Before closing, I would like to mention that the University of Utah College of Medicine is the only functioning medical school between Denver and the Pacific coast and between the Canadian and Mexican borders. It is the center of medical training for a number of States, and it has established an enviable record of excellence in all three major phases of medical school activities, namely education, research, and patient care. It makes a great contribution to the health and welfare of the people of the entire area and it is essential that its standards be kept high and that it is assured all of the facilities it needs.

Sincerely,

Chairman, Committee on Labor and Public Welfare,
U.S. Senate, Washington, D.C.

DEAR SENATOR HILL: I am forwarding the enclosed letter from Dr. John R. Amberg, chairman of the library committee of the Milwaukee County General Hospital, for your information. I would appreciate the committee's full consideration of Dr. Amberg's comments in its deliberations on S. 597, the Medical Libraries Assistance Act.

As you know, I am a dedicated supporter of sound education legislation. I believe improved library facilities are vital to the development of our medical professions and increased knowledge in such special fields as heart disease, cancer, and stroke. I hope all the members of the committee will recognize the importance of this legislation and will act promptly on S. 597. Thank you for your efforts in this field. Sincerely yours,

GAYLORD NELSON,

U.S. Senator.

Hon. GAYLORD NELSON,

U.S. Senate, Washington, D.C.

MILWAUKEE COUNTY GENERAL HOSPITAL,
Milwaukee, Wis., April 9, 1965.

DEAR SENATOR NELSON: I am writing to you as chairman of the library committee at Milwaukee County General Hospital which has studied the bill to improve medical libraries and most thoroughly endorses the proposals therein. In the operation of a library in a hospital such as ours there are no entries on the income side of the ledger only those on the expense side. For this rea son it is rather difficult to hope to obtain the funds we need to automate our library and to provide it with the books, journal, and staff that it needs. Within our hospital we have a large nursing school, the students from Marquette University School of Medicine, interns, residents, and other paramedical trainees. The overall influence that a modern library would have on the education of these people is immeasurable.

While I know that you are well aware of the need for this legislation I hope you can assure the other members of your committee that there is a real problem here. The fact that this was so specifically mentioned in the report of the President's Commission on Heart Disease, Cancer, and Stroke is another indication that many people are concerned about this matter.

Sincerely yours,

JOHN R. AMBERG, M.D., Chairman, Library Committee.

Hon. LISTER HILL,

THE AMERICAN PUBLIC HEALTH ASSOCIATION, INC.,
June 18, 1965.

Chairman, Senate Committee on Labor and Public Welfare,
New Senate Office Building, Washington, D.C.

DEAR MR. CHAIRMAN: I am pleased to inform you of the support of the American Public Health Association of the principles and objectives of S. 597, the bill which you have introduced relating to medical libraries. The statement of

declaration of policy in S. 597 wherein the needs of medical libraries are enumerated is fully subscribed to by the APHA. The proposed course of remedial actions appears to us to be both logical and necessary.

We are delighted to note that under the definitions the term "sciences related to health" includes public health and fundamental and applied sciences related thereto. We believe, you will agree, that public health schools and departments should be clearly eligible to participate under all applicable sections of the bill. The language of section 394 is explicit in this respect, but we believe it would be very helpful to clarify the language of the remaining portions of the bill in this respect.

May I reiterate, Senator Hill, our support of S. 597 and urge passage after the minor amendments referred to above.

Sincerely yours,

BERWYN F. MATTISON, M.D.,
Executive Director.

AMERICAN HOSPITAL ASSOCIATION,

June 14, 1965.

Hon. LISTER HILL,

Chairman, Committee on Labor and Public Welfare,
Senate Office Building, Washington, D.C.

DEAR SENATOR HILL: In this statement to you we wish to express the views of the American Hospital Association in respect to S. 597, "Medical Library Assistance Act of 1965." The bill amends the Public Health Service Act so as to provide for a program of grants to assist in meeting the need for adequate medical library services and facilities.

The American Hospital Association approves the general purposes of the bill. There exists a vast unmet need for the dissemination of information in the health sciencs. The very rapid advancements now being made in health research and in the treatment of illness have outpaced existing means of communication. There is also a failure to support the growth of library facilities and materials commensurate with the development of major health research. Adequate library and communication facilities and services are also necessary in all of the schools and educational programs directed to the training of health personnel.

The Congress has already enacted legislation looking toward a rapid acceleration in the training of physicians, dentists, public health workers, nurses, and others. It is imperative to the success of these efforts that we direct attention now to the sources of fundamental knowledge and toward the dissemination of such knowledge. Your committee is presently considering S. 596, a bill with far reaching implications for the health care of the American people. The kinds of proposals which are embodied in S. 597 are of vital concern to the successful implementation of the "Heart Disease, Cancer, and Stroke Amendments of 1965.” For many years the health field has been aware of the problems developing because of the unmet needs for adequate health science libraries. We believe perhaps the most urgent need is that of training more people in library science. At present libraries are often staffed largely by either untrained or inadequately trained personnel. The overall objectives of the bill will be seriously handicapped without major emphasis on training. We sincerely hope that the Congress will move ahead rapidly in making available the assistance proposed in S. 597. Our general approval of the bill is limited only by what we believe are limitations in the language of the bill.

RECOMMENDATIONS ON SPECIFIC PROVISIONS

We would strongly urge that the title of the act which cites overall intent be broadened beyond its present limited language and that the act may be cited as the "Health Science Library Assistance Act of 1965." The term "medical" is far too limited in light of the essentially broad purposes of the act. We urge that the appropriate language changes be made throughout the bill to accomplish this purpose.

Section 390 (b) (3) provides for special fellowships for the creation of written matter. The purpose of the provision is not at all clear. However, written material in any way essential to research is part of research projects. We, therefore, do not support the inclusion of this provision in the bill.

(1) Section 391 should be broadened so as to include the term "hospital administration" following the term "public health" on line 22. There are at the present time 16 university programs providing master's degrees in hospital administration. We believe the bill should provide assistance in its various purposes to such libraries and programs.

Paragraph (3) of this section, line 4, should be amended by deleting the word "medical" and insert the phase to any "health science" library.

We recommend that section 393, "Assistance for Construction of Facilities"; section 397, "Grants for Improving and Expanding the Basic Resources of Medical Libraries and Related Instrumentalities" should clearly provide for assistance to all teaching hospitals and other hospitals maintaining such essential health science information on behalf of their staffs and students.

In section 399 (a) we question both the necessity and desirability of the section. We believe it will tend to promote the unnecessary publication of material. It can further burden libraries with materials in an area which appears to be adequately served. There is the definite likelihood of publishing materials that recognized scientific channels and publications will not carry because they deem it to be inadequate.

Section 3, part (h) of title III of the "Public Health Service Act" which deals with the National Library of Medicine is amended so as to provide regional branches of the National Library.

We would urge that this section not be limited, as it appears to be at present, so to make it essential that such extended facilities be separate and independent facilities. The bill should provide that insofar as possible, such "regional branches" be located in existing hospitals and medical centers which may serve a large geographic area.

We appreciate this opportunity of submitting to you the views of the American Hospital Association on S. 597. We would appreciate your making this statement a part of the record of the hearings on this bill.

Sincerely yours,

KENNETH WILLIAMSON,

Associate Director, American Hospital Association.

STATEMENT IN SUPPORT OF S. 597, MEDICAL LIBRARIES ASSISTANCE ACT OF 1965, TO THE SUBCOMMITTEE ON HEALTH OF THE SENATE LABOR AND PUBLIC WELFARE COMMITTEE, JUNE 15, 1965

I am Dr. Frederic H. Barth. I have long been interested in the field of education as a member of the board of education of the city of Philadelphia and president of the Philadelphia College of Osteopathy.

I am president of the American Association of Osteopathic Colleges, which consists of the five schools of osteopathic medicine and surgery, all of which are nonprofit and accredited by the American Osteopathic Association, on whose behalf I am privileged to express enthusiastic support for all parts of the pending Medical Libraries Assistance Act of 1965, S. 597.

The principal objective of the American Osteopathic Association is the maintenance and improvement of standards of education in osteopathic colleges. The association's standards for accreditation require that the school must maintain a medical library which shall include current texts, reference books, and the periodicals needed in the teaching and research program, and that a qualified librarian shall be employed to supersive and develop the library.

Association standards for approval of teaching hospitals require that the hospital shall provide a professional library which must contain modern texts and current periodicals on anatomy, anesthesiology, bacteriology, chemistry, dermatology, diagnosis, internal medicine, laboratory diagnosis and technique, neurology, obstetrics and gynecology, ophthalmology, orthopedics, otorhinolaryngology, pathology, pediatrics, physics, physiology, practice of osteopathy, proctology, psychiatry, radiology, surgery, syphilology and urology, and additional current texts and other professional periodicals of a general and specialty nature. Nonteaching hospitals accredited by the association are also required to provide and maintain a professional library to meet the professional needs of the institution.

There is a wide variation in the facilities and equipment provided in the schools and hospitals. Little or no facilities are provided by most State osteopathic societies notwithstanding the urgent needs of practitioners for more ready

acress to the growing body of new metal hbmation, and the number of States which require animal regstraten of physicians folowing refresher

As stated in the special repres of the Sabe mire on Facilities contained in voimme II of the regret of the President's Commission oc Heart Disease. Cancer, and Strike, the disrepair of je neball Day swem w essential to the transmission of medial Dovede bess time and spare, castitates a major weakness in hoch Federal and peate leath and nebeal progrLES.

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The special report en casted that the red for space in which to maintain their Ceerivas and may essay today operations is perhaps one of the most bent needs of the netval Stories, and cited the following table of nesteal Dorary spare retirements.

The time table refers the spare foure engiiged, and needed by the 113 estadested whris of medi the decrisory, and scagathy, and the 12 developIF IT Deb 1 SATs and 3 bem dectal sevis Fe the parposes of this 20 DTA stopt use five pebbe bealth schools but was not

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wrc 38 4 8.5 mb rizes a T-Tear program of assistance for the conwowed medal Brary farities The about any gran: would not * Jovens of the beeSSETT MOstracti e cust. Priety wald be given MEIOADVEN AT BADAing the createst Deed.

won 34 brines & Spear peran of gras de training in medical Grants would be made to individuals to sa traineeships

aut fourstiga in the Seld of medical library slave in related felds pertainTowers Teated to health and in the field of the communicativa of inforGrants Wild als be made to individuals who are rarians or spe

mative in scences relating to health to enable them to attain junensive training and retraining. This should help reduce the deficit of profesvional librarians and persons adequately trained at the subprofessional level. Section 36 authorizes a 5-year program of grants for special fellowships to be awarded to physicians and scientists for the compilation of existing, or writing of original, contributions relating to scientific advancements in sciences related to bealth.

Section 396 authorizes a 5-year program of grants for projects of research and investigations in medical library science and the development of new techniques, systems, and equipment for processing, storing, and retrieving and distributing information on sciences related to health.

Section 397 authorizes a 5-year program of grants for improving and expanding the basic resources of medical libraries. According to the Subcommittee on Facilities above referred to, one of the most significant inadequacies of the Nation's medical libraries "is that they have only about half the books, journals, and other resources they need." Information provided by the osteopathic colleges shows that their holding of volumes ranges from 6,000 to 23,225, and their annual budgets range from $10,500 to $23,500. Obviously, none of the colleges has a desirable number of volumes or adequate budget. Section 397 provides funds for acquisition of books, journals, photographs, motion picture and other films, and for cataloging and binding, and for acquisition of duplication devices, and new technological equipment to facilitate the use of the library. As pointed out in the Medical Education Facilities, PHS Publication No. 1180-A-1b, budgeted expenses for books, subscriptions, and other supplies are as high for 64 students per class as for 96. A smaller class and a smaller faculty do not reduce the need for library reference material. However, the increase in class size will call for more services or larger library staff and the library facilities will be more fully utilized. An estimate of what the program envisaged in this bill can mean as applied to the Philadelphia College of Osteopathy is provided in the following comment by Dean Sherwood Mercer:

(a) A long-term program of construction, beginning with a $7 million hospital project now under construction, includes a new college building in which will be a greatly enlarged library for a student body to be expanded from about 350 to 575 (based on increasing the first year class from 100 to 150). The new library can be made an even more effective instrument in support of learning than is now possible under present plans, if we could enjoy the additional support as projected in S. 597.

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(b) The library system of the college will be built around the main collection at the new City Line Campus where the building cited above will be located. satellite collection will be housed in the presently used (and to be entirely renovated) college and hospital building at 48th and Spruce Streets; another satellite collection will be located at our 20th and Susquehanna Avenue hospital. As is presently our practice, departmental libraries will be developed in all three locations.

(c) Because the college is located in Philadelphia and in close proximity to some of the world's finest collections in medical libraries, our plans call for a more efficient intercommunication system with area libraries and we hope, through regional library facilities with the entire county. Clearly, the intent of S. 597 seems to support these projections.

(d) We have begun the search for professional leadership for the library complex. Our discussions always included an exploration of our interest in training people for careers in medical libraries. Here again we are fortunate in being close to the Graduate School of Library Science at Drexel Institute of Technology.

(e) We are aware of the role of electronic equipment in the management of libraries more effectively to make them vital teaching centers. Because of costs we can do little other than to plan space into the new library where this equipment could be housed and used. S. 597 would make possible application for support for this and other equipment, personnel and facilities to make our new library a better one than we can now afford to plan.

(f) In our discussions with candidates for the post of librarian we have outlined ideas for the education of faculty and students alike in the communication of ideas, new knowledge and new techniques, so that the whole body of physicians will know how better to be informed and to inform.

We appreciate this opportunity of presenting our views on S. 597, and the hope for early enactment of the legislation.

AMERICAN NURSES' ASSOCIATION, INC.,
New York, N.Y., June 17, 1965.

Senator LISTER HILL,

Chairman, Senate Committee on Labor and Public Welfare,
U.S. Senate, Washington, D.C.

DEAR SENATOR HILL: The American Nurses' Association wishes to record its support of S. 597, the Medical Library Assistance Act of 1965. We believe the provisions in this bill will do much to meet the current and ever-increasing need for trained medical librarians, adequate space, equipment, books, and journals.