PODIATRISTS IN FUTURE YEARS

Losses of the manpower in podiatry occur in two ways: (1) by death and (2) by retirement. Unfortunately the records of the profession over the past years are not complete and therefore estimates of the numbers of podiatrists in the future are made on the basis of survival rates of podiatrists in 1963, and the recruits (graduates of podiatry colleges) who join the profession from time to time. The additions to the profession (graduates of colleges of podiatry) for 1955, and the following years are shown in table II.

The estimates of numbers of podiatrists under 75 years of age at various times are shown in table III. They are explained as follows:

1. Survival rates are from mortality tables. Thus, of 100 persons 25 to 29 years old, 99.259 percent will survive into the next 5-year period (col. 2).

2. The age distribution of the podiatrists in 1963, has been computed from ages reported by 3,309 respondents to a questionnaire early in 1964 (col. 3). 3. Of the 553 podiatrists in the age group 25 to 29 years, 549 (99.259 percent of 553) will be found in the age group 30 to 34 years, in 1968 (col. 4).

4. Similarly of the 929 podiatrists in the age group 30 to 34 years, 921 (99.133 percent of 929) will be found in the age group 35 to 39 years in 1968 (col. 4). Similar computations for all age groups in column 3 produce other numbers in column 4.

5. In each 5-year interval new podiatrists join the profession. They will be in the age group 25 to 29 years (693, 955, and 955, as shown in cols. 4, 5, and 6). 6. Additions of columns 3, 4, 5, and 6, respectively, show the numbers of podiatrists under 75 years of age to be: 7,995 in 1963, 8,272 in 1968; 8,688 in 1973; and 8,832 in 1978.

TABLE II.-Enrollments in colleges of podiatry, 1951-52 to 1960-61 with projections to the future, and annual numbers of graduates

1 From 1951-52 to 1960-61 the total of 1st year enrollments was 1,482. The corresponding graduates 4 years later came to a total of 1,267-about 85 percent of the corresponding 1st year enrollments. The numbers of graduates from 1955 to 1964 are actual; the numbers beginning with 1964 are estimates based on enrollments in 2d, 3d, and 4th year classes in 1964-65; the numbers beginning in 1968 are 85 percent of 1st year enrollments 4 years earlier.

2 Number that can be accomodated on the basis of present capacity and continuing indefinitely. 3 Continuing indefinitely.

TABLE III.-Numbers of podiatrists at various times based on (1) the total number in 1963, (2) the number of recruits (graduates of the colleges), and (3) the number of survivors through the passing years

DEFICITS OF PODIATRISTS IN FUTURE YEARS

In tale IV data from tables I and III are combined to show the deficits in the numbers of podiatrists required in future years. The figures indicate that the supply of podiatrists will increase in the next 15 years but not as rapidly as the number needed in order to maintain the podiatrist-population ratio of 4.22 per 100.000 as in 1963 (assumption A) or 5.81 per 100,000 (assumption B). The result will be a mounting deficit due to the supply of podiatrists not keeping up with the population increases, which by 1978 will reach 4,017 (1,017 plus the 3,000 deficit in 1963) (assumption A) or 4,727 (assumption B).

TABLE IV.-Deficits in the numbers of podiatrists needed at various times,

It is now possible to obtain a general picture of the manpower situation in podiatry in the near future years. The summary runs as follows:

1. In 1963 there were 8,008 registered podiatrists in the Nation; 7,995 were under 75 years of age.

2. The deficit in the number of podiatrists needed in the Nation in 1963 on the basis of geographic distribution was about 3,000.

3. The deficit in numbers required in the future to keep up with the population increase, taking into account the supply in 1963 (7,995) and the deficit (3,000) in the same year, will be considerably more than 4,000 by 1978. In making this statement it is assumed that the present capacity of the colleges of podiatry will remain unchanged.

4. The situation cannot be changed materially until the facilities of the col leges of podiatry are expanded to accommodate and graduate greater numbers of students. In order (1) to care for the deficits in the number of podiatrists needed by 1980 and (2) to provide the number needed to supply the profession in keeping with increases in population, the colleges would have to graduate about 600 students annually beginning with 1968. That number of graduates each year would require first year enrollments of about 700.

WHAT THIS MEANS

It appears rather obvious from the situation described above that public need for podiatry service will not be adequately cared for in the near years ahead unless (1) there is considerable improvement in recruiting, (2) expansion of facilities to train more persons to practice the profession occurs, and (3) steps are taken to effect a distribution of podiatrists, particularly newcomers to the profession, into geographic areas which are undersupplied. This presents a challenge to many persons and groups, but more especially to the podiatry profession which is dedicated to serving the foot-health conditions of the public, and (2) to those public spirited individuals and groups outside the podiatry profession who are particularly concerned for the health and welfare of the men, women, and children of the Nation.

Acknowledgement.-The helpful assistance of Mrs. Maryland Y. Pennell, Chief, Health Manpower Statistics Branch, Center for Health Statistics, U.S. Public Health Service, is gratefully acknowledged. Mrs. Pennell suggested the way to compute the numbers of survivors in various age groups of podiatrists. She also read and criticized a draft of the article.

EXHIBIT C

[Reprinted from vol. 54, No. 8, Journal of the American Podiatry Association, August 1964, pp. 551-553]

PRESENT MANPOWER DEFICIT IN PODIATRY

(By Lloyd E. Blauch, Ph. D.1)

In a paper published earlier this year, the first report of the manpower studies being conducted by the Division of Special Studies of the American Podiatry Association was presented. A summary table showed the number of registered podiatrists and the ratio of podiatrists per 100,000 population, by State.

From that table it can be seen that over half the podiatrists practice in States where the ratio is 7.6 or higher. With the Nation's population today (June 1964) being 192 million, there would need to be 14,692 podiatrists to provide every State with at least the aforementioned ratio of podiatrists to population. But there are only slightly over 8,000, which represents a deficit of more than 6,600 podiatrists. This is one rough estimate. To obtain more valid estimates, and on a State-by-State basis, the division of special studies has made a detailed manpower survey.

Lists of State registered podiatrists as of the end of 1963, were obtained directly from State boards of podiatry examiners, or other appropriate State licensing bodies. Lists were cross-checked to eliminate duplicate registrations (or license). A podiatrist who is licensed in more than one State is listed only by his principal office or address.

Detailed tables were then compiled for each State. In each State the podiatrists were tabulated by county, cities, and standard metropolitan statistical areas. From these State tables, a summary table (table I) for the Nation was prepared. It may be of interest to the reader to know that, in the Nation, there are 3,115 counties, 2,168 places with over 10,000 population and 215 standard metropolitan statistical areas.

1 Director, Division of Special Studies. American Podiatry Association, Washington, D.C. 2 Blauch. Lloyd E., Ph. D., Numbers and the Podiatry Profession, JAPA, 54:4: 248-252 (April 1964).

TABLE I.-Number of podiatrists registered in the United States and deficit in numbers based on ratios of numbers of podiatrists to population

In estimating the number of additional podiatrists that the country should have, one could use several procedures. In the light of our present state of knowledge, the best procedure seems to be to employ as a basis the size of communities that afford a satisfactory practice for a podiatrist. In following this procedure, three figures are used: (1) The number of registered podiatrists; (2) the number of podiatrists needed, based on the ratios of podiatrists to population; and (3) the deficits, or the number of podiatrists needed less the number registered. These deficits are taken as the estimates of additional podiatrists needed.

The deficits (estimates) are obtained by using three types of geographical units, as follows:

(1) Counties.-It is assumed that a county with a population of 20,000 or more can provide a satisfactory practice for a podiatrist; a county with 40,000

people can provide practices for 2 podiatrists, and so on. This assumption appears to be justified by the fact that 69 counties with smaller populations have one or more podiatrists. In computing the deficits by counties, those counties with fewer than 20,000 people which had no podiatrists were not included.

(2) Cities. It is assumed that a city with a population of 10,000 or more can provide a satisfactory practice for a podiatrist. This assumption appears to be justified by the fact that 582 podiatrists are found in 494 cities with populations under 10,000.

(3) Standard metropolitan statistical areas.-Such an area consists of a large city (at least 50,000 population) and a surrounding county or counties. These areas, 250 of them, have been designated by the Bureau of the Budget. They are used in estimates made by Federal offices from time to time. A standard metropolitan statistical area (SMSA) is defined as an "integrated economic and social unit with a recognized large population nucleus." Each SMSA is treated in this study as a city (1 podiatrist to 10,000 population) in estimating the number of podiatrists needed.

From these data it can be assumed that there is a present deficit of podiatrists ranging from 2,000 to 6,600 depending upon the manner in which the estimate is obtained. A deficit of 3,000 is probably the most realistic estimate.

Future reports will consider manpower needs in podiatry for our rapidly expanding population and the greatly increasing utilization of and demand for podiatry services.

Senator YARBOROUGH. Our next witness is Carl J. Megel, Washington representative of the American Federation of Teachers.

Mr. Megel, we have suggested the possibility of each witness condensing his statement, if possible. I am glad to hear you, but Senator Morse is still in a critical hearing. I have an Appropriations Committee meeting to mark up. If you think this attendance is not large, it is because this is a hearing and whereas on the other bills they have reached a decision and we need to be over on the committee for the markup. When it comes time to decide this we have to have a quorum on this subcommittee to decide it.

STATEMENT OF CARL J. MEGEL, WASHINGTON REPRESENTATIVE OF THE AMERICAN FEDERATION OF TEACHERS

Mr. MEGEL. Yes, I understand, Senator, and I will condense my statement considerably.

I am here in behalf of the establishment of the American Teachers Core as a part of S. 600. However, before I do so or before offering any testimony, being here this morning and hearing the testimony of Dr. Beckes, from Vincennes University on the junior colleges, I want to interject the fact that the American Federation of Teachers supports the inclusion of junior colleges in S. 600.

I am in support of the teacher core program.

May I ask that my statement be inserted in the record in full?
Senator YARBOROUGH. Without objection, it is so ordered.
(The prepared statement of Mr. Megel follows:)

PREPARED STATEMENT OF CARL J. MEGEL, WASHINGTON REPRESENTATIVE, AMERICAN
FEDERATION OF TEACHERS

Mr. Chairman and members of the subcommittee, my name is Carl J. Megel. I am the Washington representative of the American Federation of Teachers, a national organization of more than 100,000 classroom teachers affiliated with the AFL-CIO.

I am privileged to appear before this committee in support of the establishment of an American Teachers' Corps through which teachers can make their