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Mr. ROGERS of Florida. Thank you very much, Congressman Pickle.

Dr. Waldman, before you begin, I think you should know that the committee receives you with great affection after all of this very fine introduction from our good and close colleague here from Texas whom this committee regards most highly. STATEMENT OF DR. NELSON F. WALDMAN, 0.D., CHAIRMAN, COM

MITTEE ON VOCATIONAL GUIDANCE, AMERICAN OPTOMETRIC ASSOCIATION

Dr. WALDMAN. Thank you very much. I was unprepared for such a reception. However, if it were possible, I could take much more time than what I am allotted here this morning to tell you some very wonderful and very, very flattering things about Congressman Pickle who, as he indicated, served as our executive secretary in Texas for several years.

Frankly, I think that you people here in Washington are very fortunate to have him.

Mr. ROGERS of Florida. We agree with you 100 percent.

Dr. WALDMAN. I think he will be a tremendous asset to all of you and all of us serving here in Washington. I hope you take advantage of him.

Mr. Chairman, I, too, will attempt to summarize the statement that has been presented to you.

Mr. ROGERS of Florida. That will be fine. Your full statement will be made a part of the record at this point without objection.

(Dr. Waldman's statement in full follows:)

STATEMENT OF NELSON F. WALDMAN, O.D. Mr. Chairman and members of the committee, thank you for the privilege given me today to speak in favor of legislation which can do so much to aid the visual welfare of our Nation.

I am Dr. Nelson Waldman, practicing optometry in Houston, Tex. I am chairman of the American Optometric Association's Committee on Vocational Guidance and president-elect of the Texas Optometric Association.

The American Optometric Association has done a great deal of research in an effort to determine the current and future needs of optometrists in the United States and the prospects for meeting these needs. We have studied ways and means of attracting intelligent young men and women and have devised a program to assist in eliminating the shortage of optometrists which will otherwise become a problem of serious consequences for this great country.

The services of optometrists are essential to the health and well-being of the American people; the missions of the U.S. armed services and of civilian space and other scientific endeavors; the production of vital military and related equipment and materials needed for national defense; and to the development of skills and the improvement of educational techniques among students and workers. However, as the demand for optometric services has expanded—both in civilian and military life—the number of optometrists has not been keeping pace, and has, in fact, been declining. Thus, it is imperature that every effort be made to emphasize the need for and the shortage of, men and women trained in this vital professional specialty.

Optometrists devote 5, 6, or more years to college or university education to the purpose that at the conclusion of such education they can make a conscientious measurement of refraction and visual acuity and apply their acquired knowledge to increase the visual performance of both young and old who seek their professional services.

Optometrists fill a public health need which can be met from no other source than by utilization of their services. They presently supply two-thirds of all the vision care to the general public of the United States, and in the Armed Forces this percentage is close to 85 percent.

Optometry is the only profession specifically licensed in all of the 50 States, the District of Columbia, and the outlying possessions of the United States to deal with refractive and visual anomalies. Optometry exists only because the public reposes trust in it to fill its visual needs, and compensates optometrists for doing so.

Most Americans requiring vision care are dependent upon the availability of members of our profession. In addition, most of the preventive work in the field of vision care periodic examinations for evidences of vision difficulties relating to such near-point vision tasks as reading or eye-hand coordination—is performed by optometrists in the home community. While medical practitioners also frequently provide such services, the number of medical doctors trained in this specialty is approximately one-sixth as large as the admittedly limited number of optometrists.

Results of the 1960 Census of Population show 16,044 optometrists practicing in the United States. This was a gain over the 1950 census of 9.6 percent. The same census revealed a gain in the same period for dentists of 10.1 percent and for physicians and surgeons of 18.9 percent.

Our latest tabulation for May 1964 shows there are some 17,000 optometrists in practice. As of 8 a.m., May 21, 1964, the Bureau of Census, Department of Commerce, reports that the U.S. population is 191,741,430. In round figures, then, we have a ratio of 1 optometrist to every 11,250 Americans.

Since most Americans—including those in the armed service—are dependent primarily upon members of the optometric profession for most of their vision care requirements (or for referral, when indicated, to physicians for medical attention), the question is whether there are sufficient licensed optometrists to meet the needs of this country.

The data we have establishes that there is a pronounced and serious shortage in our profession, and that this shortage, under the present conditions of college enrollment, and vigorous competition with the health and other sciences, will get increasingly worse before it will be improved.

The facts are these :

1. More practitioners are leaving the field (through death and retirement) than are entering it.

2. The number of students enrolled in colleges of optometry has fallen off drastically since the high point of post-World War II GI bill enrollments. However, there has been a steady, but all too slow growth since 1958.

3. According to a recent, professionwide survey, less than 7 percent of the practicing optometrists in this country are under the age of 29, while about half of all optometrists are over 38.

The following figures are based on a 1959 survey made by the American Optometric Association, on which there was a 45-percent response to the questionnaire. This study, providing the best information currently available on the characteristics of the profession, showed that

Percent Were then under 29_.

7 Were then between 29 and 38_

44 Were then between 39 and 48_

30 Were then between 49 and 58_

12 Were then between 59 and 68--

5 Were then 69 or older (of which 3/10 of 1 percent were still practicing at 90 or older)

2 4. The accepted minimum ratio of optometrists to population has been determined to be one practitioner to each 7,000 persons. The actual ratio, however, is now of one optometrist to each 11,250 persons. At the current level in 1964, then, we have a present shortage of 10,000 optometrists needed to provide the barest minimal vision needs of our population.

Since it requires at least 5, and usually 6, years of college-level training to prepare an optometrist for general practice, and since college enrollments have not kept pace with the attrition rate in the profession, the present unfavorable ratio of optometrists to population will worsen, if the trend is not reversed quickly.

The shortage of optometrists is much more serious in some States than in others, but is acute in all States. There are 45 counties in Kentucky, according to a report by that State's Governor, which are without a single full-time optometrist. But even in States where the ratio is more favorable than in others, patients must schedule their appointments far in advance, and often wait an inordinate length of time for examinations. This problem, common to medicine, dentistry, and osteopathy, is equally true in optometry.

States with the highest percentage of population per optometrist are generally those States with the highest Negro or Spanish-American population. They are also generally the States with the lowest per capita income. Applicants desiring to enter the study of optometry from these Sates are those most in need of financial assistance to pay the costs of their education.

The Midwestern States are usually considered to be as self-sufficient as any group of States in our Nation. It is significant, therefore, to study the following table taken from the Optometric World, a privately published magazine, which appeared in that magazine's December 1963 issue.

The scope of the study was limited to 10 States and was to find those counties having 10,000 or more population per optometrist. Note that all counties having no optometrists are included regardless of population.

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Population per optometrist-Continued

KANSAS

County

1960 population Optometrists

143, 792 185, 495 48, 524 13, 909 25, 865 12,897 12, 886 343, 231 11, 253 11, 252 22, 279 10, 739 10, 309 10, 254

9, 574 32,368

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38, 555 29, 939 29, 063 57, 622 55, 381 26, 974 208, 769 23, 824 22, 545 22, 488 21, 219 20, 198 18, 564 18, 439 18, 369 18, 301 17, 991 36, 653 17, 624 33, 709 16, 726 48, 833 32, 186 111, 351 60, 771 14, 796 28, 535 14, 177 84, 656 27, 927 13, 330 51, 697 37, 606 49, 931 12, 395 59, 434 81, 493 230, 058

11, 421 101, 663 223, 859 44, 015 9, 978 9, 163

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Population

per optometrist

Johnson Wyandotte. Leavenworth. Rice. Harvey. Nemaha. Osage. Sedgwick Greenwood. Jefferson. Cherokee Washington Jackson Pawnee. Doniphan Barton.

28,758 18, 549 16, 175 13, 909 12, 932 12,897 12, 886 11, 441 11, 253

11,139 10, 739 10,309 10, 254

8,062

38, 555 29, 939 29, 063 28, 811 27, 690 26, 974 26,096

22, 545 22, 488 21, 219

18, 301

Vermilion..
Iberville.
St. Martin.
Bossier
Lafourche.
Livingston..
Jefferson.
Richland.
Plaquemines..
Pointe Coupee-
St. Charles
East Feliciana.
Sabine..
St. John the Baptist.
St. James.
Vernon.
Assumption.
Natchitoches.
Union.
Morehouse
Bienville.
St. Mary-
St. Bernard.
Rapides.-
Terrebonne
West Baton Rouge.
Lincoln.
West Carroll.
Lafayette.
Ascension.
Grant.
Iberia.
Avoyelles.
Acadia.
West Feliciana.
Tangipahoa..
St. Landry.
East Baton Rouge
Catahoula.
Ouachita.
Caddo
Washington
Red River.
St. Helena.

17, 826 17, 624 16, 854 16, 726 16, 277 16, 093 15, 907 15, 193

14, 267 14, 177 14, 109

13, 963

12, 914 12, 535 12, 483

11, 887 11, 642 11, 503

11, 296 11, 192 11, 004

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Population per optometrist-Continued

MINNESOTA

County

1960 population Optometrists

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85, 916 23, 196 21, 909 54, 432 17, 287 16, 720 33, 035 16, 288 78, 303 15, 523 29, 935 14, 743 14, 460 14, 262 13, 419 13, 330 26, 641 13, 259 12, 861 12, 162 12, 154 23, 249 11, 262 10, 650 9, 651

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MISSOURI

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Population

per optometrist

28, 638
23, 196
21, 909
17, 477

Anoka..
Nicollet.
Scott.
Washington.
Benton
Cass.
Goodhue
Sibley-
Dakota.
Yellow Medicine.
Wright.
Murray
Watonwan.
Marshall.
Chisago.
Lac Qui Parle.
Morrison.
Dodge.
Sherburne
Aitken.
Roseau
Renville
Stevens
Wilkin.
Lincoln

16, 720
16, 512
16, 288
15, 661
15, 523
14, 967
14, 743
14, 460
14, 262
13, 419
13, 330
13, 320

12, 162 12, 154 11, 624 11, 262 10, 650

46, 567 38, 095

23, 260 17, 758 17, 657 16, 706 15, 507 15, 047 14, 851 14, 579 14, 346 14, 183 13, 847 13, 753

Pulaski.
Pemiscott
New Madrid
Platte
Lawrence
Texas
St. Charles
Pike.
Monroe.
Newton.
Cass.
Clay-
Washington
Wright
Carroll
Webster
Chariton
Christian.
Grundy.
Ste. Genevieve.
Callaway.
McDonald
Montgomery,
Andrew..
Osage.
Howard
Monroe
Moniteau..
Mississippi.
Taney.
Bollinger
Sullivan.
Clark.
Wayne
Caldwell
Ralls
Iron.

12, 359 12, 220 12, 116 11, 929 11, 798 11, 097 11, 062

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