius of a medical school. Hence, such libraries are extremely valuable assets to the practitioners of medicine and allied health fields in this country. Nonetheless, it is a paradoxical fact that efforts to obtain gift funds for the support of libraries are relatively unrewarding, at least in our experience. In view of these facts, and in view also of the provisions for very desirable developments in library techniques which are elaborated in your bill, this proposal for Federal assistance is of utmost importance to the health and related professions of this country. May I thank you on behalf of this school for your introduction of this bill. and for your efforts in moving it through the Congress. Sincerely yours, SIDNEY RAFFEL, M.D., Acting Dean. Hon. LISTER HILL, U.S. Senate, Washington, D.C. UNIVERSITY OF COLORADO MEDICAL CENTER, DEAR SENATOR HILL: I am in receipt of a copy of Senate bill 597, your proposal for a "Medical Library Assistance Act of 1965." A more basic, forward-looking legislative proposal scarcely could be conceived as a contribution to the continued progress of medical education, biomedical research, and the health care of American citizens. Medical libraries lie at the heart of the modern system of medical science. Without them, it would be impossible to maintain, much less to advance, the high standards of education and scientific investigation upon which the practical, everyday medical care of people depends. Your proposed legislation indicates your keen awareness of the dilemma now facing medical libraries. The enormous and rapid progress of biomedical knowledge, increasing yearly at geometrical rates, is confronting medical libraries with problems of expansion, staffing, and processing which are close to overwhelming. Unless immediate solutions are found to these problems, much new knowledge will be effectively lost, since medicine is a cumulative and scholarly science which builds upon all that has gone before. Every effective means must be sought to assist medical libraries in their vital and Herculean labors of information collection, preservation, and retrieval. It is greatly encouraging that this legislation has been proposed, and I am delighted to take this opportunity of expressing my support for it and my appreciation to you and your associates for developing and sponsoring it. Sincerely, JOHN J. CONGER, Ph. D., Vice President for Medical Affairs and Dean, School of Medicine. |