W '2 3 M ED IC AL LI BRA RY A SS IS T A N CE ACT OF 1965

GO VERN ME NT ^

Storage

H E A R I N G

B E F O R E T H E

COMMITTEE ON

INTERS TAT E AND FOREIGN COMMERCE 

HOUSE OF RE PRESENTATIV ES

EIGH TY -N IN TH CONGRESS

F IR S T SE SS IO N

ON

H.R. 3142 and H.R. 6001

B IL LS TO AM EN D T H E PU BLIC HEA LT H SER V IC E ACT TO 

PR O V ID E FO R A PR OG RA M OF GR AN TS TO A SSIS T IN 

M EE TI NG TH E NEE D FO R AD EQ UA TE M ED IC AL LIB RARY 

SERV IC ES AN D F A C IL IT IE S

SEPTE M B E R 14, 19G5

Seria l No. 89-23

P ri n te d fo r th e us e of th e 

Co mm ittee on In te rs ta te an d For ei gn Co mmerce

53- 762

U.S. GOVER NM ENT PR IN TIN G OFF IC E 

W A SH IN G TO N : 1965
<

» r

COMMITTEE ON IN TE RS TA TE AND FOREIGN COMMERCE

ORE N H A R R IS , Arkansas, Chairman

H A R L E Y O. ST AGGERS, West Virginia

W A LTE R RO GER S, Texas

SAM U EL N . FR IE D E L, Maryla nd

T O R B E R T H . M ACD ON ALD , Massachusetts

JOH N JA R M AN , Oklahoma

LE O W. O’ B R IE N , New York

JOHN E. MOS S, California

JOHN D. D IN G E LL, Michigan

P A U L G. ROGERS, Florida

H O RACE R. K O R N EG AY, North Carolina

LIO N EL V AN D EERLIN , California

J. J. P IC K L E , Texas

FR ED B. RO O N EY, Pennsylvania

JOHN M. M U R PH Y, New Yo rk

DA VID E. S A T T E R F IE LD I II, Virginia

D A N IE L J. RO NAN , Illinois

J. OL IV A H U O T, New Hampshire

JA M ES A. M A C K A Y , Georgia

JOHN J. G IL LIG AN , Ohio

CH A RLE S P. FA R N SLEY, Ken tucky

JOHN B E L L W IL LI AM S, Mississippi

W IL LI AM L. SPR IN G ER , Illinois 

J. AR TH U R YO U N G ER , California 

SAM U EL L. DEVIN E, Ohio 

A N CH E R N ELS EN , Minnesota 

H AST IN GS K E IT H , Massachusetts 

W IL LA R D S. CU RTIN , Pennsylvan ia 

G LEN N CU N NIN GH AM , Nebraska 

JA M ES T. BR O YII IL L, Nor th Carolina 

JA M ES H A R V E Y , Michigan 

A L B E R T W. W AT SO N, South Carolina 

TIM LE E C A R TE R , Ke ntucky

W. E. Williamson, Clerk

K enn eth J. P aint er , Assis tan t Clerk

Professional Staf f

A ndrew Stev enson James M . Men ge r, Jr.

K urt B orchardt William J. Dixon

ii
C O N T E N T S

Page

Tex t of II.R. 3142__________________________________________________ 1

Report of—

Bureau of the Budge t_________________________________________ 8

Comptroller General of th e United States________________________ 15

Hea lth, Education, and Welfare, Dep artm ent of__________________ 8

Labor, Department of________________________________________ 14

Nav y, Departm ent of t he _____________________________________ 13

State ment of—

Berson, Dr. Rob ert C., execu tive director, Association of American

Medical Colleges___________________________________________ 38

Brandon, Dr. Alfred N., president, Medical Library Association____ 45

Budington, William S., Special Libraries Association, Chicago, Ill---- 80

Cohen, Wilbur J., Ass istant Secretary for Legislation, Department of

Health, Education, and Welfare______________________________ 19

Cummings, Dr. Martin M., Director, National Library of Medicine,

Department of Health, Educatio n, and Welfare________________ 26

Dempsey, Dr. Edw ard W., special assistant to the Secretary, Health 

and Medical Affairs, Department of Health, Edu cation, and

Welfare___________________________________________________ 19

Donelan, Paul R. M., att orney, Legislative Department, American

Medical Association________________________________________ 34

Fog arty , Hon. John E., a Represe ntative in Congress from the State

of Rhode Islan d____________________________________________ 15

Hea th, Dr. Gordon G., professor of opto metry, Ind ian a University, 

Bloomington, Ind., represen ting the American Optometric Association_____________________________________________________ 67

Kre ttek, Miss Germaine, associate executive director, American

Library Association_____________________________________ ___ 54

Lodwick, Lyle, director of marketing, Williams & Wilkins Co.,

Baltimore, Md_____________________________________________ 72

Logsdon, Dr. Richard IE, director of libraries, Columbia University. 56 

McCracken, William, Washington counsel, American Optometric Association_________________________________________________ 71

Parkins, Mrs. Phyllis V., director, BioSciences Information Service,

Philadelphia, Pa ___________________________________________ 79

Parks, Dr. John, dean of Medical School, George Washington University, Washington, D.C___________________________________ 38

Pearlman , Dr. Sholom, American Dental Association and American

Association of D enta l Schools________________________________ 61

Reville, Charles O., Jr., vice president, Williams & Wilkins Co.,

Baltimore, Md_____________________________________________ 72

Rubin, Dr. Abe, editor a nd secreta ry, Council on Education, American

Podiatry Association________________________________________ 77

Ruhe, Dr. C. H. William, assistan t secretary, Council on Medical

Education, American Medica l Association_____________________ 34

Skipper, James E., executive secretary, Association of Research

Libra ries__________________________________________________ 56

Sodeman, Dr. William A., Council on Medical Edu cation, American

Medical Association________________________________________ 34

Terry, Dr. Luther L., Surgeon General, Department of Health, Education, and Welfare__________________________________________ 19

Wakerlin, Dr. George E., medical director, American He art Association_____________________________________________________ 27

h i
IV CONTENTS

Additional information subm itted for the record by—

American Association of Colleges of Pharm acy, letter from Joseph B. Page

Sprowls, chairman, executive committee_______________________ 93

American Hospital Association, letter from Kenne th Williamson,

associate dire ctor__________________________________________ 91

American Medical Association: Letter from Dr. F. J. L. Blasingame, executive vice president— 44

Table I.—Comparison of existing libraries with recommended

standard s_____________________________________________ 35

Table II.— Medical school libraries, 1963-64--------------------------- 35

American Nurses’ Association, letter from Jud ith G. Whitaker, R.N.,

executive director__________________________________ 96

American Optometric Association: Estimated library facilities needed

by optometry, next 5 years (tab le)------------------------------------------ 68

American Public He alt h Association, letter from Dr. Berwyn F.

Mattison, executive director _________________________________ 93

Association of American Medical Colleges, letter from Dr. Robert C.

Berson, executive dir ector ___________________________________ 44

Barth, Dr. Frederic II., president, Philadelphia College of Osteopathy:

Medical library space requirements (tab le)----------------------------- 87

Sta tem ent______________________________________________ 87

College Young Democratic Clubs of America, Nation al Executive

Committee of, resolution____________________________________ 89 Ebert, Dr. Robert II., dean, Harvard Medical School, letter from ---- 92

Hager, Geo. I’., dean, College of Pharm acy, University of Minnesota,

letter from ________________________________________________ 95

Health, Education, an d Welfare: Estima ted bud getary requirem ents

for 5-year program ________________________________________ 40

Alternative method of authorizing appropriations to carry out

H.R. 3142 (ta ble)______________________________________ 41

Appropriations auth orizations recommended by HEW to carry

out proposed Medical Library Assistance Act of 1965 (table ), 41 

Heath, Dr. Gordon G.: Essential optometric research materials—Attachm ent A----------- 70

Library holdings of 10 schools and colleges of optometry for

1964—Attachme nt B ___________________ ,______________ 71

Hubbard, Dr. William N., Jr., sta tem ent------------------------------------ 83

Hungate, Hon. William L., lette r from ---------------------------------------- 91

Pennsylvania College of Podiatry, letter from Robert J. Wagnon,

dea n_____________________________________________________ 97

Rose, Dr. John C., dean, School of Medicine, Georgetown University,

Washington, D.C., lette r from_______________________________ 96

Rosenow, Dr. Edw ard C., Jr., executive director, American College of

Physicians, s tatem en t______________________________________ 89

Special Libraries Association, southern California chapter, telegram

from J. E. Tallman, chapter president------------------------------------- 91

Stu dent American Medical Association, resolution------------------------- 90

Young Democratic Na tional Committee, resolution----------------------- 89
MEDICAL LIBRARY ASSISTANCE ACT OF 1965

TUESDAY, SEPTEM BER 14, 1965

H ou se of R e p r e s e n t a t iv e s,

C om mit te e on I n t er sta te and F oreig n C om m er ce,

Washington, D.C.

The committee met at 10 a.m., pursuant to call, in room 2125, 

Rayburn Building, Hon. Harley O. Staggers presiding.

Mr. Staggers. The committee will be in order. Hearings this 

morning are on H.R. 3142, which Chairman Harris introduced, and 

H.R. 6001, introduced by our colleague from Rhode Island (Mr. 

Fogarty). These two bills are both identical with S. 597, introduced 

by Senator Hill, on Ja nua ry 19, this year.

These bills would authorize a program of grants to finance the 

construction of medical library facilities, the training of biomedical 

librarians and information specialists; the expansion and improvement of medical library resources; research and development in 

medical library sciences; the support of biomedical publications; the 

support of special scholarly scientific projects; the establishment of 

regional medical libraries; and the establishment of regional branches 

of the National Library of Medicine.

The needs of medical libraries throughout the United States are 

critical. Existing libraries are cramped for space, frequently inadequate in resources, deficient in trained manpower, and in need of 

new methods for handling the growing amounts of medical literature.

A number of persons have expressed their interest in this legislation 

to the committee and so far as I am aware there is no opposition to 

the legislation.

Under the circumstances, then, I would like to suggest to the 

witnesses here today that there should not be any need for prolonged 

presentations. We hope to be able to complete the hearings on this 

legislation today.

At this point in the record, we will print the text of the bill and the 

agency reports thereon.

(The bill and reports referred to follow:)

[H.R. 3142, 89th Cong., 1st sess.]

A BIL L To amend the Public Hea lth Service Act to provide for a program of gra nts to assist in meeting 

the need for adequate medical library services and facilities

Be it enacted, by the Senate and House of liepresentatives of the United States of

Am eric a in Congress assembled,

Section I. This Act may be cited as the “Medical Library Assistance Act 

of 1965”.

Sec. 2. Title II I of the Public Health Service Act is amend ed by inserting 

at the end thereof the following new part:
2 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

“ P a r t I — Ass is ta nce to M ed ic a l Lib r a r ie s

“ d ec la r a tio n o f po li cy an d sta tem en t o f pu rpo se

“ S e c . 390. (a) The Congress hereby finds and declares that (1) the unprec edented expansion of knowledge in the health sciences within the past two dec ­

ades has brought abou t a massive growth in the quant ity, and major change s 

in the nature of, biomedical informa tion, materia ls, and publications, (2) there 

has not been a corresponding growth in the facilities and techniques necessary 

adequat ely to coordinate and disseminate among hea lth scientists and prac tion - 

ers the ever increasing volume of knowledge and inform ation which has been 

developed in the health science field; (3) much of the value of the ever increasing volume of knowledge and informatio n which has been, and continues to be, 

developed in the health science field will be lost unless proper measures are tak en 

in the immediate future to develop facilities and techniq ues necessary to colle ct, 

preserve, store, process, retriev e, and facilitate the dissemination and utilizat ion 

of, such knowledge and informa tion.

“ (b) It is therefore the policy of this part to—

“ (1) assist in the construction of new, and the renovation, expansion, or

rehabilitation, of existin g medical library facil ities;

“ (2) assist in the training of medical librarians and other infor mati on

specialists in the heal th sciences;

“ (3) assist, thro ugh the awarding of special fellowships to physicians and 

scientists, in the compilation of existing, and the creation of add ition al, 

written matter whic h will facili tate the distribution and utilization of k now ledge and inform ation relating to scientific, social and cultural advan cements 

in sciences related to health;

“ (4) assist in the conduct of research and investigations in the field of 

medical library science and related activities, and in the development of 

new techniques, syste ms and equipment for processing, storing, retrievin g, 

and distributing informatio n in the sciences related to health;

“ (5) assist in improving and expanding the basic resources of med ical 

libraries and relate d facilities;

“ (6) assist in the development of a nation al system of regional med ical 

libraries each of which would have facilities of sufficient depth and scope to 

supplement the services of other medical libraries within the region served 

by it; and

“ (7) provide financia l support to biomedical scientific publications. 

“ d e f in it io n s

“ Se c. 391 . As u s e d in th is p a r t—

“ (1) the term ‘sciences related to health’ includes medicine, oste opathy, 

dentistry, and public health, and funda mental and applied sciences when 

related thereto;

“ (2) the terms ‘N atio nal Medical Libraries Assistance Advisory Bo ard ’ 

and ‘Boa rd’ mean the Board of Regents of the Na tio nal Library of Med icine 

established under section 373(a) of t his Ac t;

“ (3) the terms ‘con struction’ and ‘cost of const ruction’, when used wit h 

reference to any med ical library fac ilit y, include (A) the construction of new 

buildings, and the expansi on, remodeling, and alteration of existing building s, 

including arch itects’ fees, but not includi ng the cost of acquisition of land or 

off-site improvements , and (B) equipping new building s and existing buildi ngs 

(whether or not expan ded, remodeled, or altered) for use as a library (inclu ding provision of automatic data processing equip ment), but not with books, 

pamphlets, or related material.

“ n a t io n a l m e d ic a l l ib r a r ie s a s s is t a n c e b o a r d

“ S e c . 392. (a) The Board of Regents of the Na tio nal Library of Med icine 

established pursuant to section 373(a) shall, in a dditi on to its functions prescribed 

under section 373, constitu te and serve as the Na tio nal Medi cal Libraries Ass istance Advisory Board (hereinafter in this part referred to as the 'Boar d’).

“ (b) The Board shall—

“ (1) advise and assist the Surgeon General in the preparation of general 

regulations and with respect to policy matters arisin g in the administration 

of this part, and

“ (2) consider all applications for construction grants under this part and 

make to the Surgeon General such recommendations as it deems advi sabl e
MEDICAL LIBRAR Y ASSISTANC E ACT OF 1965 3

with respect to (A) the approval of such applications, and (B) the amount which should be granted to each applicant whose application, in its opinion, 

should be approved. “ (c) The Surgeon General is authorized to use the services of anv member or members of the Board, in connection with matters related to the administration of this part, for such periods, in addition to conference periods, as he may 

determine. “ (d) Appointed members of the Board who are not otherwise in the employ of the United States, while attending conferences ot the Board or otherwise serving at the request of the Surgeon General in connection with the administration of this part, shall be entitled to receive compensation, per diem in lieu of subsistence, and travel expenses in the same manner and under the same conditions as that prescribed under section 373(d), when attending conferences, traveling, or serving at the request of the Surgeon General in connection with the administration of 

part II which deals with the National Library of Medicine.

“ a s s is t a n c e f o r c o n s t r u c t io n o f f a c il it ie s

“Sec. 393. (a) In carrying out the purposes of section 390(b)(1), the Surgeon General may, upon application of any public or private nonprofit agency or institution, make grants to such agency or institution toward the cost of con­ struction of any medical library fac ility to be constructed by such agency or 

institution. “ (b) A grant under this section may be made only if the application therefor is recommended for approval by the Board and is approved by the Surgeon 

General upon his determination that— “ (1) the application contains or is supported by reasonable assurances that (A) for not less than ten years after completion of construction, the facility will be used as a medical library facility, (B) subject to subsection (c), sufficient funds will be available to meet the non-Federal share of the cost of constructing the facility, and (C) sufficient funds will be available, when construction is completed, for effective use of the facility for the 

purpose for which it is being constructed; “ (2) the proposed construction is necessary to meet the demonstrated needs for additional or improved medical library facilities in the community or area in which the proposed construction is to take place; “ (3) the application contains or is supported by adequate assurance that any laborer or mechanic employed by any contractor or subcontractor in the performance of work on the construction of the facility will be paid wages at rates not less than those prevailing on similar construction in the locality as determined by the Secretary of Labor in accordance with the Davis- Bacon Act, as amended (40 U.S.C. 276a-276a5). The Secretary of Labor shall have, with respect to the labor standards specified in this paragraph, the authority and functions set forth in Reorganization Plan Numbered 14 of 1950 (15 F.R. 3176; 64 Stat. 1267), and section 2 of the Act of June 13, 

1934, as amended (40 U.S.C. 276c). “ (c) Within such aggregate monetary limit as the Surgeon General may pre­ scribe, after consultation with the Board, applications which (solely by reason of the inability of the applicants to give the assurance required by clause (B) of subsection (b) (1)) fail to meet the requirements for approval set forth in sub­ section (b) may be approved upon condition that the applicants give the assurance required by such clause (B) within a reasonable time and upon such other reason­ able terms and conditions as he may determine after consultation with the Board. “ (d) In acting upon applications for grants under this section, the Board and the Surgeon General shall take into consideration the relative effectiveness of the proposed facilities in meeting demonstrated needs for additional or improved medical library services, and shall give priority to applications for construction of 

facilities for which the need is greatest. “ (e) The amount of any grant made under this section shall be tha t recom­ mended by the Board or such lesser amount as the Surgeon General determines to be appropriate; except that in no even t may such amount exceed 75 per centum of the necessary cost of the construction of such facility as determined by him. “ (f) Upon approval of any application for a grant under this section, the Surgeon General shall reserve, from any appropriation available therefor, the amount of such grant as determined under subsection (e), and shall pay such amount, in advance or by way of reimbursement, and in such installments con­ sistent with construction progress, as he may determine, Such payments shall be made through the disbursement facilities of the Department of the Treasury.
4 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

Th e Su rgeon G en er al ’s re se rv at io n of an y am ount under th is su bs ec tio n m ay be 

am en de d by him, eit h er up on ap pr ov al of an am en dm en t of th e ap plica tion or 

up on revisio n of th e est im ate d cost of co nst ru ct io n of t h e fac ility.

“ (g) In de te rm in in g th e am ou nt of any gra nt under th is sec tio n, th ere sh al l 

be exclu de d fro m th e co st of co ns truc tion an am o u n t eq ua l to th e su m of (1) 

th e am ou nt of any o th er Fe de ra l gra nt which th e ap plica nt ha s obt ai ne d, or is 

as su red of ob ta in in g, w ith re sp ec t to th e const ru ct io n wh ich is to be fin an ce d in 

p art by gr an ts au th ori ze d un de r th is section, and (2) th e am oun t of an y nonFe de ra l fu nd s re qu ired to be e xp en de d as a co nd itio n of such ot her Fed er al g ra n t.

“ (h) If, w ith in te n yea rs af te r co mpletion of any co ns truc tion fo r which fu nds 

ha ve been pa id un d er th is section—

“ (1) th e appli cant or ot he r ow ne r of th e fa ci li ty shall cease to be a pub lic 

or no np rofit in st it uti on, or

“ (2) th e fa ci lity sh al l cease to be us ed for m ed ic al libr ar y pu rpos es, un le ss 

th e Su rgeon G en er al de term in es , in ac co rd an ce w ith regu latio ns pr es cr ib ed 

by him aft er co nsu lt ati on w ith th e Bo ard, th a t th er e is good cause fo r re ­

lea sin g th e appli cant or ot he r ow ne r from th e ob lig atio n to do so, 

th e U nited S ta te s sh al l be en titled to reco ve r from th e ap pl ic an t or oth er ow ner 

of th e fa ci lit y th e am o u n t be ar in g th e same ra tio t o th e t hen va lue (as d et erm in ed 

by ag reem en t of th e p art ie s or bv ac tio n br oug ht in th e U ni ted S ta te s d is tr ic t 

co ur t f or th e di st ri ct in w hi ch su ch fa ci lity is si tu at ed ) of th e fa cilit y, a s th e a m o u n t 

of th e Fed er al p art ic ip ati on bo re to th e co st of co nst ru ct io n of such fa ci lit y.

“ (i) For the pu rp ose s of ca rryi ng ou t th e pr ov isio ns of th is secti on , th ere a re 

he re by au th or ized to be ap pr op riat ed for ea ch fis cal ye ar, be ginn ing w ith th e 

fiscal ye ar en di ng Ju ne 30, 1966, an d en ding w ith th e fiscal ye ar en ding Ju n e 30, 

1970, such su ms , not to exc ee d $10,000,000 fo r a ny fiscal ye ar, as may b e nec es sa ry .

“ grants f o r t r a in in g in m ed ic al lib r a r y sc ie n c es

“ Sec. 394. (a) In o rd er to en ab le th e Su rgeo n G en er al t o ca rr y out t he p urp os es 

of section 39 0(b) (2), th ere are he reby au th orize d to be ap pr op riat ed for ea ch 

fiscal year, be ginn ing w it h th e fiscal ye ar en ding Ju n e 30, 1966, an d en di ng w ith 

th e fiscal ye ar en di ng Ju ne 30, 1970, su ch sums, not to exc eed $1,00 0,0 00 fo r 

an y fiscal ye ar, as m ay be ne cessary . Su ms m ad e av ai la bl e un de r th is se ct io n 

sh all be utilize d by th e Su rgeo n Gen eral in m ak in g gra nts —

“ (1) to in div id ual s to en ab le th em to ac ce pt trai ne es hi ps an d fello wsh ips 

lea ding to post bac cala ure ate ac ad em ic degrees in th e field of med ical li bra ry 

scie nce , in re la te d fie lds pe rtai ni ng to scie nces re la te d to he alth, or in th e fie ld 

of th e co m m un ic at io n of info rm ation;

“ (2) to in div id ual s wh o are libr ar ia ns or sp ec ia lis ts in in fo rm at io n on 

scie nce s re la ting to hea lth, to en ab le th em to un de rg o intens ive tr ain in g or 

re trai ni ng so as to a tt a in gr ea te r co mpe tenc e in th eir oc cu pa tio ns (inc lu di ng 

compe tenc e in th e fie lds of auto m at ic d ata pr oc es sing an d re tr ie v al) ;

“ (3) to as si st appro pri ate pu blic an d pri v ate no np ro fit in st it uti ons in 

develop ing, ex pa nd in g, an d im prov ing, tr ain in g pr og ra ms in libra ry sc ienc e 

an d th e field of co m m un ic at io ns of in fo rm at io n per ta in in g to sc ien ces re la ti ng 

to he al th ; an d

“ (4) to as sist in th e es ta bl is hm en t of in te rn sh ip pr og rams in es ta blish ed 

medica l l ib rarie s m ee ting st an dar ds which th e Sur ge on Gen eral s ha ll p re sc ribe . 

“ (b) Pay m en t p u rs u a n t to gr an ts mad e unde r th is section may be m ad e in 

ad va nc e or by way of re im bu rs em en t an d in su ch in st al lm en ts as th e Sur ge on 

Gen eral sh all pr es cr ib e by re gu la tion s aft er consu ltat io n w ith th e Boa rd.

“ a ssis t a n c e to spe c ia l s c ie n t if ic pr o je c t s

“ Se c. 395. In or der to en ab le th e Su rge on G en er al to ca rry out th e purp os es 

of se ction 39 0( b) (3 ), th ere ar e he reby au th ori ze d to be ap pro pri at ed for eac h 

fisc al ye ar , be ginn ing w it h th e fiscal yea r en ding Ju n e 30, 1966, an d en ding w it h 

th e fiscal ye ar en di ng Ju n e 30, 1970, su ch sums , not to exc eed $500,000 fo r any 

fisc al ye ar, as m ay be ne ce ss ar y. Sums m ad e av ai la ble un de r th is section sh al l 

be utili ze d by th e Su rg eo n G en eral fo r th e est ab li sh m en t of special fello wships to 

be aw ar de d to ph ys ic ia ns an d scientists fo r th e co m pi la tion of existing , or w riting 

of original, co ntr ib uti ons re la ting to scien tific, socia l, or cu ltu ra l, advan ce m en ts 

in scienc es re la te d to hea lth. In es ta bl ishi ng su ch fellow shi ps, th e Su rg eo n 

G en eral sh all m ak e ap p ro p ri ate ar ra nge m en ts w he re by th e facilities of th e 

N at io nal L ib ra ry of M ed ic in e an d th e facilit ies of libr ar ie s of pu blic an d p ri v a te 

no np ro fit in st itutions of hi gh er learning m ay be m ad e av ailable in co nn ec tion 

w ith th e pr oj ec ts fo r w hi ch su ch fel low shi ps are es ta bl is he d.
MEDICAL LIBRARY ASSISTANCE ACT OF 19 65 0

“ resea r c h and d ev e l o pm e n t in m ed ic a l l ib r a r y s c ie n c e an d r e l a t e d f ie l d s

“ Se c. 396. (a) In o rd er to e na ble th e Su rg eo n Gen eral to c ar ry o ut th e pu rp os es 

of se ct ion 39 0( b) (4 ), th er e are he re by auth ori zed to be appro pri ate d fo r ea ch fiscal ye ar , be gi nn in g w ith th e fisc al yea r en din g Ju ne 30, 1966, and en din g w ith th e fiscal yea r en din g Ju ne 30, 1970, su ch su m s, no t to exceed $3 ,000 ,00 0 fo r an y fiscal ye ar , as m ay be ne cessary . Su ms m ake av aila bl e under th is se ct io n sh all be utiliz ed by th e Su rgeo n Gen eral in m ak in g gra nts to appro pri ate pu bl ic or pri vat e no np ro fit in st it uti ons an d ent er in g in to c ont ra ct s w ith a ppro pri ate p ersons, fo r pu rp os es of carr yin g out pr oj ec ts of re se ar ch an d in ve stig at io ns in th e field of med ical libra ry scienc e an d re la te d acti vit ie s an d for th e de ve lo pm en t of new tech ni qu es , sy st em s an d eq ui pm en t, fo r pro cessing , stor in g, re tr ie vin g, an d 

dis trib uting in fo rm at io n pe rtai ni ng to sc ienc es re la te d to hea lth. “ (b) P aym ent purs uant to gra nts m ad e under th is se ct ion m ay be in ad van ce or by way or re im bu rs em en t an d in su ch in st al lm en ts as th e Su rg eo n G en eral 

sh all pres cr ibe by regu la tio ns af te r consu lt ati on with th e Boa rd .

“ gran ts fo r im pr o v in g an d e x p a n d in g t h e basic r eso u r c e s o f m ed ic al

L IB R A R IE S AN D R E L A T E D IN S T R U M E N T A L IT IE S

“ S e c. 397. (a) In or de r to en ab le th e S ur ge on Gen eral to c ar ry o ut th e pu rpos es 

of se ction 390(b ) (5 ), th er e are he re by auth ori zed to b e ap pro pri at ed f or ea ch fiscal ye ar , be ginn ing w ith th e fiscal yea r en di ng Ju n e 30, 1966, and en di ng w ith th e fiscal ye ar e nd in g Ju n e 30, 1970, su ch s um s, not to exceed $3,00 0,0 00 for any fiscal 

ye ar, as may be ne ce ssary. “ (b) Su ms m ad e av aila bl e und er th is se ct io n sh all be ut iliz ed by th e Su rgeo n Gen eral for m ak in g gr an ts of mon ey, m at eri als , or bo th, to pu blic or pri vat e no np ro fit m ed ical lib ra ries an d re la te d sc ie nt ific co mm un ication in st ru m en ta lities for th e pu rp os e of ex pa nd ing an d im pro vin g th eir basic med ical libr ar y or re la te d res ou rces. T he uses for wh ich gra nts so m ade may be em pl oy ed includ e, b u t are 

no t lim ite d to , th e following: (A ) ac quis itio n of books, jo ur na ls, phot og ra ph s, 

mot ion pi ct ur e an d ot he r films, and o th e r simila r m at er ia ls, (B) ca taloging , bind in g, an d o th er service s an d pr oc ed ur es fo r process ing libra ry re so ur ce m at e­ ria ls for use by th os e who are se rv ed by th e libr ar y or re la te d in str um enta li ty , an d (C) ac qu is itio n of du pl ic atio n de vice s, fac sim ile eq ui pm en t, film pro je ct or s, reco rd ing eq ui pm en t, an d ot he r equip m en t to fa ci lit at e th e use of th e reso urce s of th e libr ar y or re la te d in st ru m en ta lity b y th os e who ar e se rv ed by it, and (D> 

in tr od uc tion of ne w tec hn olog ies in m ed ical lib ra rian sh ip . “ (c)(1) The am o u n t of an y gra nt under th is section to an y med ical libra ry or re la te d in st ru m enta li ty sh all be dete rm in ed by th e Su rgeo n G en er al on th e basis of th e scop e of libr ar y or re la te d s er vi ce s pr ov id ed by su ch libra ry or in st ru ­ m en ta lity in re la tion to th e po pu la tion an d pu rpos es se rv ed by it. In mak in g a de te rm in at io n of th e scope of ser vic es se rv ed by an y m ed ical libra ry or re la te d in st ru m enta li ty , th e Su rge on Gen eral sh all ta ke in to ac co unt th e follo wing 

fa ct or s—

“ (A ) th e nu m ber of gra duat e an d und er gra duat e st udents m ak in g use 

of th e re so ur ce s of su ch lib ra ry or in st ru m enta li ty ; “ (B) th e nu m ber of ph ys icians utilizi ng th e resources of su ch libra ry or 

in str u m e n ta li ty ; “ (C) th e ty p e of su pp or tiv e staf fs , if an y, av ai la bl e to su ch libra ry or 

in str u m en ta li ty ; “ (D) th e ty pe, size, an d qu al ific at io ns of th e fa cu lty of an y sc ho ol w ith 

which su ch li bra ry or in st ru m enta li ty is affil iated ; “ (E) th e st af f of an y hos pi ta l or hosp ital s or of an y clinic or clinics w ith 

wh ich su ch li bra ry or in st ru m enta li ty is affil iated; an d “ (F) th e ge og raph ic ar ea se rv ed by su ch lib ra ry or in str u m en ta li ty an d th e av ail abil it y, w ith in su ch ar ea , of med ica l libr ar y or re la te d ser vic es 

pr ov id ed by o th er lib rarie s or re la te d in st ru m en ta lities . “ (2) In no case shall an y gra nt un d er th is secti on to a med ica l li bra ry or re la te d in st ru m enta li ty du ring an y fiscal y ear exc eed $20 0,00 0, or, if les ser, an 

am ount eq ua l to —

“ (A ) 60 per ce nt um of th e annual oper at in g expense s of su ch li bra ry or 

re la te d in st ru m enta li ty , if su ch fiscal y ear is the first fiscal yea r w ith re sp ec t 

to which a g ra n t un de r th is se ction is m ad e to it; “ (B) (i) 50 pe r ce ntum of th e an n u al op er at in g ex penses of su ch libr ar y 

or re la te d in st ru m en ta li ty , (ii) or, if lesser, fiv e-s ixths of th e am ount of its its first year gra nt un de r th is se ct io n, if su ch ye ar is th e seco nd fis cal ye ar 

w ith re sp ec t to wh ich a gra nt under th is se ction ha s be en mad e to it ;

53- 76 2— 65 -------2
6 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

“ (C) (i) 40 per centum of the annual operating expenses of such libra ry or 

related instrum entality , (ii) or, if lesser, four-fifth s of the amou nt of the 

second year gra nt under this section, if such year is the third fiscal year with 

respect to which a grant under this section has been made to it;

“ (D) (i) 30 per centum of the annual opera ting expenses of such libr ary or 

related instr ume ntality, (ii) or, if lesser, three-fo urths of the amou nt of the 

third year grant under this section, if such yea r is the fourth fiscal year with 

respect to which a grant under this section has been made to it; and

“ (E) (i) 20 per centum of the annual oper ating expenses of such libra ry 

or related inst rum enta lity, (ii) or, if lesser, two-thirds of the amount of the 

fourth year gran t under this section, if such year is the fifth fiscal year with 

respect to which a grant under this section has been made to it.

The ‘annual opera ting expense’ of a library or related instrum entality sha ll for 

purposes of the preceding sentence, be an amount equa l (if such annual oper ating 

expense is to be determi ned with respect to the first grant to me made to such 

library or instrumenta lity under this section) to the amoun t of the average of the 

annual operating expenses of such library or instr umentali ty over the three fiscal 

years preceding the yea r in which such grant is applied for; and if such libr ary or 

related instr umen tality has been operating for less th an three years prior to a pp lying for such grant, its ‘ann ual operating expense’ shal l be an amount determ ined 

by the Surgeon Gen eral pursuant to regulations prescribed by him. Fo r the 

second or succeeding fiscal year in which a gran t is made to a library or relat ed 

instrumentality, the ‘ann ual operating expense’ of such library or related instrumentality shall, for purposes of such sentence, be equal to its oper ating 

expense (exclusive of Federal financial assistance under this part) for th e preceding 

fiscal ye ar.

“ g r a n t s f o r e s t a b l is h m e n t o f r e g i o n a l m e d ic a l l ib r a r ie s

“ S e c . 398. (a) In order to enable the Surgeon General to carry out the purposes of section 390(b)(6), there are hereby autho rized to be approp riated for 

each fiscal year, beginning with the fiscal year end ing June 30, 1966, and ending 

with the fiscal year end ing June 30, 1970, such sums, not to exceed $2,500,000 

for any fiscal year, as may be necessary. Sums made available under this sectio n 

shall be utilized by the Surgeon General, with the advice of the Board, to make 

grants to existing publ ic or private nonprofit medic al libraries so as to en able each 

of them to serve as t he regional medical library for the geographical area in which 

it is located.

“ (b) The uses for which grants made under this section may be employed 

include, but are not limi ted to, the following—

“ (1) acquisition of books, iournals, and othe r similar materials;

“ (2) cata loging, binding, and other procedures for processing libr ary 

resource materials for use by those who are serve d by the library;

“ (3) acquisition of duplicating devices and other equipment to faci lita te 

the use of the resources of the library by those who are served by it;

“ (4) acquisition of mechanisms and employme nt of personnel for the 

speedy transmission of materials from the region al library to local libraries in 

the geographic area served by the regional libr ary ; and

“ (5) constructio n, renovation, rehabilitation, or expansion of physica l 

plant considered necessary by shell library to carry out its proper functio ns 

as a regional library.

“ (c)(1) Gran ts under this section shall be made only to medical libraries 

which agree (A) to modify and increase their libr ary resources so as to be abl e to 

provide supportive services to other libraries in the region as well as ind ividua l 

users of library services , (B) to provide free loan services to qualified users, and 

make available photo duplic ated or facsimile copies of biomedical materials which 

qualified requesters may retain.

“ (2) The Surgeon Gener al, in awarding grants under this section, shall give 

priority to medical libraries having the greatest potential of fulfillin g the needs 

for regional medical libraries. In determining the priority to be assigned to any 

medical library , he shall consider—

“ (A) the need of such library , as determined by the levels of research, 

teaching, and medic al activities of the library in relations to other existing 

library and medica l communication services in the region;

“ (B) the adequacy of the library (in terms of collections, personnel, equipment, and other facilities) as a basis for a regiona l medical library; and

“ (C) the size and nature of the popula tion to be served in the region in 

which the library is located.
MEDICAL LIB RARY ASSISTAN CE ACT OF 1 9 6 5 7

“ (d) G ra nts un de r th is se ct io n fo r co ns truc tio n, re no va tion , re hab ilitat io n, or ex pa ns io n of ph ys ical pla nt sh all be m ad e in th e same m an ner and su bj ec t to th e sa m e co nd itio ns as are pr ov id ed fo r gra nts mad e under se ct io n 393 , ex ce pt th a t th e e ligi bi lity f or a ny s uch gra nt w ou ld b e de term in ed o n th e ba sis of th e c on stru c­ tion re quir em en ts of th e libr ar y so as to be ab le to serv e as a region al med ical libr ar y. G ra nts un de r th is se ct io n fo r basic reso urce m at er ia ls to a libr ar y may not exce ed 50 pe r ce ntum of th e li b ra ry ’s an nu al op er at in g ex pe ns e (exclu siv e of Fed er al fin an cial assistan ce under th is par t) for th e prec ed ing yea r; or in case of th e fir st yea r in wh ich th e li bra ry rec eiv es a gra nt un der th is se ct io n for basic reso urce m at er ia ls, 50 per ce ntu m of its av erag e an nu al oper at in g ex pe nses ov er th e p ast th re e ye ar s (or if it had be en in op er at io n for less th a n th re e ye ars, its annual oper at in g expense s det erm in ed by th e Su rgeo n G en er al in ac co rdan ce 

w ith re gu la tion s pres cribed by hi m ). “ (e) P ay m en t pu rs uan t to g ra nts m ad e un de r th is se ct ion m ay be mad e in ad va nc e or by wa y of re im burs em en t an d in su ch in st al lm en ts as th e Su rgeo n 

G en er al sh al l prescri be by re gu la tions af te r co ns ul ta tion w ith th e Bo ard.

“ f in a n c ia l s u ppo r t o f b io m e d ic a l s c ie n t if ic p u b l ic a t io n s

“ Se c. 399. (a) In o rd er t o en ab le t h e S urge on Gen er al t o c ar ry o u t th e p urpo ses 

of se ct io n 39 0( b) (7 ), th er e ar e here by au th or iz ed to be ap p ro p ri ate d for ea ch fiscal yea r, be ginn ing w ith th e fis ca l year en ding Ju ne 30, 1966, an d en ding w ith th e fiscal y ear en ding Ju ne 30, 197 0, su ch sums , not to exceed $1 ,50 0,0 00 for an y fis cal y ea r, as m ay be ne ce ssary. Sum s m ad e av ai la bl e under t h is se ction sh all b e utiliz ed b y th e S urgeon G en eral, w it h th a adv ice of t he Boa rd, in m ak in g gra nts to, and ente ri ng in to ap pro pri at e contr acts , with , pu blic or p ri v ate no np ro fit in­ st it u ti o n s of high er ed uc at io n an d in di vi dua l sc ie nt is ts fo r th e pu rp os e of su p­ po rt in g biom ed ical scien tific publicati ons of a no np ro fit n atu re an d to proc ur e th e co m pi la tion , writing, ed itin g, a n d pu bl ic atio n of review s, ab st ra cts , ind ices, ha nd bo ok s, bibliograp hies, and re la te d m att er per ta in in g to sc ientifi c works 

and scientifi c de ve lopm en ts. “ (b) G ra n ts un de r th is se ct ion in su pport of an y sin gle per io di ca l pu bl ic atio n 

m ay not be m ad e for mo re th a n th re e ye ars. “ (c) P aym ent pu rs ua nt to g ra n ts m ad e un de r th is se ct io n m ay be m ad e in ad va nc e or by wa y of re im burs em ent and in such in st al lm en ts as th e Su rgeon 

G en er al sh al l prescribe by re gula ti ons aft er co ns ul ta tion w ith th e Boa rd.

“ c o n t in u in g a v a il a b il it y of a ppr o pr ia t e d fu n d s

“ Se c. 39 9a . Fun ds appro pri at ed to ca rr y out an y of th e pur po se s of th is part 

for an y fiscal ye ar sh all re m ain avail able fo r such pu rp os es fo r th e fiscal ye ar 

im m ed ia te ly follo wing th e fiscal y ear fo r wh ich th ey we re ap p ro p ri ate d .”

R E G IO N A L B R A N C H ES O F T H E N ATIO N A L LI B R A R Y OF M E D IC IN E

S e c. 3. P art II of ti tl e III of th e Pub lic H ea lth Se rvice Act whi ch de als w ith th e N ational Lib ra ry of M ed ic in e is am en de d by ad di ng a t th e en d th er eo f th e 

follo wing ne w se ction:

“ R EG IO N A L B R A N C H ES O F T H E NATIO N A L LIB RA RY O F M E D IC IN E

“ Se c. 378. (a) W he ne ve r th e Sur ge on Ge neral , w ith th e ad vi ce of th e Bo ard, 

det er m in es th a t—

“ (1) in an y ge og raph ic are a of th e United Sta te s, th ere is no regi on al 

m ed ic al libra ry adeq uat e to se rv e su ch ar ea ; “ (2) un de r th e cr iter ia pre sc ribed in secti on 398, th ere is a ne ed fo r a 

re gio na l med ical libr ar y to se rv e su ch ar ea ; an d “ (3) be ca us e th er e is lo ca te d in su ch area no m ed ical li b ra ry which , un der th e pr ov isions of se ction 398 , ca n feasibly be de ve lope d in to a region al 

m ed ic al libra ry ad eq uat e to se rv e su ch are a, he is au th ori zed to es ta bl ish, as a b ra nch of th e N at io nal L ib ra ry of Medici ne, 

a re gi on al m ed ic al libr ar v to se rv e th e ne ed s of su ch ar ea . “ (b) F or th e pu rpos e of est ab lish in g br an ch es of th e N ational Lib ra ry of M ed icine under th is section, th ere a re he reby au th or iz ed to be appro pri ate d fo r each fisc al ye ar , be ginn ing w ith th e fis cal ye ar en ding Ju ne 30, 1966, an d en di ng w ith th e fiscal ye ar en ding Ju ne 30, 1970, such sums, not to ex ce ed $2,00 0,0 00 fo r any fis cal ye ar, as ma y be ne ce ss ar y. Su ms appro pri at ed p u rs u an t to th is 

section fo r any fiscal ye ar sh all re m ai n av ailable until ex pe nd ed .”
8 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

COM PE NSA TIO N O F M EM B E R S OF TH E BO AR D O F R E G E N T S OF TH E N ATIO N A L L IB R A R Y 

OF M ED IC IN E

Sec. 4. Part II of title II I of th e Public Health Service Act which deals with 

the Natio nal Library of Medicine is amended by striking out, in section 373(d) 

thereof, “$50” and insertin g in lieu thereof “$75” .

Executive Office of the President,

B u r ea u of th e B u d g et, 

Washington, D.C., Ju ne 1, 1965.

Hon. Oren Harris,

Chairman, Committee on Interstate and Foreign Commerce,

House o f Re present atives, W ashinglon, D.C.

Dear Mr. Chairman: This is in reply to your letter of February 15, 1965, 

requesting the views of the Bureau ot the Budget on H .R. 3142, a bill to amend th e 

Public Health Service Act to provide for a program of grants to assist in meeting 

the need for ade qua te medical library services and facilities.

The bill would authorize a program of gran ts to finance the construction of 

medical library facilities, the train ing of biomedical librarians and information 

specialists the expansion and improvement of medical library resources, research 

and development in medical library science, the sup por t ot biomedical publications, the support of special scholarly scientific projects, the establishme nt of 

regional medical libraries, and the establish ment of regional branches of the 

National Library of Medicine.

V hile the Bureau of the Budget recognizes the importance of the objectives 

of H.R. 3142, we note th at there appears to be uncer tainty as to the best fut ure 

course of development of scientific—including biomedical—libraries in view of 

the rapid advances being made in techniques for the indexing, storage, and 

retrieval ot information. This has led as to the following conclusions:

1. That a stud y s hould be undertak en of future biomedical library needs which 

takes full account of developing techniques for th e improved handling of scientific 

information. The Office of Science and Technology has agreed to und ertake 

such a study.

2. That it would be pruden t to defer beginning a program of medical lib rary 

construction until 1967 in order to allow time for completion of the above stu dy 

and consideration of its implications on the facilities needs of medical libraries.

3. That the need for regional branches of the National Library of Medicine 

is not clear a t the presen t time, and hence the provision of H.R. 3142 relating to 

the establishment of these branches constitu tes a contingency au tho rity for 

something which may or may nor ultim ately prove desirable. We believe th at 

the optimum allocation of resources between national, regional, and local medical 

library facilities is a matter deserving close att entio n under the program of research 

anti development grants authorized in this bill.

The Bureau would further suggest that the sep ara te authorizations for each 

of the bill’s provisions may be undulv restrictive as further studies give a clearer 

indication of priorities among medical library needs. A combined app ropriat ion 

ceiling would appear to offer greater latitude to dire ct funds in accordance with 

the priority of the objectiv e.

Subject to these considerations, enactment of this legislation would be consistent with the adminis tration’s objectives.

Sincerely yours,

Phillip S. Hughes,

Ass istant Director for Legislative Reference.

D e p a r t m e n t of H ea l t h , E d u c a t io n , an d W e l f a r e,

May 5, 1965.

Hon. Oren Harris,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D.C.

Dear Mr. C hair man: This letter is in response to your request of Feb rua ry 15, 

1965, for a repo rt on H.R . 3142, a bill to amend the Public Health Service Act 

to provide for a program of grants to assist in meeting the need for adequate 

medical library services and facilities. The popular title of this bill is Medical 

Library Assistance Act of 1965.
MEDICAL LIBRAR Y ASSISTA NCE ACT OF 1 9 6 5 9

The bill would provide the basis for a coordinated atta ck on a number of 

serious, interrelated problems with which medical libraries are confronted today.

The plight of the Nation’s medical libraries is critical. During a period of 

intensive development of health research institutions, medical schools, and other 

medical facilities, support for medical libraries has been seriously neglected. 

The condition of medical libraries has steadily deteriorated under the pressures 

of rapid development of other programs and activities of medical institutions, 

most of which make increasing demands upon the medical library. In addition, 

the broadening base of medical research and practice, calling for literature from 

many ancillary fields, has added to the magnitude and complexity of medical 

literature. Medical libraries are cramped for space, critically deficient in trained 

manpower, deplorably inadequate in resources and desperately in need of new 

methods for handling the growing medical literature. A large-scale national 

effort is needed now to rehabilitate medical libraries.

The President’s Commission on Heart Disease, Cancer, and Stroke, reacting 

to this situation, stated “ The Commission feels strongly 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 fut ility.”

The Commission recommended “ Th at not less than $30 million per year for 

5 years be authorized and appropriated to the National Library of Medicine for 

a program of grants and contracts to support improved medical library services 

in the United States— including facilities, resources, training of personnel, secondary publications, and library and communications research” and “that broadly 

conceived legislation be initiated clearly authorizing the National Library of 

Medicine to assist medical libraries in the ways recommended.” Enactment of 

this bill would be a major step in ca rryin g out the Commission’s recommendations. 

Facilities

The bill would authorize the Surgeon General to make grants of up to 75 percent 

of the costs of constructing, renovating, expanding, or remodeling medical library 

facilities. In acting upon applications for grants, consideration would be given 

to the relative effectiveness of the proposed facilities in meeting demonstrated 

needs for additional or improved medical library services, and priority would be 

given to p rojects for construction of facilities for which the need is greatest. For 

these purposes, the bill would authorize appropriations not to exceed $10 million 

a year for a 5-year period beginning with fiscal year 1966.

One of the most critical needs of medical libraries is for space in which to 

maintain their collections and to carry out their necessary d ay-to-day operations. 

The chronic shortage of shelf space precludes the acquisition of essential additional 

books and materials each year. Crowding obstructs and often completely 

prevents access to the volumes on hand. Working space for library staffs is so 

restricted as to be a real barrier to effective operations (many medical libraries are 

so crowded that there is not even space for desks for the staff), and many libraries 

lack the space for up-to-date processing and labor-saving equipment. The need 

for space is desperate and of great magnitude. However, in order to make the 

most effective use of the funds that will be available for this program, we believe 

that initiation of the construction program should be preceded by a study of the 

kinds of facilities which will be most suited for meeting present and future requirements in the light of rapid technological advances. To allow time for such a 

study, and a t the same time achieve the full objective of the construction program 

envisaged by the bill, we recommend tha t this provision of the bill be amended 

to provide for a 4-year construction program, beginning with fiscal year 1967, 

with annual appropriation authorizations of $12.5 million.

Training

The bill would authorize the Surgeon General to make grants to assist in the 

training of medical librarians and other information specialists in the health 

sciences. Not to exceed $1 million a year would be authorized for 5 years, 

beginning with fiscal year 1966. Sums made available under this section shall 

be used by the Surgeon General to make grants (1) to individuals to enable them 

to accept traineeships and fellowships leading to postbaccalaureate academic 

degrees in the field of medical library science, in related fields pertaining to sciences 

related to health, or in the field of communications; (2) to individuals who are 

librarians or specialists in information on sciences related to health, to enable 

them to undergo intensive training or retraining to attain greater competence in 

their occupations (including competence in the fields of automatic data processing 

and retrieval); (3) to assist appropriate public and private nonprofit institutions 

in developing, expanding, and improving training programs in (medical) library
10 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

science and the field of communications of informa tion pertaining to sciences 

relating to health; and (4) to assist in the establi shment of internship programs 

in medical libraries meeting standards prescribed by the Surgeon General.

There is a criti cal shortage of professional personnel trained to meet the special 

needs of medical libraries and the medical commun ity they serve. There are 

approximately 6,300 medica l libraries in the country , staffed by only abo ut 3,000 

professionals. The annual attrition from this professional group is appr oxim ately 

150. There is urgent need for specialized train ing over and above the gener al librarianship for professional persons to staff medica l libraries. The typ e of 

professional needed to deal with the medical science communications problems 

is not being trained at the present time. Tra inin g programs must go beyon d the 

basic, traditional trainin g in library science and provide advanced trai ning, 

specifically related to the communication needs of the medical commun ity, with 

a heavy emphasis on the biomedical sciences, the existing patterns of commun ication in the medic al comm unity (including fam ilia rity with the medical libr ary 

system), and such specialties as systems engineering, linguistics, and the like as 

they relate particularly to medical commu nicatio n.

H .R . 3142 would authorize the kinds of training assistance particularly suite d 

to the development of this specialized competence. Postbaccalaureate suppo rt 

of selected trainees and fellows in programs dire ctly related to the problems of 

medical science is essential. Centers of excellence could be developed in which 

comprehensive interdisciplinary advanced train ing could be furnished persons 

preparing for careers in medical library science. This would require medical 

direction and leadership. Many of those prese ntly staffing medical libraries need intensive specialized 

training in order to increase and update their competence. The tra inin g of 

biological scientists as informatio n specialists and the training of scien tists in 

information techn iques in relation to medical problem s also constitute imp orta nt 

segments of a farsi ghte d effort to upgrade the qualit y of service of medical librar ies 

to the student, the investigator, and practitioner of the health profession. 

Internship programs in outstanding medical libraries would assist greatly in 

training of new librarians and in updating the skills and increasing the compe tency 

of persons already in the field.

Resources

The bill would autho rize the Surgeon Gene ral to make grants of money, 

materials, or both to public or other nonprofit medical libraries and relate d 

scientific comm unication instrumentalities to expa nd and improve their basic medical library or related resources. Not to exceed $3 million a year would be 

authorized for these purposes for a 5-year period, beginning with fiscal year 1966. No grant in an y yea r could exceed $200,000 or, if lesser, 60 percent of the a nnu al 

operating expense of the library for the first yea r; 50 percent (or, if lesser, fivesixths of the first yea r grant) for the second yea r; 40 percent (or, if lesser, fourfifths of the second yea r grant) for the third ye ar ; 30 percent (or, if lesser threefourths of the third year grant) for the fourth yea r, and 20 percent (or, if lesser, 

two-thirds of the fou rth year grant) for the fifth year . Grants could be used ’ for (but not limited to) acquisition of books, jour nals , 

films and other mate rials; cataloging , binding, and other services and procedures 

for processing library resource materials for users of the library ; acqu isitio n of 

duplication devices, recording equipment, and other equipment to fac ilit ate the 

use of the resources of the library by those it serves; and introduction of new 

technologies in medica l librarianslup. The medical library resource need is of great magn itude and so directly relate d 

to medical research, to the training of medical manpower, and the infor mati on 

essential to the prac ticin g medical comm unity that it requires special, intense 

attentio n immediately if fundamental responsibilities in the health area are to be 

fulfilled. Neglect of support of the resources of the Na tio n’ s medical libraries has been 

chronic and cum ulat ive to the point where they now have only about hal f the 

books, journals, and other resources they need. In additio n to these shortages, 

a larger majority of the medical libraries have large backlogs of tasks such as 

cataloging and index ing necessary for the effective use of the literature and are 

in critical need of new and additional types of equipm ent (such as photodup lication) to speed the processing of materials. Signi fican t Federal assist ance is 

essential to build up collection to minimum stand ards and to support necessary 

bibliographic app arat us. In this connection, it is important to note the vital 

role to be played by regional medical libraries to be established under anot her
MEDICAL LIBRARY ASSISTANC E ACT OF 1 9 6 5 11

provision of this bill. These regio nal libraries will collect materials in depth 

and make their resources and services available to other medica l libraries in a 

broad geograp hic area so tha t the resources of the amaller libraries can be limited 

to the most-used classes of mate rials . Eve n with the efficiency and economy 

which the regional medical library mechanism will foster, the need for basic 

resources is tremendous.

The descending scale of Feder al gran t support for these essential resources 

would encourage the upward revision of medical library budgets over the 5-year 

period, and serve to stimulate sub stan tial, continued insti tutio nal support for the 

medical libra ry funct ion in the futu re.

Regional medical libraries

The bill would add a new section 398 to the Public Hea lth Service Act which 

would autho rize the Surgeon General to make grants to existing public or other 

nonprofit medical libraries to enable them to serve as regional medical libraries 

for the geograp hical areas in which the y are located. Not to exceed $2.5 million 

a year would be authorized to be appropriated for these purposes for a 5-year 

period begin ning fiscal year 1966.

Gra nts could be made only to medical libraries which agree to provide supportive services to other medical libraries in the region, provide free loan service 

to qualified users, and make ava ilab le photoduplicated or facsim ile copies of 

biomedical materials which qualified requestors may retain. Prio rity would be 

given to medical libraries having the greatest potential for fulfil ling the needs for 

regional medical libraries. In determ ining priorities consid eration would be given 

to such fact ors as the need for a regional medical library (assessed in terms of the 

levels of research, teaching, and medic al activities of tha t library in relation to 

other medica l library services in the region ); and adequ acy of the library (in 

terms of collections, personnel, equ ipment, and facilities) as a basis for a regional 

medical libr ary; and the size and natu re of the populatio n to be served in the 

region in which the library is located .

Gra nts under this section for basic resource materials could not exceed 50 

percent of the libra ry’s annual o perat ing expense for the preceding yea r (exclusive 

of Federal finan cial assistance under this bill). Cons truct ion, renov ation, or 

expansion of the physical plant necessa ry for the carrying out of func tions as a 

regional libra ry would be authorized in the same manner and subject to the same 

terms as other construction grants auth orized in the bill. Gra nts could also be 

used for equip ment, staff, and services necessary for the funct ions of a regional 

medical library.

Need for regionalization has become acu te with the growth in the magnitude 

of the medica l literature and the speed with which inform ation is required. At 

present, the Nat ion al Library of Med icin e is serving as the “ libra ries’ library ” 

in meeting the needs for increasing amo unts of material which local medical 

libraries do not have on their shelves. Assistan ce in meeting the need for basic 

library resources will help materially in relieving this problem, but it is neither 

economically feasible nor necessary for each medical library to seek to build its 

own collection to try to encompass even a sizable proportion of the whole of the 

medical litera ture.

The development of a system of regional medical libraries, locally operate d and 

controlled but with Federal assistance in the collection of materials in depth and 

of the equip ment and staff necessary for an effective regional service, would do 

much to meet the needs of individual med ical libraries in the region, and at the 

same time assure rapid, quality medical library service throu ghout the Nat ion. 

It would also contribute greatly to the effec tive utilization of scarce, skille d manpower, since the services and knowled ge of highly qualified staff would be 

available thro ughout the region served.

In some regions of the Natio n there ma y be no medical library adequ ate to 

serve such area as a regional medical libr ary . The bill would add a new section 

(sec. 378) to part II of title III of the Pu bli c Healt h Service Act (relating to the 

Nati ona l Lib rar y of Medicine) which would authorize the Surgeon General in 

such cases to estab lish, as branches of the Nat ion al Library of Medicine, regional 

libraries of medicin e to serve the needs o f such regions. No t to exceed $2 m illion 

annu ally would be authorized to be appropriated for this purpose for a 5-year 

period, beginning fiscal year 1966. Sums so appropriated would remain avai lable 

until expended.

We strongly endorse these complemen tary authorizations as providing the 

flexibility necessary for the most rapid and efficient deployment of medic al library 

resources and services throughout the Na tio n.
12 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

Special scientific projects

The bill would add a new section 395 to the Public Health Service Act which 

would authorize not to exceed $500,000 a year for a 5-year period beginning with 

fiscal year 1966, to be used by the Surgeon General to assist, through award s to 

physicians and scientists, in the compilation of existing, or the writing of original, 

contributions relating to scientific, social, and cultural advancements in the 

sciences related to health which will f acilitate the distribu tion and utilizatio n of 

such knowledge and information. The Surgeon General would be authorized to 

make appropriate arra ngemen ts whereby the facilities of the National Library of 

Medicine and of other institutions would be made available in connection with 

the projects for which the awards are made.

With the tremendous increase in the volume and complexity of the literatu re 

in the biomedical sciences there is an urge nt need for preparation of critical reviews, articles, abstracts, and other compilations or original contributions of a high 

degree of excellence and reliability to make more readily available to the medical 

community knowledge of advancements in the medical sciences. Such reviews, 

by physicians and scientists of stature, can serve as one of the most im porta nt 

keys to the liter ature, by providing practition ers, teachers, scientists, students , 

and others with access to, and appropriate perspectives on, significant aspects of 

scientific developments.

Research and development in medical library science and related fields

The bill would add a new section 396 to the Pub lic Health Service Act which 

would authorize appropriations of not to exceed $3 million a year for a 5-year 

period beginning with fiscal year 1966, for grants or contracts for research or investigations in the field of medical library science and related activities, and for 

the development of new techniques, systems, and equipment for processing, 

storing, retrieving, and distribu ting information pertaining to sciences rela ted to 

health.

The magnitude and diversity of the requirements of the Nation ’s corps of 

healthworkers for the information in the medical lite rature is tremendous. The 

information resources of the Nation’s biomedical libraries must be made avail ­

able to its corps of health practitioners, to researchers in the health fields, and to 

stud ents being trained in the health professions, in ways which are commensurate 

with their urgency, variety, and volume.

The volume and chara cte r of the published biomedical literature are such as 

to pose peculiar problems of storage, retrieval, and transmission of the information 

contained therein. The uses to which the information is put are of such vita l 

importance in terms of the health needs of the Nation th at the urgency of improving these aspects of its handling cannot be too strongly emphasized. Nearly 

all aspects of current medical library science need to be reassessed to develop 

more efficient skills an d technologies. In addition, research is needed in rela ted 

areas such as the uses of information b.v scientists, teachers, and practitioner s 

and their searching tech niques and attitud es; medical terminology and classification ; machine indexing; graphic image storage and retrieval, and the like. Such 

research will not only provide answers to many immedia te problems of medical 

information handling, it will also provide important guidelines for the future. 

Support of biomedical publications

The bill would add a new section 399 to the Pub lic Health Service Act which 

would authorize appro priations of not to exceed $1.5 million a year for a 5-year 

period beginning with fiscal year 1966 for grants or contracts with nonprofit 

institutions of higher education or individual scientists for support of nonprofit 

biomedical scientific publications and to procure the compilation, writing, editing, 

and publication of reviews, abstracts, indices, handbooks, bibliographies, and 

related matter pertainin g to scientific works and scientific developments. No 

grant for support of an y periodical publication could be made for more th an 3 

years.

Effective access to the medical literature require s a variety of secondary 

publications, including abstrac ts, indices, handbooks, critical reviews, and the 

like. This is p articu larly true as the volume, magnitude, and complexity of the 

literature increases. The support authorized by thi s section would be limited 

in duration and could serve as a stimulus to the initiation and successful maintenance of a few carefully selected publications which have potential for making 

a special contribu tion to the biomedical comm unity.

National Medical Libraries Assistance Board

The bill would provide that the Board of Regents of the Natio nal Lib rary 

of Medicine shall constitute and serve as the Na tional Medical Libraries Assist-
MEDICAL LIB RARY ASSISTA NCE ACT OF 196 5 13

ance Board to advise and assist the Surgeon General in the preparatio n of regulations and with respect to policy ma tters relating to the adm inistra tion of the 

programs which the bill would authorize. The Board would also review a con stru ctio n applications, and would advise the Surgeon General on supp ort 

of biomedical scientific publications and on estab lishm ent of regional medical libraries. (Note tha t, in its capac ity as Board of Regents of the National Li­ brary of Medicine, the Board would also advise the Surgeon General on the 

establishment of branches of the National Library of Medicine to serve as regional medical libraries.) We strongly endorse the use of the Board of Regents of the National Library 

of Medicine as the advisory council for the programs authorized under this bill. This would assure maximum coordination and continu ity between the new programs and the ongoing activities an d responsibilities of the National Library of Medicine. We would suggest however, tha t, in line with the advisory role of the Board in the construction program , the introductory phra se in the proposed 

section 393(b) (p. 6, lines 5-7) be changed to read: “A grant und er this section may be made only if the app lica tion therefor is reviewed by the Board and is 

approved by the Surgeon Gen eral.” Section 4 of th e bill would provide for an increase in the auth orized ceiling for 

per diem pay of members of the Board of Regents of the National Library of Medicine from $50 to $75. This would bring the authorized ceiling for the per 

diem of members of the Board of Regents to the same level as th at authorized 

last year for the Federal Hospital Council and the National Advisory Council on 

Nurse Training. In summary: the medical libr ary is an essential instrum ent in the train ing of 

medical personnel, the conduct of me dical research, and the practice of medicine. Yet in recent years the Nation’s m edic al libraries have been seriously neglected and t oday are in critical condition. The difficulties of medical libraries and the 

effect of their weaknesses on medical trainin g, research, and practice must now be recognized as a problem of national proportions, and one which ultimately could 

pose a thre at to the health of the American people. The needs are extensive and urgent. An intensive, comprehensive program directly related to meeting these 

needs should be initiated without furth er delay. H.R . 3142 would provide the 

basis for such effort. We would therefore strongly recommend enactm ent of II. R. 3142. (We 

suggest, however, th at a clarifying amendment, along th e lines enclosed herewith, be included in the bill to make clear th at nothing in the bill is intended to limit 

any authority existing under present law. It should also be noted th at favorable actio n on thi s bill will make unnecessary the references in the proposed Higher 

Edu cation Act of 1965 to the “biomedical” field. (See S. 600, p. 20, lines 13-14; 

p. 23, lines 10-11.) We are advised by the Bureau of the Budget that there is no objection to the 

presentati on of this report from th e standp oint of the adm inistration’s program.

Sincerely,

Wilbur J. Cohen,

Assis tan t Secretary.

Draft Language To Carry Out Suggestion in Department’s Report on

H.R. 3142

On page 23, a fter line 3, insert the following new section:

“other authority not affected

“Sec. 5. Nothing in this Act shall be construed as limiting the authorities and 

responsibilities, under any other provision of the Public Health Service Act or 

any other law, of the Surgeon General, the Public Health Service, or the Secretary 

of H ealth, Education, and Welfare.”

Department of the Navy,

Office of the Secretary,

Washington, D.C., September 13, 1965.

Hon. Oren Harris,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D.C.

My Dear Mr. Chairman: Your request for comment on H.R. 3142, a bill to

amend the Public Health Service Act to provide for a program of grants to assist 

53-7 62— 65----- 3
14 MEDICAL LIB RA RY ASSISTAN CE ACT OF 19 65

in meeting the need for ade quate medical library services and facilities, has been 

assigned to this Depar tment b y the Secretary of Defense for the preparation of a 

report thereon expressing th e views of the Department of Defense.

This bill would amend th e Public Health Service Act to permit assistance to 

medical libraries. This assistance would include renovation and construction, 

tra ining of medical librarians, assistance to medical and oth er scientific authors 

and assistance in investiga tion and research. The bill includes a section autho rizing regional branches of the National Library of Medicine. The Surgeon 

General of the Public Health Service would m anage the program with the advice 

and assistance of the Board of Regents of th e National Library of Medicine.

The proposal is considered desirable, not only for the National Library of 

Medicine, but for medical practic e and medical libraries in the Departm ent of 

Defense. Accordingly, the Depar tment of the Navy, on behalf of the Department of Defense, recommends enac tment of legislation to accomplish the purpose 

of II.R. 3142 but defers to th e Departm ent of Health, Educatio n, and Welfare 

as to the specific provisions of t he legislation.

This report has been coordinated within the Depar tment of Defense in accordance with procedures presc ribed by the Secretary of Defense.

The Bureau of the Budget advises tha t, from the standpoint of the administra tion ’s program, there is no objection to the presenta tion of this repo rt on 

H. R. 3142 for the consideration of the committee.

For the Secretary of the Nav y.

Sincerely yours,

M. K. Disney,

Cap tain, U.S. Navy, Director, Legislative Division.

U.S. Department of Labor,

Office of the Secretary, 

Washington, September 15, 1965.

Hon . Oren Harris,

Chairman, Committee on Intersta te and Foreign Commerce,

House of Representatives, Wa shin gton, D.C.

Dear Mr. Chairman: This is in further response to you r request for our views 

on H.R . 3142, the Medical Lib rary Assistance Act of 1965.

Since the Department of Labor has no direct responsibility in this area, we 

prefer to leave comments on th e substan tive provisions of this bill to th e Departme nt of Health, Educatio n, an d Welfare, the agency with special competence in 

thi s field and most directly concerned with the adm inistration of the program.

From the standpoint of o ur particu lar responsibilities, we note with approval 

th at the bill contains provisions to protect the labor sta ndard s of laborers and 

mechanics employed on pro jects authorized by this legislation. However, since 

the bill defines “construction” to include “equipping new buildings and existing 

buildings” , we recommend th at section 393(b)(3) of the bill be amended to 

lim it the application of the lab or standa rds to the typ e of construction normally 

covered by the Davis-Bacon Act, as amended. Suggested dra ft language is 

enclosed.

The Bureau of the Budget advises th at there is no objection to the submission 

of this repo rt from the sta ndpoint of the adm inistration’s p rogram.

Sincerely,

W. Willard Wirtz,

Secretary of Labor.

Proposed Language for Section 393(b)(3) of H.R. 3142

“No grant for a project of construction under this Act shall be made unless the 

Secretary finds that the application contains or is sup por ted by reasonable 

assuranc e that all laborers an d mechanics enployed by contractors or subcontra cto rs on projects of the type covered by the Davis-Bacon Act, as amended 

(40 U.S.C. 276a-276a-5), will be paid wages at rates not less tha n those prevailing on similar work in the locality as determined by the Secretary of Labor in 

accordance with that Act; and the Secretary of Labor shall have with respect tothe labo r standards specified in this para graph the au tho rity and functions set 

for th in Reorganization Plan No. 14 of 1950 (15 F.R . 3176; 5 U.S.C. 133z-15) 

and section 2 of the Act of Jun e 13, 1934, as amended (40 U.S.C. 276 c)/’
MEDICAL LIBRARY ASSISTANCE ACT OF 19 65 15

C om ptr o ller G e n e r a l of t h e U n it ed S t a t e s,

Washington, D.C., March 8, 1965.

B-74254.

Hon. O r en H a r r is ,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives.

D e a r M r . C h a ir m a n : By letter dated February 15, 1965, you requ ested our 

comments on H.R. 3142. The sta ted purpose of this measure is to amend the 

Public Health Service Act to provide for a program of grants to assist in meeting 

the need for adequate medical library services and facilities.

While we have no special information th at would assist the committee in its 

consideration of the merits of H.R . 3142, we would like to offer the following 

comments rega rdin g this measure. No provision is made in H.R . 3142 nor in 

legislation applicab le to other gra nt programs now authorized by the Public 

Health Service Act, as amended, 42 U.S.C . 201 et seq.—with the exception of the 

hospital programs under title VI thereof— to require a gran tee to keep adeq uate 

cost records of the projects to which th e Federal Government makes financial 

contributions, or specifically authorizing th e Secretary of H ealth, Educa tion , and 

Welfare or the Comptroller General to have access to the grantee’s records for 

purposes of audit and examination. In view of the increase in grant programs 

over the last several years, we feel th at in order to determ ine whether grant funds 

have been expended for the purpose for which the grant was made, the grantee 

should be requ ired by law to keep records which fully disclose the disposition of 

such funds. We also feel that the agen cy as well as the General Accounting 

Office should be perm itted to have access to the grantee’s records for the purpose 

of audit and examination. We there fore suggest th at consideration be given to 

amending the bill to include such require ments with respect to the proposed new 

grant program, or preferably to an amend ment of the Public Health Service Act 

to cover all gra nt programs therein authorized. The l att er could be accomplished 

by the following language:

“ Rec o r d s a n d A udit

“ (a) Each recipien t of assistance under this Act shall keep such records as the 

Surgeon General shall prescribe, inclu ding records which fully disclose th e amount 

and disposition by such recipient of the proceeds of such grants, the total cost of 

the projec t or u nde rtak ing in connection with which such funds are given or used, 

and the amoun t of tha t portion of th e cost of th e project or und ertaking supplied 

by oth er sources, and such other records as will facilitate an effective aud it.

“ (b) The Secretary of Health, Educa tion, and Welfare and the Comptroller 

General of the United States, or any of the ir duly authorized representatives, 

shall have access for the purpose of au di t and examination to any books, documents, papers, and records of the recipie nts th at are pertin ent to the grants received under this Act.”

Language similar to tha t suggested abo ve is contained in section 11 of th e Clean 

Air Act, approved December 17, 1963, Pub lic Law 88-206, 77 Stat. 401, the act 

of May 31, 1962, Public Law 87-460, 76 Stat. 83, and in section 25 of the Area 

Redevelopment Act, approved May 1, 1961, Public Law 87-27, 75 Sta t. 63, 

42 U.S.C. 2522 (supp. V).

Sincerely yours,

J o se ph C a m p b e l l,

Comptroller General of the United States.

Mr. Staggers. Again, I would like to say that any witness who is 

here who would like to present his testimony for the record will be 

considered as giving it and it will be inserted in the record.

At this time we will hear from our colleague, Mr. Fogarty of Rhode 

Island, who is one of the sponsors of the legislation under consideration.

STATEMENT OF HON. JOHN E. FOGARTY, A REP RES ENT ATIVE IN 

CONGRESS FROM THE STATE OF RHODE ISLAND

Mr. Fogarty. Mr. Chairman, early in June I appeared before this 

committee to urge passage of another vital health measure—the 

Health Professions Educational Assistance Amendments of 1965. 

Under your skillful handling on the floor of the House th at bill passed
16 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

the House and is going to become law. Earlier this month this 

committee reported out the regional medical plan which has already 

passed the Senate and which, when it comes before the House, is 

sure to pass and become law. Today we are considering a related 

health measure, the Medical Library Assistance Act of 1965, and it— 

like the other bills—deserves to become a part of the law of this land.

In January T introduced on the House floor three separate measures—H.R. 5999, H.R. 6000, and H.R. 6001—which embodied proposals now incorporated in the health professions educational assistance amendments, the regional medical plan, and the Medical 

Library Assistance Act we are considering today. Unlike some of 

the other health bills to come before this Congress, the medical 

library assistance bill has a striking unanimity of support and I have 

no doubt that it will pass this Congress and become law. Without a 

dissenting voice, the health professions and librarians alike are agreed 

tha t the need to strengthen the country’s medical library system is 

urgent.

For the medical libraries of this Nation are indeed in shocking 

state. There are 6,000 libraries in this country, but only 3,000 

librarians—one-half a librarian for each library. The needs for 

additional space to allow libraries to expand to a size sufficient to 

meet minimum standards runs to millions of additional square feet. 

The requirements for books and journals to support medical research 

are massive. And as for training, only 40 additional professional 

librarians are being added to the field of medicine every year—while 

the national attrition of medical librarians is 150 every year.

A weak and inefficient medical library system results in a wastage 

of our medical research effort that is both unnecessary and of such 

proportions tha t it can no longer be overlooked. Unplanned and 

unnecessary duplication of research costs time and money. And research results tha t are reported but cannot be retrieved might as 

well never have been reported. Someone else will have to duplicate 

them and report them again before they can help one other scientist 

or be used by one practitioner to alleviate the sufferings of patients.

The irony of this is tha t our success in creating and sustaining a 

national effort in biomedical research over the past two decades has 

resulted in a flow of new medical information the like of which has 

never been seen before in human history. Bu t this flow of information has turned into a flood and swamped the reservoirs—the Nation’s 

medical libraries are the inevitable reservoirs of tliis new knowledge. 

The flooding—the information that has seeped away or has been lost 

down the spillways—is a tragic thing to watch.

I think tha t it is this spectacle that has brought about the general 

recognition tha t we mus t act quickly to meet this desperate situation. Everyone seems to have suddenly recognized what such organizations as the Association of American Medical Colleges have been 

saying for a number of years about the worsening plight of this 

Nation’s medical libraries. The President’s Commission on Heart 

Disease, Cancer, and Stroke, as well as the American Medical Association have pointed to the need to improve our Nation’s medical 

libraries.

Everyone seems to be saying with one voice that a large-scale 

national effort has to be made now to rehabilitate medical school 

libraries. It is clear to all th at no temporary solution is possible, and
MEDICAL LIBRAR Y ASSISTAN CE ACT OF 1965 17

no sing le agency can do th e job. Only a coopera tiv e effort by the 

med ical schools, the Fe de ral and St ate Go vernme nts , and pr ivate 

org ani zation s can do th e job th at has to be done.

M r. Chairma n, in all th e years we have worked toge ther on he alt h 

leg islation—in these two dec ades—I ca n’t recall a healt h mea sure 

th at had more unanimous support than is enjoye d by this mea sure . 

In par t thi s is a tri bu te to the care with which th is legislation was 

writte n. It wisely assum es that priva te, local, and St ate resources 

will continue to ca rry mos t of the expense of ou r Nat io n’s lib rary 

syste m. At the same tim e it assum es th at the lea dersh ip role of the 

Nationa l Libra ry of Medi cin e should he reco gnized, utilized, and 

str ength ened.

I need not review before this grou p nil the de tails of the Med ical 

Lib ra ry Assistance Ac t of 1965. 1 would like to sum ma rize its ma jor

pro vision s to emphasize in specific terms how this mea sure would 

benefit the health of the Am erican people.

First , funds for the constru ction of facilities.

Second, grants for tra ining in medical lib ra ry inform atio n 

science.

Th ird , assistance to special scientific pro jec ts, such as studie s 

in the histor y of med icine.

Fo urth, research an d dev elopment in medical lib rar y science 

and related fields.

Fifth , grants for im pro vin g and exp and ing th e basic resources 

of medical libraries an d related instr um ental ities.

Sixth, grants for est ablishm ent of regional med ical libra ries. 

Sev enth, financial su pp ort of biome dical scie ntific publications. 

Th ese specific provis ions o f the bill will enable our h ea lth professions 

to utilize to a higher deg ree th an ever before the fruits of research 

which are being pro duc ed in great er qu an tit y. If I may, I would 

like to suggest—in ord er to remove any do ub t as to the app lica tion 

of this measure and to cla rify the intent of thi s body—th at the term 

“sc iences related to he al th ” (p. 3, line 21, H R . 6001) be ame nded 

to includ e optom etry. Th is spe cia lty is b eing inc rea singly recognized 

as a vital pa rt of the en tir e field of professions related to he alt h.

Now , this bill recognize s th at the chronic neglect of the Nation’s 

medic al libraries has rea ched the point where significant Federal 

ass istance is needed to build up libraries to a rea sonable sta nd ard. 

In addit ion , it will pro mo te th e acquisition of new type s of e quipm ent 

for the processing of m ate ria ls. In this connection, it is intere sting to 

con sider the role to be pla yed by regional libr aries to be establis hed 

un de r one section of this bill.

Th ese regio nal libraries will collect ma ter ial s in de pth and make 

their reso urces and serv ices availab le to other me dic al libraries in 

broad geograp hic areas so th at resou rces of the sm alle r libraries can be 

lim ited to the most used class of materi als. Even with the efficiency 

and econom y which the reg ion al medical lib rary mecha nism will 

foster, th e need for basic resources will be tremendous.

Mr. Ch airma n, just 2 m on th s ago you and I—alon g with th at 

gr ea t sta tesm an for he alth, Senator Lis ter Hill, an d oth ers—were 

honored by taking pa rt in th e Jo hn Shaw Billinas C en tenn ial m ark ing 

the first centu ry of the exi stence of the Na tio nal Li br ary of Medicine. 

I recall th at in your spe ech presented by th e dis tinguish ed Re presen tativ e from New York, Leo O ’Brien, you ma de an excellent reference
18 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

to th e role the regio nal libraries will play in fostering American m edica l 

edu cation.

You noted t ha t, in addition to the 81,000 medical stu dents , interns, 

and residents, there are an addition al 170,000 stu de nts of de ntistry, 

nursing, osteo pathy , public health, and ot he r healt h sciences wh o 

need librar y services. You were ma kin g a po int which should ne ve r 

be fo rgo tten —which we in Congress h ave a special du ty to re me mb er—■ 

th at is, th at these yo un g people and the ir insti tutio ns are sc attere d 

all across this Nation, an d all re quire access to th e medical lit er at ur e 

for the ir training an d edu cation.

The need for region alization has become acute with the grow th 

in the ma gnitude of th e medical literatu re an d the speed with wh ich 

inf onnation is req uir ed. As you know, the Na tio nal Library of 

Medicine is serv ing as a libr aries’ lib rary in meeting the needs for 

increasing am ounts of ma terials which local medical libraries do no t 

have on the ir shelves. Assistance in me eting the need for local 

lib rary resources will help relieve this problem .

The develop men t of a sys tem of regional libraries locally op erated 

and controlled b ut w ith Fede ral assistance in th e collection of materials 

and equ ipm ent and sta ff will do much to ma ke for the max imum use 

of scarce tra ine d me dic al lib rary ma npo wer while assu ring fas t, 

qu ali ty libr ary service.

And if in some region of the Na tio n the re is no t now some medic al 

lib rary adequate to ser ve area needs, regional libr aries ma y be es ta blished as branch es of the National Li brary of Medicine for th at 

purpose.

The N ational Lib ra ry of Medicine has ha d mo re experience tha n an y 

lib rary in the world in providing lib rary serv ices in the medical are a, 

and its splendid repu ta tio n is int ern ational. Th e NL M will pro vid e 

the kind of lead ership nee ded —and is pre pared to do so ju st as q uic kly 

as this medical lib ra ry assistan ce bill is signed int o law.

When this measu re conies before the H ouse I think it is im po rtan t 

th at our colleagues be ma de aware im me dia tely th at medical librar ies 

are the leaky and alread y flooded reservoirs into which are flowing 

the man y researc h acc omplis hments of our increasingly prod uctiv e 

nation al biomedical res earch effort. Eq ua lly im po rta nt, I think , is 

th at the y be mad e aw are of the ex tra ordina ry un an im ity of su pp or t 

this measure enjoys. I t has not oidy the endorse me nt of all tho se 

dir ectly conc erned— th e Medical Li brary Associa tion, the Special 

Lib raries Association, the Association of Re sea rch Lib raries, the 

Asso ciation of Am erican Medical Colleges—it also has the su pp ort of 

th e volun tar y healt h agen cies su ch as the Am erican Hea rt Assoc iatio n 

and the professional organizations such as the American Den tal 

Associatio n, American Publi c He alth Ass ocia tion, and the Am eric an 

Med ical Association.

Yes; let me emp hasize, the American Me dic al Association join s in 

the support of th is m eas ure . Our colleague, S en ator Hill, was in for me d 

ear lier this year th roug h testim ony befo re the Senate Comm itte e on 

La bo r and Pub lic We lfare th at th e AMA str on gly sup ports the i nt en t 

an d purposes of thi s measu re.

En joy ing the su pp ort of such varied ele me nts—go vernmental an d 

vo lunta ry, academic, professional org ani zation s— thi s mea sure cann ot 

fail to pass this Con gress.

As we consider the man y hu manita ria n me asu res coming ou t of 

Con gress this session—un de r the lead ership of our health-o riente d
MEDICAL LIB RA RY ASSISTAN CE ACT OF 1965 19

President—it is imperative that we improve the flow of new medical 

information from the N atio n’s laboratories to this Natio n’s physicians, 

who are moving in on the domain of disease. There is only one way 

to do this, and tha t is by repairing our medical library system and 

bringing it up to date. Libraries must be helped to channel the 

information that is flowing into them at an accelerating rate in such 

ways th at the knowledge they are receiving may pass on to irrigate the 

vast regions of man’s ignorance. When these reservoirs of knowledge 

are used as they can and should be used, medical research, medical 

education—and above all, medical practice—will flourish as never 

before.

Mr. Staggers. Thank you for your testimony, Mr. Fogarty.

Mr. Fogarty. Thank you for the opportunity, Mr. Chairman.

Mr. Staggers. Next we will hear from Dr. Luth er L. Terry, 

Surgeon General of the Public Health Service.

Dr. Terry, you may proceed.

STATEMENT OF DR. LUTHER L. TERRY, SURGEON GENERAL,

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE; ACCOMPANIED BY DR. EDWARD W. DEMPSEY, SPECIAL ASSISTANT

TO THE SECRETARY, HEALTH AND MEDICAL AFFAIRS; AND

WILBUR J. COHEN, ASSISTANT SECRETARY FOR LEGISLATION

Dr. Terry. Thank you, Mr. Chairman.

Under Secretary Wilbur Cohen is our principal witness. If we may, 

we would like to open with his testimony, sir.

Mr. Staggers. Yes, sir. You may proceed as you see fit. We 

would like to identify for the record all the gentlemen you have with 

you, please.

Mr. Cohen. Mr. Chairman, on my left is Dr. Luther Terry, the 

Surgeon General, Public Health Service. On my right, Dr. Edward 

Dempsey, the Acting Assistant Secretary for Health. On my far 

right, Dr. Martin Cummings, the Director of the National Library of 

Medicine. On the far left is Mr. Ralph Huitt, the Assistant Secretary 

for Legislation.

Mr. Chairman, I have a statement, and Dr. Dempsey and Dr. 

Terry have statements. My suggestion would be that all three of 

these be printed in the record, in compliance with your request. 

Then I think each of us will make a brief statement which will summarize our views.

Mr. Staggers. Tha t certainly is agreeable with the committee, 

Mr. Cohen.

Mr. Cohen. I think the basic argument as to why we are strongly 

in favor of this legislation, Mr. Chairman, is contained in the paragraph in my testimony on the top of page 3. I think by reading this 

one paragraph I can summarize the whole argument that is in favor 

of this legislation.

The plight of the Nation’s medical libraries is critical. During a 

period of intensive development of health research institutions, medical schools, and other medical facilities, support for medical libraries 

has been seriously neglected. The condition of medical libraries has 

steadily deteriorated under the pressures of rapid development of 

other programs and activities of medical institutions, most of which 

make increasing demands upon the medical library. In addition, the
20 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

broadening base of medical research and practice, calling for literature 

from many ancillary fields, has added to the magnitude and complexity of medical literature. Medical libraries are cramped for 

space, critically deficient in trained manpower, deplorably inadequate 

in resources and desperately in need of new methods for handling the 

growing medical literature. A large-scale national effort is needed 

now to rehabilitate medical libraries.

For that reason, Mr. Chairman, we wholeheartedly support the 

bill pending before you today and urge its prompt enactment.

(Mr. Cohen’s full statement follows:)

Sta tem en t by W il b u r J. C o h e n , U n d er S e c r e ta r y , D e p a r t m e n t o f

H ea lt h, E d ucati on, and W el fa r e

Mr. Chairman and members of the comm ittee, before I comment on the legislation before you tod ay, I wish to take this opportu nity to thank all th e mem bers 

of this committee, and particularly its distinguished chairman, on behalf of the 

administration for the leadership and vision which you have shown in the consideration and enactme nt of very important health legislation during this session of 

the Congress. I sincerely believe that your efforts will be rewarded by the 

improved health of the American people!. We, in the Dep artm ent of Health, 

Education, a nd Welfare, are grateful for the splendid cooperation we have received 

from this committee.

I appear before you today ip support of H.R. 3142, the Medical Library Assistance Act, introduced by Chairman Harris.

Among the bills which you have considered during this session are those which 

would:

Expand the Na tio n’s capacity for education in the health professions, 

Establish regional programs which would serve to furth er research into the 

prevention and treatm ent of the killer diseases— heart disease, cancer, and 

stroke—-and bring the fruits of this research more rapidly to the ir victims 

through improved diagnosis and treatm ent,

Extend the effectiveness of our health research institutions thr ough the 

provision of im proved research facilities.

These and other programs which have come before you are estremely significant 

in terms of better health for all of us. These programs may not fully succeed, 

however, unless th ere is a very considerable improvement in society’s mechanisms 

for the comm unication of health information.

In the field of hea lth, the keystone of this comm unication system is th e biomedical library. We are investing large sums of money in programs of research, 

education, and health services. Unless th e resea rch scientist has available complete and up-to-the-min ute information in his field, progress in the under standing 

of disease a nd disability will be slowed. Unless the physician has the lates t and 

best information on diagnosis, treatm ent, and rehabilitatio n, the well-being of 

the patie nt may be at stake. Unless our stu den ts in the health professions have 

available to them ade quate facilities and resources during their educ ation, the 

quality of their training may be affected, and the consequences serious and far 

reaching.

The library has been established as the major learning resource of u niveristies 

for centuries. I know from my own experience as a teach er th at the library is 

the place where the past and the present meet. It is also the source of ideas 

for the future for the faculty, students, and researchers. Medicine, as pa rt of 

society, needs library resources to capitalize upo n the technical, cultura l, and 

educational adva nces which take place everyw here. We must not allow the 

progress of medicine to be impeded for lack of support of this vital act ivity.

The plight of the Nation’s medical libraries is critical. During a perio d of 

intensive developm ent of health research institu tions, medical schools, and oth er 

medical facilities, sup port for medical libraries has been seriously neglected. 

The condition of medical libraries has steadily dete riorated under the pressures 

of rapid development of other programs and activities of medical institu tions, 

most of which make increasing demands upon the medical library. In add ition, 

the broadening base of medical research and practice, calling for lite rature from 

many ancillary fields, has added to the magnitude and complexity of medical 

literature. Medical libraries are cramped for space, critically deficient in t rai ned 

manpower, deplorably inade quate in resources and desperately in need of new
MEDICAL LIBRARY ASSISTA NCE ACT OF 196 5 21

methods for handling the growing medical literatu re. A large-scale national 

•effort is needed now to reha bilitate medical libraries. The bill would authorize the Surgeon General to make grants of up to 75 percent of the costs of constructing, renovating, expanding, or remodeling medical library facilities. In acting upon applications for grants, consideration would be given to the. relative effectiveness of the proposed facilities in meeting demonstrated needs for additional or improved medical library services, and priority would be given to projects for construction of facilities for which the need is greatest. For these purposes, the bill would authorize appropriations not to exceed $10 million a year for a 5-year period beginning with fiscal year 1966. One of the most critical needs of m edical libraries is for space in which to main­ tai n their collections and to carry o ut their necessary day-to-day operations. The chronic shortag e of shelf space precludes the acquisition of essential additional books and materials each year. Crowding obstructs and often completely pre­ vents access to the volumes on han d. Working space for library staffs is so re­ stricted as to be a real barrier to effective operations (many medical libraries are so crowded t ha t there is not even space for desks for the staff), and many libraries lack the space for up-to-date processing and laborsaving equipment. The need for space is desperate and of great magnitude. However, in orde r to make the most effective use of the funds th at will be available for this program, we believe th at initiation of the construction program should be preceded by a study of the kinds of facilities which will be most suited for meeting present and future require­ ments in the light of rapid techno logical advances. To allow time for such a stu dy, and at th e same time achieve the full objective of th e c onstruction program envisaged by the bill, we recommend th at this provision of the bill be amended to provide for a 4-year construction program, beginning with fiscal yea r 1967, with 

annual appropriation authorizations of $12.5 million. The Department believes t ha t th e Medical Library Assistance Act now before you would provide a comprehensive and imaginative program for correcting the deficiencies of the biomedical libraries of the Nation and would there by strengthen 

our efforts in medical research, educ ation, and practice. I would like to assure the com mittee of the enthusiastic sup port of this bill by the Depar tment with the one or two modifications we have suggested to you in our repo rt. We are convinced that unless such a program to improve our medical libraries is undertak en, other hea lth programs may be seriously imperiled. I urge ena ctm ent of this measure so t ha t th e very pressing problems of t he communica­ tion of biomedical information may be met head on and the h ealth of our Nation 

may be adva nced accordingly.

Mr. Cohen. Mr. Dempsey.

Dr. Dempsey. Mr. Chairman, like Mr. Cohen, I would like to urge 

enactment of the bill and to indicate that it has the complete support of the Department, and that it is, in my opinion, greatly needed to assist the libraries in medical institutions in our country to do the 

job now before them. There is a very real need for this legislation. The number of 

librarians who are trained as medical librarians in the United States is totally inadequate to staff the libraries that now exist. There are about 6,000 libraries, there are only 3,000 trained medical librarians, and we are training only at the rate of about 50 medical librarians per 

year. The use of the libraries to assist the practicing profession has grown 

enormously in the past years. The great additional use of interlibrary loans as a mechanism to provide information to medical schools, to hospitals, and to centers of medicine in localities in which their own 

libraries are inadequate atte sts to the need for a greatly improved 

library system than we have now. There are many other ways in which I could illustrate the plight of 

libraries and indicate how valuable the assistance tha t would be pro­ vided u nder this bill would be. But in the interest of time, I would simply like to emphasize again the Department’s support of this bill 

and to indicate tha t to the best of my knowledge virtually every
22 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

professional organization in the health field has endorsed the need for 

this legislation. There is a wide recognition of the need for and there 

is confidence in the proposed solution to the problem. We urge the 

enactment of H .R. 3142.

Thank you.

(Dr. Dempsey’s statement follows:)

Sta te m en t by E dward W. D em ps ey , A ct in g Ass is ta nt Se c r e t a r y, 

D ep ar tm en t of H ea lt h, E du ca ti on, and Welf a re

Mr. Cha irm an and members of the committee, I appear before you toda y in 

support of H .R . 3142, the Medical Library Assistance Act, which was introduced 

by Chai rman Harris. The need for the enactment of this legislation is quite 

apparent when one considers the vita l and overwhelming needs for informatio n 

which are being generated by the expande d health programs of the Nati on, 

both public and private. Before speaking about the provisions of the bill, I must 

underscore the fac t tha t we in the Dep artm ent believe tha t there is real need for 

this legislatio n.

The report of the Secretary to the chairman of this committee on H .R . 3142 

sets forth in detail the Departmen t’s support of the specific prov isions of the bill. 

I should therefore like to outline the provisions for you briefly this morning, and 

emphasize some of the things the bill would accomplish.

The bill would authorize grants-in-aid of up to 75 percent of the costs of constructing, renovatin g, expanding, or remodeling biomedical libra ry facilities. 

We believe t hat this section of the bill is directed a t one of the most serious problems 

of the libraries. More than 50 percent of all medical school libraries were constructed more tha n 30 years ago, long before the publication explosion was 

anticipated or fel t. The Association of American Medi cal Colleges has conducted a survey of the medical libraries of their member schools to determine 

what their needs might be. They found th at at the present time the average 

medical school library occupies about 18,000 square feet. This is less than 

one-half the amo unt of space required to operate a modern medical libr ary. In 

many libraries there is crowding to the poin t tha t routine day -to- day activitie s 

arc impeded, access to materials is made difficult or impossible, and the utilizat ion 

of the libraries by scientific and medical personnel and students is inhib ited. 

Construction gran ts are needed.

However, since the technology of library science has shared in the technological 

revolution of the last few decades, we feel th at the construction progr am should 

be preceded by a careful study of the kinds of facilities which will be best suited 

to meeting present and future requirements in the light of these rap id te chno logical 

developments. We have, therefore, recommended in our letter to you , Mr . 

Chair man, th at this provision be amended for this purpose.

The cont ribut ion tha t biomedical libraries can make to the adva ncem ent of 

medical knowled ge and medical service is direc tly related to the calib er and 

number o f people who staff them. There is a tremendous deficit of professionally 

trained manpower in this field. For example, there are more than 6,000 medical 

libraries in the coun try today, but only abou t 3,000 medical librarians with any 

specialized trainin g or experience are available to staff them. Trai ned medical 

librarians are being produced today at a rate of less tha n 50 per year, a number 

which replaces only a fraction of those lost by attrit ion.

The bill w’ould authorize the Surgeon General to make grants to assist in the 

training of med ical librarians and other inform ation specialists in the health 

sciences. To day it is essential that the personnel responsible for the operati on 

and future planning of the medical libraries have special training in medical 

librarianship. Th is trainin g must be related to the specialized communi cation 

problems of the medic al comm unity. The y must be well grounded in the biomedical sciences, and they must be thorou ghly familia r with the design of technical inform ation systems. Many of those presently staffing health sciences 

libraries are in need of intensive specialized train ing in order to increase and 

update their comp etence. The urgency to begin action programs in this area 

cannot be o verstated .

The requirements of health sciences libraries for books, journals, and other 

resources is of s uch magnitude and so directly related to medical research, to the 

training of professional health manpower, and the information essential to the 

practicing community as to require speci al, intense attention immediately if our 

fundam ental responsibilities for a healthy nation are to be fulfilled. In a study
MEDICAL LIBRARY ASSISTANC E ACT OF 19 65 23

made in 1963, it was found t ha t only 14 of the 87 existing medical schools met the 

standard s for number of volumes for medical school libraries. Published information is of little value unless it is available to those who need it when they 

need it. Two sections of the bill are dire cted at aiding in making more and better 

resources available to local biomedical libraries. One of these would authorize the Public Health Service to make grants on a matching basis to expand and 

improve basic biomedical library and related resources. These grants would be limited to 5 years for any institu tion and would decrease each year. The other 

section of the bill is designed to increase the availability of books, journals, and 

other informational material to local libraries through the sup port of regional 

libraries. Grants under this sectio n would be made to major hea lth science 

libraries which would agree to prov ide supportive services to other libraries in the region. These grants would be made to suitable existing biomedical libraries. 

Where t he re are areas of the country in which there are no existing health science 

libraries of sufficient strength to serv e a regional community, the bill authorizes 

the establishme nt of branches of the National Library of Medicine. The need 

for this regional service has become acute with the growth in the size of the 

medical lite rature and with the need for increased speed of access to it.

Presently the National Library of Medicine is serving as the libraries’ library in meeting the requirements for increasin g amounts of material which local 

medical libraries do not have on th eir shelves. This function of the National 

Library of Medicine has reached such proportions as to make man datory the assumption of a part of the responsibility elsewhere. Regional hea lth science 

resource libraries, in lending such assistance to the local libraries, would help 

materially in solving this problem, while taking account of the fact th at it is 

neither economically feasible nor necessary for each biomedical libr ary to try 

to build its collection to encompass the whole of the biomedical lite rature . Such 

a program would also serve to pre ven t the growth of a highly centralized, monolithic system of lib rary service which could not be as responsive to local needs as 

could a decentralized system.

Many of the tools and methods used today to operate health science libraries 

are hopelessly inadequate. Research and development is re quired to devise new 

and more efficient techniques to deal with biomedical information requirements. 

The bill would authorize the award of grants and contracts to accomplish this.

The bill would authorize a pro gra m of grants and contracts for support of 

nonprofit publicatio ns and to proc ure the preparation and publication of reviews, 

abstrac ts, indexes, handbooks, bibliographies, and other forms of secondary 

publicatio ns. Effective access to the medical literature requires a variety of these 

forms of publications. This is p articu larly true now tha t the biomedical literature 

is .so complex and voluminous.

This increase in complexity and volum e of the lite ratu re has given rise to the 

need for a program of support for individual scholars for the prep aration of 

critical reviews and similar compilations of original contributions of a high degree 

of excellence and reliability. These works are needed to make more readily 

available to the biomedical com munity knowledge of advances in the health 

sciences which have been carefully eva luated and interpre ted by experts in the 

particular field. The bill would authorize a program of g rants to scholars in the 

medical sciences to accomplish these ends. All sections of H.R. 3142 are interr ela ted and together con stitute a comprehensive plan which can effectively repair the devastation of many years oi neglect, 

maximize th e resources, functions, and services which do exist, and bring bio­ medical library practice and facilities to th e frontiers of knowledge an d capability, 

both th eoretic al and practical, in this field. The existing informal health science library network is a logical base upon 

which to build our overall effort to improve and perfect a health inform ation 

system . A well-developed program of assistance is necessary and time ly. I am 

confident the program, as conceived in H.R. 3142, is entirely feasible and practical. I wish to stress the close rela tionship between this bill and the other 

health legislation which this committee has considered during this session and 

to point ou t th at the success of these oth er programs is dependent on a strong 

system of health science libraries. In conclusion, I again emphasize the Departme nt’s su ppo rt of this bill for the 

strengthen ing of our Nation ’s health science libraries and its importa nt relationship to many of our other programs. Virtually every professional organization 

in the h ealth field has endorsed the need for this legislation. This recognition of 

need for, and confidence in, the proposed solution of the problem is shared by 

the De par tment. We urge ena ctm ent of H.R. 3142.
24 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

Mr. Cohen. Dr. Terry.

Dr. T erry. Mr. Chairm an, 1 too would like to urge the enactment 

of this legislation. I feel that it represents one of the most important 

parts of our entire developmental program in the health and biomedical sciences today, because this represents the basic underpining 

for so many of our other programs in the Public Health Service, 

virtually all of them, whether they be research training, medical service, or whatever they may be.

The manner in which our other programs develop is going to depend 

a great deal upon the proper development of an adequate medical 

library and information system throughout this country. It is for 

that reason that I am particularly happy that this bill is up for hearings, and I hope that we can get favorable and rapid action.

For several years, my principal advisory council, the National 

Advisory Health Council ; the Board of Regents, which is a Presidentially appointed Board of the National Library of Medicine; and our 

other important advisory groups, have strongly urged this sort of 

legislation. So that I feel tha t we have the background and the 

support.

And in speaking of background, I would not like to let it pass, 

Mr. Chairman, without referring to the development of many of th e 

technological aspects of this program which have been developed in 

the National Library of Medicine. I would refer specifically to the 

medlars which has been developed and installed and is in operation 

at the National Library of Medicine.

Medlars (Medical Literature Analysis and Retrieval System) is a 

system for storage and rapid retrieval of information. This represents 

an outstanding development, and this can be the core of a national 

system by feeding out from our National Library of Medicine to 

medical libraries over the country.

If I may inject one personal note, Mr. Chairman, T think this is 

probably the last opportunity that J will have to appear before this 

committee, since I am shortly retiring from the Public Health Service. 

I couldn’t let this occasion pass without expressing to all of the 

members of this committee my deep appreciation for the work which 

you have done over the past several years. At no time in the history 

of our Nation, Mr. Chairman, has so much and such important health 

legislation been enacted, been heard, recommended, and enacted by a 

committee and by the Congress than has happened in the past four 

and a half years. For tha t reason, I consider it has been a real 

privilege for me to have played a part in this.

I would like to take this opportunity of saying thank you, and, 

Mr. Chairman Designate, I can assure you tha t during your time as 

chairman of this committee you are going to have a hard time meeting 

the record that this committee has made during the past 4 years. I am 

sure you are capable of it, and I would like to extend my thanks and 

best wishes to all of the members of the committee.

(Dr. Terry’s statem ent follows:)

Statement by Luther L. Terry, M.D., Surgeon General, U.S. Public

Health Service, Department of Health, E ducation, and Welfare

Mr. Chairman and members of the committee, I am very pleased to appear 

before you today in sup port of H.R . 3142, the Medical Library Assistance Act, 

introduced by the distinguished chairm an of this committee. I strongly urge the
MEDICAL LIB RARY ASSISTAN CE ACT OF 1 9 6 5 25

enactm en t of th is le gislati on a s es se ntial t o t he success of all of th e pr og ra m s of th e 

Pu blic H ealth Service. The pro gra m s of th e Service en co m pa ss hea lth research , 

pr of es sion al ed uc ation, an d se rv ices , as yo u know. In or de r fo r th es e pr og ra m s 

to fu nc tion eff ectiv ely and co n tr ib u te to th e ac hi ev em en t of our nati onal goals in 

he al th , a mod er n na tion al s ys te m o f biom ed ica l in fo rm at io n in a n a bso lu te req ui re ­

men t. All elem en ts ®f th e Pub lic H ealth Servi ce recogn ize th is and join me in 

enth usi as tic su pport of th e M ed ic al Lib ra ry Assist an ce Act. The N ational Adv iso ry H ea lth Co un cil, th e di stin gu ishe d pa nel of he al th 

sc ie nt is ts and lay cit ize ns which ad vi se s me on m att ers re la ting to th e ac tivi ties 

an d fu nc tion s of th e en tire Se rvice, ha s for seve ral ye ar s reco gn ized th e serio us 

co nd itio n in which th e bi om ed ical libr ar ie s of th e N at io n fin d th em se lv es . The 

H ea lth Cou nc il an d th e Boa rd of R eg en ts of th e N at io nal L ib ra ry of Med ici ne 

ha ve ur ge d th a t leg isl ati on su ch as th a t bef ore yo u now be enacte d in ord er to 

st re n g th biom ed ical lib rarie s.

In addit io n, th e P re si dent’s Com miss ion on H eart Dise as e, Can ce r, and Strok e 

lias fo un d se riou s wea kn esses in th e libra ri es se rv in g th e hea lth scienc es an d ha s 

st ro ng ly reco mmen de d th a t le gis la ti ve ac tion be ta ken to re cti fy th es e deficien ­

cies as so on as possible.

O ur N ation ha s a co ns id er ab le c a p it a l in ve stm en t in t h e h ealt h scienc e libr ar y. 

I t fo rm s th e ba sis of th e de ve lo pm en t of a medica l in fo rm at io n an d co mmun ica­ tion s sy stem . The med ical scienc es hav e a long tr ad it io n of co nce ntr ati ng th eir 

in fo rm ati on re so ur ce s in libra ri es. In th e pre se nt and fu tu re pla nn in g of 

hea lth pro gra m s an d th eir es se ntial co m m un ications ca pab ilitie s, we m us t ta ke 

fu ll ad vanta ge o f th es e ba sic re so urc es an d th e in ve st m en ts alr ead y m ad e in ou r 

biom ed ical libr ar ie s. Ther e is a fu rth e r chara cte ri st ic in th e hea lt h sci ence 

li b ra ri es whi ch is alm os t un ique . I re fe r to th e tr ad it io n est ab lish ed some 50 

or 60 years ag o of in te rd ep en de nc e an d co op eration am on g th ese libra ri es . In ­

te rl ib ra ry lo an ac tivity is so c h ara cte ri sti c in th e med ical field th a t an in fo rm al 

but ve ry vi ab le ne tw or k re la ti onsh ip has lon g been in ex iste nc e. (T o cit e an 

ex am pl e of loc al nee ds, th e N ational Lib ra ry of Med ici ne m ad e mo re th an 

200,000 lo an s of its m ate ri als la st year. ) Ther e is ne ed to fo rm al iz e an d 

st re ngth en th is ne tw or k re la ti onsh ip so th a t co ns um ers may gai n acce ss to th is 

in fo rm at io n loc ally.

T he Pub lic H ea lth Service is pro ud of th e fact th a t th e first su cc essful use of 

co m put er s fo r stor ag e an d re tr ie val of me dical in fo rm at io n w as de ve lope d by 

our N ational Lib ra ry of M ed ic in e. T hi s au to m ate d sy st em ca lle d M ed lars 

(m ed ical li te ra tu re an alys is and re tr ie v al sy ste m) co nta in s m or e th a n 350,000 

ci ta ti ons to th e wo rld m ed ical li te ra tu re wh ich m ay be re tr ie ved by su bj ec t 

or au th o r w it hin a m att er of m in ute s. In ad ditio n it pri n ts m onth ly In de x 

M ed icus , th e mos t co mpr eh en sive bib liog ra ph y of ou r m ed ical pu bl ic atio ns , 

as well as sp ec ializ ed bi bl io gr ap hi es of th e med ica l li te ra tu re of th e wo rld . The 

N at io nal L ib ra ry of Medici ne ha s p ro ven th a t it ca n ec on om ic ally de ce nt ra liz e 

th is po w er of stor ag e an d re tr ie val of med ical li te ra tu re to m ed ic al schools, 

ho sp ita ls, and ot he r hea lth- or ie nt ed in st itutions by pr ovid in g its mag ne tic 

ta pes to us er s in va riou s co m m un itie s th ro ughout th e N at io n.

Pro gr am s ar e be ing desig ne d to re habil it ate an d ma ximize th e co nt ributions 

of th e ex is ting med ical libr ar y est abli sh m ent an d a t th e same ti m e pla n fo r th e 

co nv er sion of th e tr ad it io nal m ed ic al libra ry form to serve mor e effic iently th o 

co m m un ic at io n pu rp os es of co nte m pora ry he al th sci ences.

T he M ed ic al L ib ra ry A ssistanc e Act o f 1965 t hr ou gh th e support of con stru ct io n, 

reso urce s, rese ar ch , man po wer dev el op m en t, regi on al and bra nch libr ar ie s, an d 

scientific publ ic at io ns pr ov id es a so und an d co mpr eh en sive legi slat iv e base 

w ith w hi ch to ac co mplish both th e re h ab il it ati o n a nd co nv ersion .

Fin al ly , I sh ou ld say th a t th e Publi c H ealth Service co ns id er s th e N at io nal 

Lib ra ry of M ed icine, wr

ith its Pre si denti all y ap po in te d B oa rd of R eg en ts an d 

al re ad y th e le ad er in me dic al libra ry tech no lo gy , to be th e appro pri ate org an iz ati onal ele m en t to ca rry out th e pro gra m s ca lle d for in th is bill.

I ca nnot close w ith ou t ex pres sin g to yo u my de ep ap pre cia ti on fo r th e fine 

co op er at io n w hi ch th e Pu blic H ealt h Service ha s al w ay s re ce iv ed fro m th is 

co m m itte e an d I wo uld like als o to exte nd my ow n pe rs on al th a n k s to th e d is ­

ting ui sh ed chai rm an for his m an y ou ts ta n d in g ac co m pl ishm en ts over th e ye ar s 

in th e in te re st of he al th .

Mr. Cohen. I think we might hear a word from Dr. Cummings, 

Director of the National Library of Medicine.
26 MEDICAL LIB RA RY ASSISTAN CE ACT OF 1965

STATEMENT OF DR. MARTIN M. CUMMINGS, DIRECTOR, NATIONAL LIBRARY OF MEDICINE, DEPA RTMENT OF HEALTH,

EDUC ATION, AND WELFARE

Dr. Cummings. Mr. Chairman, I, too, share the enthusiasm of 

the administration in support of H.R. 3142. As Director of the 

National Library of Medicine, I have confidence that the provisions 

of this act will go far towards solving the serious, most urgent medical 

communications problem which exists in our Nation. We are most 

hopeful that upgrading our Nation’s medical library network will 

prove to serve the interests of medical education, medical research 

and practice, which is the ultimate response to the health needs of 

our Nation.

Mr. Cohen. Tha t completes our testimony, Mr. Chairman.

I think you can see the unanimity with which we support this bill. 

We feel very strongly th at it is a very important part of the total 

legislation that you are considering in this session.

Mr. Staggers. Thank you, Mr. Secretary.

1 want to thank all of you very kindly and to you, Dr. Terry, I 

would like to say that I do believe the committee has passed legislation 

which will affect all America and you are part of it. I know, Dr. 

Terry, every American who is affected by the health legislation in 

any way will thank you because I am certain that some of the legislation tha t you have presented and have come here to testify for will 

make for a better way of life not only for all Americans but for all 

civilization. I think you have contributed greatly.

I think tha t every American owes you a debt and certainly the best 

wishes of this committee go with you, and we wish you well.

Dr. Terry. Thank you, sir.

Mr. Staggers. I than k all of jTou for your testimony.

1 notice one thing you emphasized, Mr. Cohen, is the word “now.” 

I believe Dr. Dempsey mentioned the fact tha t we had 6,000 libraries 

with only 3,000 librarians. Certainly we are in need of those.

Dr. Terry, the thing that 1 thought you emphasized is the fact 

th at your system is making available to the American medical profession the data that you have in the files so tha t they can get to them 

for information.

Dr. Cummings, yours is the fact of communications between the 

groups. I think all four of the key words are essential now.

Mr. O’Brien.

Mr. O’Brien. Mr. Chairman, I have no questions. I would like 

to join you in what you said to Dr. Terry. I have had the good 

fortune of sitting on this committee during the 4}£ years tha t Dr. 

Terry mentioned. I will say quite frankly tha t many of the things 

of which you spoke would not have been accomplished had it not 

been for him. I think all of us will agree that when he retires, he will 

retire not only as a good Surgeon General but as a great Surgeon 

General.

I also was impressed b y the testimony on the things that are to be 

done this year in the various fields and the enormous amount of data 

tha t will be stored up. It does strike me, Mr. Chairman, that it 

would be very, very foolish economy to place any barriers in the way 

of dissemination of knowledge that is going to cost us hundreds of 

millions of dollars to acquire. There is no use storing up on the
MEDICAL LIBRAR Y ASS ISTANC E ACT OF 1 9 6 5 27

wharves unless we can put it aboard and get it in the hands of the 

practitioners. In fact, this is an economy proposal.

Thank you, Mr. Chairman.

Mr. Staggers. Mr. Younger.

Mr. Younger. Thank you, Mr. Chairman.

I want to join in the remarks made to Dr. Terry. I have always 

enjoyed your services and your testimony over the years. I have 

had the pleasure of serving all the time tha t you have. I wish you 

well in your new environment, and I know you will enjoy it.

Dr. Terry. Thank you, sir.

Mr. Staggers. Mr. Murphy.

Mr. Murphy. Thank you, Mr. Chairman.

1 would like to join my colleagues on the committee in expressing 

my gratitude in having been able to work with Dr. Terry. Although 

not having had the opportunity to have done it as many years as they 

have had, the short time I have been on the committee I don’t think 

I have found any person in any branch of the Government more 

willing to make himself available and to assist in the research that we 

go into in these various problems.

I know Dr. Terry—I think it was the wettest, coldest night of the 

year last year Dr. Terry and I had gotten together on the Public 

Health Service hospitals, the largest of which was in my district. He 

had just come in from a long trip, and 1 know he was trying to get out, 

but he stayed late tha t night just to assist me in the problem we had 

in the closing of those hospitals this year. I am certain tha t the 

Public H ealth Service hospitals are open and they are going to remain 

open largely because of Dr. Terry ’s influence and ability to stress to 

the President’s Commission on Hospitals the need for a Public Health 

Service.

Doctor, you may leave the Department and the Federal Government, but your imprint is going to be left behind for many years 

to come.

Thank you.

Dr. Terry. Thank you, Mr. Murphy.

Mr. Staggers. Thank you, gentlemen, very much for your testimony.

Mr. Cohen. Thank you, Mr. Chairman.

Mr. Staggers. Our next witness we are going to call out of order, 

because he has to leave for another meeting, and he will be brief. 

He will present his testimony for the record and make a brief sta tement. Dr. George E. Wakerlin, medical director of the American 

Heart Association.

STATEMEN T OF DR. GEORGE E. WAKERLIN, MEDICAL DIRECTOR, 

AMERICAN HEART ASSOCIATIO N, NEW YORK, N.Y.

Dr. Wakerlin. Mr. Chairman and members of the committee, this 

will be a very brief statement. I am pleased to have the larger 

statement for the record.

I am Dr. George E. Wakerlin, medical director of the American 

Heart Association. Our board of directors has instructed me to testify in support of the proposed Medical Library Assistance Act of 

1965, H.R. 3142 and H.R. 6001. very enthusiastically and with no
28 MEDICAL LIB RA RY ASSISTA NCE ACT OF 1965

qualifications or res erv ations. The board did, how eve r, place certa in 

emp hases which I sha ll tr y to convey.

We have circulated th e bills and our rea ctions to them among ou r 

55 affiliate and 236 ch ap te r he art associations. We have the assurance th at the proposal has been brought to the attention of a larg e 

pro portion of our 70,000 mem bers of whom ha lf are physicia ns.

We find no one who is opposed. Qui te the co ntrary, supp ort for 

it thr oughout our organiz ation has been str on g and outspoke n.

Now in regard to ce rta in inta ngible factors. Th e American Hea rt 

Association is primarily conc erned with the contr ol of diseases of the 

he ar t and blood vessels thr ough research , education, and com mu uity 

pro gram. Since 1948 th e association has emphasize d basic research 

in the belief th at the mo st direct route to the at tainm en t of its goals 

ru ns by the discovery of fundam ental causati ve factors. This, in 

tu rn , involves lab orato ry research, inv estiga tion at the bedside, and 

field studies.

In the past few years the re has been growing up amo ng us a conside rable uneasiness th a t som ething was missing from our general 

app roa ch to our goal. We began some tim e ago to recognize th e 

fact th at some of our applican ts, often brilliant and capable people, 

were freq uen tly no t sufficiently aware of th e bac kgroun d again st 

which the y were workin g. While we see some meri t in dup licating 

work for purposes of checking and cross-che cking, we see n oth ing bu t 

dis advanta ge in enc ourag ing an inv estiga tor, yo un g or old, to set ou t 

on a piece of rese arch w ith ou t first beco ming some thi ng of an au th or ity 

on wh at has gone before. This, of cours e, req uires careful and 

tho ughtf ul stu dy of th e rel evant literatur e via ade quate lib rary 

facilities.

Eq ually inta ngib le, but scarcely less im po rta nt , is the handica p 

imposed on im agina tive plan ning and syn the sis of research res ult s 

by inco mplete kno wledge of the scientific rec ord . These are the 

processes b y m eans of which the th ink ing a nd the discoveries of oth ers 

are molded and com posed to yield new insights and new dir ectio ns 

of att ack.

Th e proposed assistance to medical libraries bills would hav e th e 

effect, of con verting m an y of o ur biomedical lib rar ies from mere wa rehouses for books to activ e info rma tion centers , rece iving, processing, 

and above all, distr ibuting knowledge of the biom edic al field mu ch 

mo re widely and freely th an has ever been done before.

Now the tan gible fac tor s. So much the n for the intangibles. 

We believe the y are of paramou nt importa nce and resist the usual 

impression th at because the y are intang ible th ey are also neb ulous 

and unimportant.

We turn now to the firs t provision of the pro posed bills which provides fund s for co nstru cti ng new facilities and ren ov ati ng old ones. 

Th e abysmal physical plight of the Nat io n’s medical libraries is such 

common knowledge th at it hardly needs ela borat ion . We sha re in 

th e general impression th at adequately tra ined lib rary personnel is 

gro ssly ina dequate—an d this was mentio ned ear lier—to meet th e 

na tio na l need. We are especially impressed with the need for lib rary 

person nel who are convers ant with medical su bjec t m atter and concep ts.

Th e matter of special fellowships. Th e pro posal to establ ish 

special fellowships for cre ati ve lib rary work in the biomedical an d
MEDICAL LIB RA RY ASSISTAN CE ACT OF 1 9 6 5 29

social sciences is worthy in itself and should be supported in our 

opinion provided such fellowships cannot be more logically included 

in existing programs. The matter of funds for improving and expanding basic researches.

Next the funds for construction. We regard this provision of the 

bills to be the most fundamental. It would provide in some instances 

for much needed expansion of holdings, especially of periodicals. 

Perhaps more important, it would give small libraries the opportunity 

of building up microfilm or microcard collections covering items that 

are unprocureable in the original. We also trust that funds under 

this provision could be used where indicated to bring salary scales of 

library workers to a reasonable level.

Then the matter of research and development. The proposal to 

support research and development in medical library science is especially important in view of rapid progress in storage and retrieval 

techniques, methods made mandatory by the explosive increase in 

the publication of biomedical material.

Then, financial support of biomedical and scientific publications. 

The American Heart Association strongly approves the proposal of 

financial support for appropriate biomedical scientific publications of 

a nonprofit nature, and lastly, the regional medical libraries provision. 

The American Heart Association fully supports the provision relating 

to regional medical libraries, but urges that careful consideration be 

given in its implementation to existing medical library developments 

of a regional nature. Special consideration should, we believe, be 

given to the library and information needs of the practicing physician.

And in conclusion, the American Heart Association puts itself 

solidly on record as strongly favoring the medical library assistance 

proposal H.R. 3142 and H.R. 6001 in the belief tha t it will make a 

contribution to the health of the Nation out of all proportion to the 

amount of money requested.

Thank you, Mr. Chairman.

(Dr. Wakerlin’s full sta tem ent follows:)

Statement of Dr. George E. Wakerlin, Medical Director, American

Heart Association

I am Dr. George E. Wakerlin, med ical director of the American Hea rt Association. Our board of directors has instructed me to testify in sup por t of the 

proposed Medical Library Assistance Act of 1965 (H.R. 3142 and II.It. 6001) 

very enthusiastically and with no qualifications or reservations. The board did, 

however, place certain emphases w hich I shall try to convey.

We are honored and pleased to hav e the opportu nity to offer support for this 

very fine proposal. As a ma tte r of fact, our first reaction to it was to wonder 

why it has been so long in coming. We have circulated the bills—and our reaction to it —among our 55 affiliates an d 236 chapter hea rt associations. We have 

the assurance th at the proposal has been brought to the attention of a large proportion of our 70,000 members (of whom half are physicians). We find no one 

who is opposed; quite the on c ontrary, support for it thro ugh out our organization 

has been stro ng and outspoken.

inta ngible factors

The American Heart Association is primarily concerned with the control of 

diseases of the heart and blood vessels through research, educ ation, and community program. Since 1948 the association has emphasized basic research in the 

belief th at the most direct route to the attainme nt of its goals runs via the discovery of fundam enta l causative factors. This, in turn, involves laboratory 

research, inve stiga tion a t the bedside, and field studies. We have supported and

53-7 62— 65------ 5
30 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

implemented work of this sort to the full extent of our resources, always placi ng 

the main emphasis on the support of people rather than on glittering glassware, 

laborato ry chromep late, and electronic machin ery. Bu t, in the past few years, 

there has been growing up among us a considerable uneasiness th at something was 

missing from our general approach to our goal. We began some time ago to 

recognize the fac t tha t many of our applicants, often brilliant and capable people, 

were frequently not sufficient ly aware of the background against which t hey were 

working.

It was not—an d is not— unusual for us to receive requests to support work 

tha t has already been done in other regions and in other countries. And while 

we see some merit in dup licating work for the purposes of checking and crosschecking, we see nothing but disadvantage in encouraging an investigator— 

young or old— to set out on a piece of research with out first becoming someth ing 

of an authority on what has gone before. We have seen investigators follow lines 

tha t have long since been disproved; we have seen them struggle along using inadqua te methods despite the fact that a few hours in a good library would hav e 

placed much more powerful tools at their disposal; we have seen men work for 

months designing and perfecting apparatus tha t was alread y in highly successful 

use in other laborato ries. And we have sat in scientific audiences listening to 

brillian t young inve stiga tors proudly layin g out the results of their studies, 

only to have someone rise, after the initial applause has died down, and sa y: 

“ We entirely agree with these results. In fac t, we did the same work and came 

to the same conclusions 10 years ago.” There then follows the citing of a pub ­

lished reference to subs tant iate the claim and the you ng investigator retires not 

in triumph, but in hideous embarrassment.

But it is not a young ma n’s discomfort tha t should concern us at such time s. 

Unfo rtuna tely, he receives what he deserves. It is the harsh and troublesome 

fac t that duplication of research in ignorance and withou t conscious plan is 

horribly wasteful and expensiv e. It is expensive not only in dollars, but also 

in terms of scientific progress and intellectual effort.

We have no figures—no totals in dollars—to subs tant iate this burden. Records 

of this sort of inve stigativ e mishap are not usually kept; indeed, the people involved are usually asham ed of the fact and have no wish to advertise it. Bu t the 

intangib le cost to our Na tio n’ s research effort and progress must be stagg ering.

Equa lly intangib le, bu t scarcely less important, is the handicap imposed on 

imaginative planning and synthesis of research results by incomplete knowledge of 

the scientific record. The se are the processes by means of which the think ing and 

the discoveries of others are molded and composed, to yield new insights an d new 

directions of attack . An d it is always, partl y or entirely, through the medium 

of the written record th at men’s minds come into effective contact and begin to 

move off on independent new scientific errands. M an y of us in the Ame rican 

Heart Association have begun to realize that we have, in the past, given insufficient 

weight to the necessity of stu dyin g the scientific record in depth as an indispensable 

forerunner to labor atory , bedside, or field studies. We have begun to appre ciate 

the damage done when a young and inexperienced investigator is allowed, and 

even urged, to rush blin dly into the laborato ry with out first having caref ully 

and though tfully studied the relevant literature. We wish to stress our profound 

conviction tha t sound scholarship is neither a luxury nor evidence of weakness 

It is rather, an utter necessity and the hallmark of the creative, successfu l 

researcher.

We immediately realized, when we began to stud y the proposed assistance to 

medical libraries bills ( II .It. 3142 and II .R . 6001) tha t implementation of it 

would go a long way to correct the dangerous imbalance that has developed in 

biochemical research; an imbalance created by a d isproportionate emphasis on the 

test tube method of answering questions; a distortion that has the effect of banishing forever any printed contribution that is more tha n a few months old. It will 

also have the effect of converting many of our biom edic al libraries from mere 

warehouses for books to active information centers; receiving, processing, and 

above all distributing knowledge of the biomedical field much more widely and 

freely than has ever been done before.

But we realize t hat no matter how freely scientific literatu re is made ava ilab le, 

the effort will be useless unless our researchers are w illing to sit down and digest it. 

Such a willingness is har dly likely to be direc tly created by passing a law; but it 

will begin to develop when an appropria te climate is created. Much of this is th e 

responsibility of our univer sities, and our directors of research, but the proposed 

bill, if enacted, will be very influ entia l in t his direction. Such a move will provide 

eloquent evidence th at our nation al leaders understand and accept the vit al
MEDICAL LIBRAR Y ASSISTANC E ACT OF 196 5 31

necessity to read and digest other me n’s views and results, as well as to labor in 

the labor atory with vigor and with wisdom.

T A N G IB L E FA CT OR S

So much, then , for t he inta ngib les. We believe th ey are of param ount importanc e an d resist the usual impression th at because they are inta ngib le the y are also 

nebulous and unimportant.

I turn now to the first provision of the proposed bill which provide s funds for 

const ructing new facilities and reno vati ng old ones. The abysmal physical plight 

of the Na tio n’s medical libraries is such common knowledge that it hardly needs 

further elaboration. But it should be noted that the recent const ructio n of a few 

very splendid medical libraries is only a small beginn ing. Our contac t with 

medical schools and their libraries is a close and continuing one; and we have 

noted with increasing dismay and bewilderment the general neglect of such libraries 

by the med ical schools themselves. Th ey h ave used funds (their own and Federal 

funds) for other types of construction imag inati vely and agres sively , but the gross 

inade quacy of library buildings and facilitie s has usually gone unrelieved as if it 

were a matter o f lowest priority; an item which can safely be ignored indefinitely. 

Eve n where we have found efforts t o relieve the inadequacies underway, we have 

often been amazed at the inade quacy of the efforts themselves; at the incredible 

lack of comprehension of the basic relation of medical libraries t o med ical research 

and education , especially at the stud ent level.

Doc umenta tion of this long-n eglecte d need is readily availab le and undoubtedly 

has been, or will be, presented to t his committee by authorities in libra ry planning. 

But the fac ts tha t over half our medical school library building s are more than 

30 years old and t hat over half of t hem are filled far beyond their nomina l capacities (Ada ms: J . Med. Education 38-20-2 7, January 1963) are cert ainly worth 

notin g. It is also of interest tha t med ical schools have for years been devoting 

about 1.5 percent of their incomes to their medical libraries and tha t the figure 

has not quite kept pace with incre asing income in recent years. Bu t, in our 

minds, the figure has been much too low all along, and man y of the deficiencies 

in our medical educatio nal system can logic ally be attri bute d in some measure to 

this fac t. I believe I can say with almost universal agreem ent that medical 

school libraries are undoubte dly the most neglected of all medic al school facilities. This generalization, inci den tally, includes their collections and operating 

budgets as well as their physical plan ts.

One should certain ly note, in passing, tha t the plight of many medic al libraries 

tha t are not parts of medical schools is likewise dismal. The Amer ican Heart 

Association depends in some measure on several such libraries and feels strongly 

tha t they should share in the use of Federal aid for upgr ading facilities and 

services and for protection of their invaluab le collections. We believe , in fact, 

tha t a good case can be made for incre asing the amount of money to be made 

available for construction in the first 2 years. And we suggest th at consideration be given to a flexible matching policy so that the Federal contr ibuti on might 

vary from 50 to 90 percent of the cost of construction, depe nding on circumstances. Th is is in line with our continu ing concern tha t under a rigid l-to-2 

matc hing policy, the affluent institutions may be able to partic ipate quite ea sil y; 

but those with inadequate funds of their own, where the need for upgradin g of 

facilities is ofte n quite urgent, may be unable to participate at all.

FU N D S F O R TR A IN IN G

We share in the strong general impression tha t adequately train ed library 

personnel is grossly inadequate to meet the national need. We are especially 

impressed with the need for library personnel who are conversant with medical 

subject matter and concepts. We suppo rt the request for tr ainin g fund s as stated 

and, in ad dition, hope that some co nsideration can be given to m ethods of inducing 

graduate physicians to consider b ecomi ng professional medical librarians . Some 

such move seems to us to be very much indicated and would, we believe, be an 

important step toward bringing physicia ns in both practic e and research into 

more effective conta ct with the biomedica l literature.

SPE C IA L FE L L O W SH IP S

The proposal to establish special fellowships for creative literary work in the 

biomedical and social sciences is worthy in itself and should be s uppor ted, in our 

opinion, provided such fellowships cannot be more logica lly included in existing
32 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

programs. They would not, however, meet the specific need for a mechanism 

to bring trained physicians into medical library work. We find the fellowship 

proposal of interest primarily in that it may serve as one means of attacking 

the growing need for better communication between the biomedical professions 

and the lay public. Such fellowships could, we believe, be made to provide 

suitable physicians with the necessary time and professional advice to enable them 

to turn out authoritative reports primarily designed for lay consumption. It 

might also make it possible for certain physicians to contribute communications 

in depth in fields, such as medical history, that tend to narrow the gap between 

medicine and the humanities.

FU N D S FO B IM PR O V IN G AN D EX P A N D IN G B A SIC RESO U R C ES

Next to funds for construction, we regard this provision of the bill to be the 

most fundamental. It would provide in some instances for much needed expansion 

of holdings, especially of periodicals. Perhaps more important, it would give 

small libraries the opportunity of building up microfilm or microcard collections 

covering items that are unprocurable in the original. Runs of many important 

biomedical journals, for example, can often be acquired in this form at reasonable 

cost but are prohibitively expensive (or unprocurable) in the original. Such funds 

would also make it possible for libraries to expand their copying facilities so that 

most loans can be issued in copy instead of in the original. This system, now 

thoroughly tested in several centers, not only spares wear and tear on the original 

source but provides the reader with a permanent copy for his own use. We also 

trust that funds under this provision could be used, where indicated, to bring salary scales of library workers to a reasonable level. In many instances, library 

workers are paid at the bottom of an institution’s pay scale and desert the library 

as soon as a better paid opening is available. We believe the descending scale of 

awards under this provision ($200,000 or 60 percent of annual operating expenses 

in the first year; 50 percent in the second; 40 percent in the third, and so on) to be 

wise and hope that it may serve to induce parent institutions gradually to increase 

the amounts allocated to their libraries.

R E S E A R C H AN D D EV E L O PM E N T

The proposal to support research and development in medical library science 

is especially important in view of rapid progress in storage and retrieval techniques, methods made mandatory by the explosive increase in publication of 

biomedical material. Also to be considered are improved methods of copying and 

transmission and other items.

The American Heart Association regards the proposal as a reasonable component 

of the larger plan to improve the Nation’s medical libra ry facilities.

FIN A N C IA L S U P P O R T O F BIO M EDIC A L S C IE N T IF IC PU B L IC A T IO N S

The American Heart Association strongly approves the proposal of financial 

support for appropriate biomedical scientific publications of a nonprofit nature.

Certain needed scientific journals, particularly of a technical nature with 

relatively limited, but crucial, readership, not infrequently require financial 

assistance in the beginning years and in some instances, in subsequent years as 

well. Likewise, other significant scientific publications may never appear without 

financial subsidy. A recent example in the caridovascular field is the Journal of 

Lipid Research (for biochemists and other investigators in atherosclerosis and 

related research) which was established with wisely expended Federal funds. 

Likewise, the “ Proceedings of the 1964 Second National Conference on Cardiovascular Diseases” and the “ Summary of the Conference” are being published 

through joint support of the National Heart Institute, the heart disease control 

program, and the American Heart Association.

Since certain highly meritorious periodical publications may not achieve 

financial stability during the first 3 years, our association recommends that the 

restriction of grant support to 3 years be liberalized, certainly to 5, and possibly 

10 years.

R E G IO N A L M ED IC AL L IB R A R IE S

The American Heart Association fully supports the provision relating to regional 

medical libraries but urges th at carefid consideration be given, in its implementation, to existing medical libra ry developments of a regional nature.

We note, for example, that the Medical Library Extension Service of the 

University of Wisconsin has been in successful operation since 1926.
MEDICAL LIB RA RY ASSISTAN CE ACT OF 1 9 6 5 33

Simila r services are provided by the University of Nebraska in its State. 

Most significant, however, is the fac t that in both instances the service is not 

actually prom oted or advertised owing to the fact th at each is already operating 

to capacity (but on a very small scale). Similarly, the fars ighted efforts of the 

Medical Library Center of New York should be studied and facilitated in implementing this provision of the bills. Special consideration should, we believe, be given to th e library and information 

needs of the practicing physician. The Wisconsin and Nebrask a operations are 

primarily devoted to meeting such needs. In some States, including Texas, Sta te medical societies m aintain special collections and facilities to serve the needs 

of practicing physicians which are not, incidentally, always sim ilar to those of the 

medical stu dent or research worker. We believe th at the experience of such units 

should be carefully studied and th at any regional medical library plan should help the m to expand and upgrade the ir operation. The services they render are 

indispensable and, in most instances, overtaxed. Whether or not such units 

join a regional library plan, or cooperate as an independent u nit, should, of course, 

be optional. In the la st analysis, regional orga nization of medical library facilities is the only 

solution to the problems created by sm all collections, in ade qua te operatin g funds, 

and the costliness of modern bibliographic and copying machinery. The American 

Heart Association believes th at th e provision relating to regional medical libraries 

will g reatly facilitate existing efforts at regionalization and considers it a wise and 

useful component of the bills. In conclusion, the American Hea rt Association puts itself solidly on record as 

strongly favoring the Medical Lib rary Assistance proposal (H.R. 3142 and H.R. 

6001) virtually in its entirety. Ev en with careful consideration, we can find no 

serious fau lt with it. More positively, we believe it will make a contribution to the health of the 

Nation th at is out of all prop ortion to the amount of money requested. Fund s 

for construction and renovation, on a matching basis which should be negotiable 

within wide limits, are very urge nt. So are funds for expansion of collections and 

services. Train ing funds are scarcely less important and we urge that some 

means of making the career of medical librarians attra cti ve to physicians be 

earn estly sought. The use of fun ds for research in library and bibliographic 

techniques seems eminently sensible to us and we hope it will receive favorable 

consideration. We are especially impressed with the need for Federal funds in 

support of special types of medical publications. It is parad oxical that there is 

a sizable num ber of biomedical publications which, although of litt le commercial 

promise, are inordinately valuable scientifically. Finally we su pport the regionalizatio n of medical library facilities as a logical and highly useful provision. And 

we again urge that in planning regional organizations previously established units 

be considered and assisted; and th at the library needs of prac ticing doctors, as 

well as oth er categories of physicians, be take n into account.

Finally, the American Heart Association finds th at the tangible reasons for 

supp orting the proposal (H.R. 3142 and H.R. 6001) are qui te compelling but 

wishes nevertheless, to place greatest emphasis on the intangible. We believe that 

progress in biomedical research will be more effectively served by renewed emphasis 

on sound scholarship th an by any oth er single action now open to us. The medical 

libraries assistance proposal, if implemented, will be a g iant stride in th is direction.

The Chairman (Mr. Harris presiding). Thank yon very much, 

Doctor. Tha t concludes your statement?

Dr. Wakerlin. It does, indeed, sir.

The Chairman. Should you desire to extend your remarks on the 

subject in the record, you may have that permission.

Dr. Wakerlin. Thank you, sir.

The Chairman. Are there any questions?

We than k you for your appearance and for your presentation on 

this highly important matter.

Dr. Wakerlin. Thank you.

The Chairman. We are glad to welcome the next witness, also, 

Dr. William A. Sodeman, dean, Jefferson Medical College, Philadelphia, who has with him Dr. Ruhe and Mr. Paul Donelan of the 

legislative department.
34 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

We are pleased to have you gentlem en an d we shall be glad to 

receive you r sta temen ts.

STATEMENT OF DR. WILLIAM A. SODEMAN, AMA COUNCIL ON

MEDICAL EDUCATION; ACCOMPANIED BY DR. C. H. WILLIAM

RUHE, ASSISTANT SECRETARY, COUNCIL ON MEDICAL EDUCATION; AND PAUL DONELAN, LEGISLATIVE DEPARTMENT,

AMERICAN MEDIC AL ASSOCIATIO N

Dr . Sodeman. Tha nk you, Mr. Chairma n.

Mr. Cha irman and me mb ers of the committee , T am Dr. William A. 

Sodeman, a phy sician residing in Phi lad elp hia , Pa . I am dean of the 

Jefferso n Medical College of Philad elphia and serve as a mem ber of 

the American Medica l Association Council on Medical Ed ucation. 

With me t oday are Dr. C. H. William Ruhe, as sistan t secreta ry of the 

AM A Council on Me dical Ed ucation, and Mr. Pa ul R. M. Donelan, 

an att orne y on the staff of the AMA Legislative De partm ent.

Th e American Me dical Associatio n has alw ays recognized the 

importance of medical libraries at all levels of edu cation of healt h 

personnel. Evidence of thi s is con tain ed in sta temen ts of the 

“essen tials” of various edu cat ion al program s acc red ited by the AMA 

Council on Medical Ed uc ation. For example, the following pa ragrap h 

is con tain ed in “F un ctions and St ructure of a Modern Medical 

School,” a sta temen t developed by the American Medical Asso ciation 

and the Associatio n of American Medical Colleges as a general guid e 

in the medical school accre dit ati on pro gra m:

A well-maintained and cataloged medical library tha t can be used conveniently 

and effectively by both stu dents and faculty is essential to a modern medical 

school. A trained librarian with experience in medical library work should be 

employed to supervise the development and operation of the library with the 

advice and assistance of an active representative committee of faculty. The 

libr ary should receive regularly the leading medical periodicals, the current numbers of which should be readily accessible. Adequate arrangem ents should be 

made by the librarian and the faculty to ins truct all stu dents in the use of the 

library at the beginning of th eir medical studies.

Similar sta temen ts m ay be found in the “E sse nti als of Approved 

Internships,” “E ssentia ls of App roved Re sid enc ies,” “Esse ntials of 

an Accepta ble School of Medica l Tec hnology,” “E sse ntials of an Accre dited School of X -R ay Techn ology,” “Essentia ls of an Acc eptable 

School of Oc cup atio nal The rapy ,” “Esse ntials of an A cceptab le School 

of Cy to techno logy,” “E sse ntials of an Accep tab le School of Physical 

The rapy ,” “Es sen tials of an Acc epta ble School for Medical Recor d 

Librarian s,” and “E ssentia ls of an Acc eptable Scho ol for Inha latio n 

The rapy Techn icians .”

'Plie medical lib rary is likewise recognized as playin g an im po rta nt 

role in the con tinuin g edu cation of the practic ing physician . Th e 

AM A’s “Guide Re garding Objectives and Bas ic Principles of Co ntin uin g Med ical E du ca tio n Program s” cites the med ical l ibr ary as o ne 

of the im po rta nt facilities which should be avail able to the physicianstud en t.

Th e curre nt bills, H .R . 3142 and H.R . 6001, are based on the 

prem ises th at the massive gro wth of knowledge in the hea lth sciences 

in the pa st 20 years ha s not been ma tch ed by a gro wth of lib rary
MEDICAL LIB RA RY ASSISTANCE ACT OF 19 6 5 35

facilities and techniques, and tha t much of the value of the knowledge 

and information may be lost unless proper measures are taken to 

develop the appropriate facilities and techniques. The American 

Medical Association is in agreement with these premises and believes 

tha t action should be taken to provide assistance in the construction 

of new facilities, the expansion and rehabilitation of existing facilities, 

the training of professional personnel and the development of new 

tools and methods for dissemination of medical knowledge and 

information.

Evidence of the need for assistance is available from information 

gathered through the annual report of the AMA Council on Medical 

Education, published in the November 16, 1964, issue of JAMA, and 

from a series of studies on the subject published in recent issues of the 

Journal of Medical Education.

A comparison of the 87 existing medical school libraries with 

minimum standards recommended by a joint USPHS-AMA-AAMC 

committee (table I) showed that the average existing library was well 

below recommendations in space, volumes and serial titles during the 

1963-64 academic year.

T a b l e I. — Comparison of existing libraries with recommended standards

Recomme nded *

Ex ist ing Num be r

above

recomAverage M ed ia n me nded

Space (sq uare feet).................. .......... ...................... 29,560 18,000 10,000 15

V ol um es .. ___ 100,000 77,000 65,000 14

Serial title s r ec eive d_______________ _____ _. L600 1,340 1,200 22

1

 Fr om M edica l E ducatio n F acilitie s, U.S. D ep ar tm en t of He alth , Ed uc at io n, an d We lfare, Pu blic He alt h 

Serv ice, Pu bl icatio n 1180-A-lb, 1964.

Sou rce: Jo ur na l of the Am erican M ed ical Associa tion, vol. 190, No. 7, Nov . 16, 1964, p. 615.

Review of the information provided by the 87 medical schools in 

existence during 1963-64 revealed startling variations in size and 

holdings among the various school libraries. The number of volumes 

held ranged from 2,000 to 359,000; the number of serial titles from 

275 to 5,057. The range in annual budget was from $13,000 to 

$382,101, and the number of full-time staff varied from a low of 1 

to a high of 55. Details are given in table II.

T a b le II .— Medical school libraries, 196 3-6

To tal Range Average M ed ian

B u d g e t__ . . __________________ _________ $8,519,412 $13,000-8382,101 $99.000 $80,000

Volum es _______ ____ _______________________ 6,751,150 2,000- 359,000 77,000 65,000

Ac quisitions . . _ . _________ . _ ___ 285,278 181- 14,612 33,000 2,800

Serial titles c ur rently re c o rd e d .. _______________ 116,568 275- 5,057 1,340 1,200

Space (sq uare feet)______________ ___ _ ______ 1,606,711 1,809- 83,497 18,000 10,000

Seat ca pa ci ty ___ _ . .. _____________________ 13,492 38- 496 155 140

Num be r of full-t ime sta ff______________________ 975 1- 55 11 9

Sou rce: Jo ur na l of th e Am erican M ed ical Associatio n, vol. 190, N o. 7, Nov . 16,1964, p. 615.
36 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

It is clear from these figures that one should not make general 

statements about the condition of all medical school libraries. A few 

appear to be relatively very well off, while many others fall below 

the minimum s tandards recommended by the joint committee.

Recent articles in the Journal of Medical Education have shown 

tha t expenditures for medical school libraries have not kept pace 

with the growth in their research expenditures, even though the 

marked increase in research activity has brought about greatly increased demands upon the library facilities. Similarly, the growth 

in complexity of activities in medical schools and hospitals has resulted in unusual demand upon the holdings and services of the 

medical library. Hosts of new professional, scientific, and technical 

personnel are seeking access to new kinds of scientific and medical 

information which many medical school libraries are simply not prepared to provide. As a result, there has been some impediment to 

the flow of productive research and to the availability of research 

information to professional practitioners.

Detailed information on the current status of private, independent 

medical libraries, of those in community hospitals, and of those in 

State and county medical societies and other professional medical 

societies is not available to us at this time. The AMA is undertaking a study of the status and needs of medical libraries of State 

and county medical societies; but the results will not be available 

until later this year.

The American Medical Association strongly supports the intent and 

purposes of H.R. 314 2 and H.R. 6001. We will comment, however, 

separately on each of the substantive sections of the bill.

SEC TIO N 39 3. A S S IS T A N C E FO R T H E C O N ST R U C TIO N OF F A C IL IT IE S

The American Medical Association supports the concept of the 

use of Federal funds for the construction of facilities. In implementing these provisions, we recommend that emphasis be given to the 

requirement tha t the construction meet demonstrated needs for additional or improved medical library facilities in the community or area. 

Properly favored, then, would be new medical schools and currently 

underprivileged institutions.

In addition, we would hope that care would be exercised in the 

administration of th e program, to prevent an overlap in grants with 

other Federal construction grant programs.

SE C T IO N 39 4. G R A N T S FO R T R A IN IN G IN M ED IC A L LIB RA RY S C IE N C E S

We believe tha t there is a need for professionally trained personnel 

in medical library science and in related health science fields, as well 

as in the field of communication of information. The provision of 

grants for traineeships and fellowships and for the establishment of 

new training programs, both for new persons entering the field and to 

modernize and improve the skills and knowledge of persons already in 

the field, is most important and the American Medical Association 

supports this section.
MEDICAL LIB RA RY ASSISTAN CE ACT OF 19 65 37

SEC T IO N 396. R E SEA R C H AND D E V EL O PM E N T IN M E D IC A L LIB R A R Y 

S C IE N C E AND RELA TED F IE L D S

Sec tion 396 provides for g rant s for proje cts of researc h and in vestigatio n in the field of me dic al lib rary science an d for “ the dev elopm ent 

of new techniques, syste ms and equip me nt, for processing, storin g, 

an d retrieving and di strib ut ing inform ation pe rta ining to sciences 

related to he alth .” We belie ve this section to be of pa rti cu lar 

im portance.

Sin ce emphasis is us ua lly placed on spac e, bu dg et, and lib rary 

holdings, the im po rta nt aspect of uti liz ati on is often overlooked. 

Th e critic al fac tor in the value of a med ical lib ra ry is, aft er all, the 

qu estio n of how effe ctiv ely its stored inf orma tio n is ma de ava ilable 

to th e lea rner in response to his need. Th e lar gest an d mo st magnifice nt lib rary is of littl e va lue until its sto reh ouse of inform ation is 

ac tu ally in use. New metho ds of meeting the req uirem ents of the 

lea rner m ore quickly an d efficiently are bad ly need ed, an d we stron gly 

su pp or t this section which is int ended to develop suc h new metho ds.

S E C T IO N 39 7. GRA NTS FO R IM PR O V IN G AN D E X PA N D IN G BASI C R E SO U R C ES 

O F L IB R A R IE S

Thi s section wou ld prov ide the means for lib rarie s to imp rov e 

their hold ings of book s, jou rna ls, et cetera, and th us str en gth en their 

bas ic reso urces and facilities. The provisions pe rm itt ing acq uisition 

of films, projectors, du plica tin g devices, an d new tech nologic equ ipm en t are pa rticular ly va luab le since mo st medical libr aries are deficien t in thes e areas. Th e AM A support s this sec tion of the bill.

SE C T IO N 398. GRANTS FO R E ST A B L IS H M E N T OF R E G IO N A L M ED IC AL 

L IB R A R IE S

The concept of havin g a strong medical lib rary in each region of 

the co un try to serve as a sou rce of su pp ort for ot he r librarie s in the 

area appears to be a rea sonable one un der present con ditions.

The purpose of thi s sec tion would seem to be bes t fulfilled by 

str en gth en ing existing me dic al libraries in str ateg ic locatio ns to serv e 

as regional libraries. Exc ep t in the unusual circum stance s where a 

geo graphic area is comp letely lack ing in lib rary reso urces, new and 

se pa rate regional libraries need not be established.

SE C T IO N 39 5. A SSIS TA N CE TO SPEC IA L S C IE N T IF IC P R O JE C T S , AN D SECT IO N 399. FIN A N C IA L S U P P O R T OF B IO M ED IC A L PU B L IC A TIO N S

We ma ke no specific co mm en t as to section s 395 and 399. However, the need for thes e pro visions is less ap pa rent to us.

M r. Ch air ma n and mem bers of the sub comm ittee, the American 

Me dic al Associatio n ap preciat es this op po rtu ni ty of presen ting its 

view s on this im po rta nt legi slation . We will be pleased to atte m pt 

to answer any questio ns th e com mittee m ay h ave .

Th e C hairman. Do cto r, th an k you very much.

I wonde r if Dr. Ru he or Mr. Don elan hav e an y fu rth er com ments 

to ma ke.

63-7 62— 65------6
38 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

Mr. Donelan. N o, sir.

Dr. R uh e. No, sir.

The Chairm an. Are there any que stio ns amo ng members of the 

committee?

Mr. Macdonald. Mr. Chairm an.

I hav e list ene d to your very fine statem en t, and I am glad to see 

th at you su pp ort the legislation, as I do. I was just wondering if 

AMA d id no t feel this would be Feder al interfere nce w ith the practic e 

of m edicine and res earch .

Dr. Sodeman. I belie ve the AMA believ es th at this is so und su pp or t 

for the h ealth of th e cou ntry.

Mr. Macdonald. Obviously this wou ld no t be leading to socia lized 

medicine, would it?

Dr. Sodeman. I do n’t see how it can, sir.

Mr. Macdonald. Because som etim es I ha ve difficulty follow ing 

the me nta l proc esse s of the AMA. Th ey su pp ort some things that, 

the Federal Go ve rnme nt does in the field of hea lth. Other tim es 

the y tak e a rat he r, sha ll we say, a dra stic po int of opposition to things 

th at we in the Congress try to do to help th e field of medicine.

Dr. Sodeman. Th is bill would give su pp or t to each an d every 

physicia n and res earch er in sha rpening his know ledge and the de pth 

of his knowledge in med ical science, and this is very im po rta nt.

Mr. M acdonald. I tak e it in th at area the AMA gives it full 

sup port.

Dr. Sodeman. The re is full support .

Mr. Macdonald. While in oth er areas th ey do not.

Dr. Sodeman. I t may be a m at ter of techniqu e, sir.

Mr. Macdonald. Th an k you very muc h.

The C hairma n. Are the re an y fu rth er question s?

Dr. Sode man, th an k you very muc h for yo ur very fine stat em en t. 

We are pleased to ha ve you gentlem en here in sup port of this legislation.

Dr. Sodeman. Tha nk you.

The C hairman. Th e next witness will be in b eha lf of th e Association 

of American Me dic al Colleges, Dr . Jo hn Pa rk s, George Wash ing ton 

Un ive rsity, in Wash ing ton , D.C ., and Dr. Ro bert C. Berson, th e 

executive dir ector of th e association.

Gentlem en, we ar e glad to have you. We shall be pleased to ha ve 

your s tatemen t.

STATEMENT OF DR. JOHN PARKS, DEAN OF MEDICAL SCHOOL,

GEORGE WASHINGTON UNIVERSITY, WASHINGTON, D.C.; AND

DR. ROBERT C. BERSON, EXECUTIVE DIRECTOR, ASSOCIATION

OF AMERICAN MEDICAL COLLEGES

Dr. Park s. Mr. Ch air ma n and memb ers of the com mittee , T am 

Dr. John Pa rks, de an of the George Wash ing ton School of Medicine 

and a mem ber of the E xec utive Council of the Asso ciation of Am eric an 

Med ical Colleges.

This is D r. Rob er t C. Berson, exe cutive director of the associatio n.

We are pleased to hav e this privilege to spe ak in behalf of thi s 

proposed bill.
MEDICAL LIB RARY ASSISTA NCE ACT OF 1 9 6 5 39

Speakin g for all the 87 me dic al schools in thi s co un try who constitut e th e insti tutio na l me mb ers hip of the Associatio n of American 

Medical Colleges, I wan t to express en thu sia stic an d unqu alified 

su pp ort for all prov isions of th is legislation and urge its passage at an 

early da te.

While the ma jor med ical lib rar ies in this co un try are loca ted in 

med ical school centers, larg e researc h complexes, an d the medical 

societies of a few metr op olita n area s, the re are over 6,000 medical 

lib rar ies servin g sma ller me dic al societies and co mmun ity hospita ls 

throug ho ut the Na tion.

Fo r a nu mb er of years responsi ble rep orts have indicated th at the 

med ical lib rar ies of the Nat ion are in a serious st at e of disrep air. It 

has been impossible for l ibraria ns to keep pace wi th the gro win g volume 

of scientific literature which is of such great importa nce to medicine.

Pr od uc tiv e medical resear ch is depend ent on access to th e releva nt 

lit eratur e. Ea ch r esearch project usually r esu lts in one or more pu blished articles or perio dicals an d as the numb er of res earch projects 

un derw ay in this and oth er countrie s has increased, th e volume of 

pub lish ed literature has gro wn at an asto nishing rate. Th e pro tection of our national investm ent in research requires ad eq ua te provision 

for ma kin g the published resu lts available to inv est iga tors.

Me dic al libraries pla y a ve ry im po rta nt role in th e edu cation of 

med ical stu de nts, denta l stud en ts, stu dents of public healt h and 

ve terin ary medicine, other stud en ts in the he alt h disciplin es, inte rns, 

and r esi dents . Fo r health care every whe re it is of g reatest importance 

th at pra cti cin g physicians ha ve access to ap prop ria te pa rts of the 

pub lish ed literature in ord er to keep abreas t of new dev elopm ents in 

th e stud y and care of the ir pa tie nts.

This tri ple role of th e me dic al lib rar y in pro vid ing a serv ice basic to 

research, edu cation, and pa tien t car e has made it difficult for existing 

natio nal pro grams to mee t th e nee ds of m edical libraries.

One of the most i mpo rtan t tra ditio ns of science h as alw ays been the 

free exchan ge of knowledge betw een scientists wh ere ver loca ted. It 

can tru ly be said th at the lite ra tu re of medical science as well as the 

pro blems it attempts to solve tra nscends natio nal boundar ies. At the 

prese nt tim e a considerable pe rcen t of the im po rtan t new’ periodicals 

in medical literatu re are pr in te d in lang uages other th an English. 

Th ere is a very active e xch ang e of literature betw’een o ur country and 

Russia, Ge rmany, Ital y and ot he r cou ntri es all ove r the w’orld. It is 

far mo re efficient to p rovide t rans lat ing, a bstra cting , an d bibliographic 

services to serve the en tire E nglish-speak ing world r at he r th an for each 

lib rary to at te m pt this type of tech nica l work. Th ere are unparal ­

leled oppo rtu nitie s for strong leader ship at the n ati on al level thro ugh 

the Na tio na l Libra ry of Me dicine.

Th e mo re than 6,000 me dic al libraries in thi s co un try reflect the 

efforts th at hav e been ma de throug h hos pitals, res earch ins titu tes , 

professiona l societies, and me dic al schools to pro vid e lib ra ry services. 

It h as bee n estimated th at the presen t investm ent in medical libraries 

in this co un try is som eth ing over $300 million, ess entially all of 

which ha s come from private, loca l, or State resources. Th e Medical 

Library A ssistance Act of 1965 recognizes th at these local sources will
40 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

continue to carry most of the library expenses. It also recognizes that 

Federal funds should be provided to augment these local funds and to 

strengthen the role of leadership of the National Library of Medicine 

in matters tha t can be handled effectively on a national basis.

Medical libraries are thought centers for medical scientists and 

physicians. Better medical library facilities are urgently needed to 

support the expanding educational and health programs of our 

Nation. The Association of American Medical Colleges strongly 

endorses the Medical Library Assistance Act of 1965 and looks 

forward to its early adoption.

That is our testimony, gentlemen. We shall be pleased to answer 

any questions.

TTie Chairman. Thank you very much, Dr. Parks.

Dr. Berson, do you have any further comment?

Dr. Berson. No, sir. We shall be glad to attempt to answer any 

questions.

The Chairman. Are there any questions by any members of the 

committee?

I would like to make this suggestion for those of you who are very 

cooperative in making the record—I thin k I will start with Dr. 

Dempsey. I believe this record should show information to supp ort 

the estimated expenditures. I would like more positive information 

as to what the estimates are. I know the bill proposes to utilize so 

much money for various purposes, but I do not see in any of your 

statements tha t have been presented yet any information as to what 

those requirements actually are going to be.

As an example, you testified for the need of certain construction. 

The Bureau of the Budget asked that this program be deferred, and 

I think with some merit, for at least a year in order tha t plans can 

be developed to provide more information. What I would like to 

know, Dr. Dempsey, is the justification for the amounts proposed for 

construction. We know that $10 million is estimated to be the amount 

tha t should be authorized. But maybe it should be $5 million or 

maybe it should be $15 million. There is no information here yet to 

indicate what the requirements will be. So, I would like to ask you, 

Dr. Dempsey, if you will give us more detailed information for the 

record to go along with your statement on what your estimated 

requirements will be for each of the budgetary items.

Dr. Dempsey. 1 will be delighted to furnish that.

The Chairman. For 1966, for 1967 and during the 5-year proposed 

program, so tha t we will have a record of what would be needed.

(The information requested follows:)

M r. J ames M . M e n o e r , P r o fe ss io n a l St a ff M e m b e r, H ouse I n t e r s t a t e

a nd F o r eig n C omm er ce C o m m it t ee

Mr. Menger, in response to Chairman Harris ’ request, we are tra nsmitting 

herewith, two sta tem ents of appropriations requiremen ts together with our 

justifications for the Medical Library Assistance Act.

The first of the sta tem ents is based on the authorization as set forth in the bill: 

The second embodies our recommendations for a uthoriz atio ns which could provide 

for maximum flexibility and efficiency of adm inistration.

You will note th at the 5-year totals arc $117.5 million in each case.
MEDICAL LIBRARY ASSISTANCE ACT OF 19 65 41

Appro priations authorizations recomm ended by Department of Health, Education,

and Welfare to carry out the proposed Medical Library Assista nce Ac t of 1965

(II.lt. 31W

[In millions of dollars]

1966 1967 1968 1969 1970

Con struction of f acilitie s... . . . ____________________ 12.5 12. 5 12.5 12.5

Training in medical libra ry sciences---------------------------------- 1.0 1.0 1.0 1.0 1.0

Special scientific projects----------------- --------------- . . .

Research and deve lopm ent in medical library science and

.5 .5 .5 .5 .5

related fields_____ ________________ .. --------------------

Improving and expa nding the basic resources of medical

3.0 3.0 3.0 3.0 3.0

libraries and related instrumentalities__ . .. . .. 3.0 3.0 3.0 3.0 3. 0

Support of biomedical oublications_________ . . . .. . ___ 1.5 1.5 1.5 1.5 1.5

Regional medical libraries . __ 2.5 2.5 2.5 2.5 2.5

Regional branches of the Na tional L ibra ry of Me dicine______ 2.0 2.0 2.0 2.0 2.0

Tota l... _______________________________ _______ 13.5 26.0 26.0 26.0 26.0

Alternative method o f authorizing appropr iatio ns to carry out H .R . 3143

[In millions of dollars]

1966 1967 1968 1969 1970

Construction of facilitie s... _______ _ ____ _______ 50 (') (') (')

Training , special scientific projects, research and dev elopment,

resources, p ublications support .. . _______ ____ 4. 0 7 10.0 12 12.0

Regional medical libraries or regional branches of N LM ______ 1.5 3 5.5 6 6.5

i Total app ropriation authorization for 1967 thro ugh 1970.

SECTION 393. ASSISTANCE FOR CONSTRUCTION OF FACIL ITIES

Based on information obtained from various health professional organizations, 

from governm ental agencies, and by its own resources, the Nation al Library of 

Medicine has determined th at an am ount of $50 million made available over a 

period of 4 y ears will make a significant imp act in reducing the backlog of constru ctio n and renovatio n needs of health science libraries. Since the re has been 

very little new construction of h ealth science libraries in recent years, it appears 

th at the large r need is for new construc tion rath er than for renova tion of existing 

facilities. This is confirmed in the case of the stud y of medical school libraries 

conducted by the Association of American Medical Colleges in 1964. This study 

disclosed th at 80 established medical schools required $87,217,062 for planned 

library construction. In addition new construction for free stan ding medical 

libraries and those in other health professions such as den tistry, public health, 

osteopathy, and optometry will requ ire an additional $10 million. At the 75- 

percent matching rate allowed in the bill, these projects would require somewhat 

more than $72 million.

SECTION 394. GRANTS FOR TRAIN ING IN MEDICAL LIBRARY SCIENC ES

The manpower deficit in th e medical librar y field is evident when one considers 

th at there are abo ut 6,000 functioning medical libraries in the cou ntry bu t only 

about 3,000 librarians with specialized training or experience. It is n ot suggested 

th at all these libraries need be manned by highly trained professional librarians. 

Many of the smaller ones could be opera ted by library technicians. At the present 

time less t han 50 new medical librarians are being added to the manpower pool 

per year. The appropriation authorization ($1 million) contained in H.R. 3142, 

section 394, would permit the support of approximately 200 individuals per year 

for training in biomedical inform ation work. Since not all of th ese would be in 

1-year programs, it is estimated th at between 125 and 150 new personnel could 

be added to the manpower force ann ually. During the 5-year period of this 

program, approximately 750 information personnel will be trained at 20 academically based training centers.
42 MEDICAL LIB RA RY ASSISTANCE ACT OF 19 65

SE CTI ON 395 . A SSIS TA N C E TO SPE C IA L S C IE N T IF IC PR O JE C TS

This section would allow for supp ort of qualified individuals who need to use 

the extensive collection of medical literature within th e Isational Library of 

Medicine or within other large research libraries for th e compilation of existing 

information or th e preparatio n of original contributions in the sciences related to 

health. There are very few opportunities presently available to the medical 

scientist to devote a period of full-time effort to intensive examination of the 

scientific record and to prod uce a thoroughgoing evaluation and synthesis of the 

work tha t has been accomplished. This section authorizes the appropriation 

of $500,000 per year for this purpose. This sum will suppo rt the studies of approximately 25 medical scholars per year or approxim ately 125 individuals for the 

5-year authorization of $2,500,000.

S E C T IO N 396. RESE ARCH AND D EV ELO PM E N T IN M ED IC AL LIB R A R Y SC IE N C E AN D 

R ELATED FIE LD S

Research and development projects, utilizing grants and contracts, will be 

reviewed, selected, and sup ported on the basis of their potential contribution to 

the biomedical information field. Such projects will include studies designed to 

define the information needs of workers in the health field, to stud y means of 

improving access to and transmission of information, and to explore the ins titution al interrelationships of organizations and facilities engaged in the acquisition, 

processing, and dissemination of biomedical inform ation.

The Medical Library Assistance Act will allow a total of $15 million over a 

5-year period. Since much of such research and deve lopment work involves longterm observation and assessm ent it can be expected th at many projects will 

require 3 to 5 years for completion. It is hoped th at the funds for expected 

increases in cost per project on contin uing projects can be balanced by the funding 

of some studies for no more tha n 1 or 2 years.

S E C T IO N 397. IM PR O V IN G A ND EX PA N D IN G T H E BASI C R ES O U R C E S O F M ED IC AL 

L IB R A R IE S A ND R ELA TED IN S T R U M E N T A L IT IE S

Resource needs for libraries in schools of medicine, den tistry, osteopathy, 

nursing, and hospitals is estim ated to exceed $85 million. II.R . 3142 authorizes 

an appropriation of $15 million spread over 5 years. The large discrepancy 

betw een the need and the requested appropriation authorization is justifiable at 

this time because of two circu mstances: (1) the program authorized by H.R. 

3142 is a descending matching one and local funds will m eet a part of the need, 

and (2) it is possible th at the magnitude of the need for local resources will d ecrease with the rapidly developing technology. Because of the wide discrepancy 

between the need and the available funds, some ratio nale must be established 

for the most effective way in which to use th e available funds.

The uses for which grants are made for resources may include but are not lim ited 

to the acquisition of books, journals, photographs, motion pictu res and other 

films, and other similar materi als; cataloging, binding, and other services and 

procedures for processing librar y resource materials for use by those who are 

served by the library or related instrum entality; acquisitio n of duplication de ­

vices, fascimile equipment, film projectors, recording equ ipm ent and other e quipment to facilitate the use of the resources of the library or relate d instrum enta lity 

by those who are served by it; and the introduction of new technologies in medical 

libra rianship.

Three main groups of library users need to be considered: O) students and 

faculties in academic ins titu tions; (2) physicians and oth er health professionals 

who are providing direct services to th e public; and (3) researc h workers.

Afte r careful review, the funds will be made available to selected libraries in 

professional schools in the health sciences, nonprofit, free standing libraries, and 

to institu tions where research, teaching, or the prac tice of medicine play an 

im po rta nt community role. It is not intended to provide sup port to all existing 

medical libraries, bu t rather t o those who show promise in providing the greates t 

service at the least cost.

SE CTI ON 398. E S T A B L IS H M E N T OF R E G IO N A L M ED IC A L LIB R A R IE S

Th e purposes to be accom plished by this section are the following:

1. To insure the equality of access to the documents comprising tho 

scientific record of medicine by all professional workers in the health fields^
MEDICAL LIB RA RY ASSISTAN CE ACT OF 19 65 43

2. To improve the quality of access to these docum ents in term s of speed 

and ease and thereby insure t he widest dissemination of research results and 

their application to health practic e.

3. To avoid the necessity of costly duplication of extensive collections and 

lessen competition for library materials now in short supply.

To esta blish and assist regional m edical facilities in accom plishing these purposes 

an amount not to exceed $2,500,000 for any fiscal y ear is requested. The 5-year 

authorization of $12,500,000 would provide for the esta blishment and supp ort 

of eight regional medical libraries. Two centers would be funded during the 

first year of the program, three centers the second year and three centers the third 

year. During the first 3 years most of the funds would be utilized to provide the 

necessary construction or ren ova tion as required by the existing facilities with 

the rem aind er providing other resources. The amounts to be expended for 

construction as opposed to other resources will reflect the vary ing needs of the particu lar centers to be chosen a nd the limitation imposed by the legislation. Fun ding a fter the third year would con cen trate on acquisition of books, journals, etc., 

and the a ddition al services made possible by th e earlier, nonrecu rring construction 

expenditures.

SE C T IO N 399. FIN A N C IA L S U P P O R T O F BIO M EDIC AL S C IE N T IF IC P U B L IC A T IO N S

The efficient provision of biomedical information to the health science community requires publication forms oth er than original journal articles. Translations. bibliographies, abs trac ting services, indexes and critical reviews are examples of the types of services which would be provided under this section. In 

addition, a program of analysis of the movement of information from the primary resea rch articles to the scientific and medical consumer would be carried 

out in order to identify the specific needs for the many segm ents of that consumer group for these secondary publications. The 5-year appropriation authoriza tion of $7.5 million would sup port 35 high-priority publication projects 

per year with the annual authorization of $1.5 million.

S E C T IO N 378. REG IO N A L B R A N C H E S O F TH E NATIO N A L LI B R A R Y O F M ED IC IN E

In geographical areas where no health science library exists which is suitable 

as a base for development as a regional library, this section would allow the 

establish ment of a branch of the Na tional Library of Medicine to serve the needs 

of that area. The $10 million, 5-year authorization would allow for the esta blishment and operation of one such branch. Major construction would be 

emphasized during the first years. The continuing support of the facility would 

be required during the rem aining yea rs of the annual author ization of $2 million.

The Chairman. Dr. Sodeman, if you have information in your files 

as to what you think will be needed in this program I would welcome 

such additional information as you can give us. What do you think 

the requirements will be, for example, for construction, or for training, or for these various purposes? We wotdd like to get down to 

more specific items.

If you gentlemen representing the American Association of Colleges 

will also favor us with this information, we would like to have it in 

the next few days because we hope to proceed with this as expeditiously as we can, and we would appreciate your cooperation.

Dr. Berson. Mr. Chairman, we will be delighted, jointly between 

the Association of American Medical Colleges and Council on Medical 

Education of the American Medical Association, we have collected a 

good bit of information tha t is relevant to the needs for construction 

and we will be happy to pull th at together and make it available.

The C hairman. It will strengthen this record a great deal and it 

will help us immeasurably.

Dr. Sodeman. Mr. Chairm an, we do have some of these data in 

the chart in our presentation which we have submitted to you. We 

can expand tha t if you wish.
44 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

The Chairman. Very well. If you think there is sufficient information in the chart that will be very fine. I notice there are a few 

tables tha t I have in mind though. But the charts you referred to 

will go into the record.

Dr. Sodeman. The need is stated. It is not translated into dollars. 

The need in volumes and so on is stated but it is not translated into 

dollars. We appreciate that. We know wha t you have in mind. 

On the other hand we do not like to authorize these open end appropriations around here. We have had some experience in the past on 

that. We would like to authorize what is needed but we would like 

to do it in a sufficient sum tha t the needs require but we will know 

where we are. We will be happy to transmit more information.

(The following letters were subsequently received from the American Medical Association and the Association of American Medical 

Colleges:)

American Medical Association,

Chicago, III., September 16, 1965.

Hon. Oren Harris,

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D.C.

Dear Congressman Harris: At the hearing held on September 14, 1965, on 

H.R . 2142 and H.R . 6001, the Medical Library Assistance Act of 1965, you 

requested that any available inform ation concerning the costs of medical library 

needs be furnished to the committee for its consideration. We can offer the 

following information a bo ut medical school libraries.

As was stated in our prep ared stat ement: “A comparison of the 87 existing 

medical school libraries with minimum stan dar ds recommended by a joint 

USPHS-A MA-AAM C committe e showed th at the average existing library was 

well below recom mendations in space, volumes, and serial titles during the 

1963-64 academic yea r.”

In the limited time av ailable to us, we have searched our sources of inform ation 

in order to provide additio nal data relating to the foregoing statement.

The average u nit cost per volume was estimated in 1961 a t $9.40. The ave rag e 

unit cost per serial title was estimated a t $11.19. (See: U.S. Office of Edu cation, 

Library Services Branch “T he Cost of Library Materials,” by Frank L. Schick and 

William II. Kurth. Wash ington, D.C., 1961,( “L ibrary Statistics OE-152029 A” 

supplement, 1962.) Construction costs for library space are currently estimated 

at $40 per square foot.

Based on these figures, to bring all existing medical school libraries to the level 

of the minimum standard s recommended, an estimate of the required expenditures 

would be approximately $18.8 million for books, $250,000 for serial titles, and 

$40 million for construction of new space. These item s would total approximately $59 million. Since the re are 12 new medical schools in development, the 

costs of their libraries should also be considered in add ition to these figures.

The above information rela tes only to a pa rt of th e costs of the proposed legislation, and does not cover such other items as the support of training of libra ry 

personnel, development of new techniques of storing an d retrieving new information, as well as other items covered by the bills. Unfortunate ly, we do not have 

available costs for these items.

We hope that the foregoing limited inform ation available at this time will be 

of assistance to your committee.

Sincerely,

F. J. L. Blasingame, M.D.,

Executive Vice President.

Association of American Medical Colleges,

Washington, D.C., September 16, 1965.

Congressman Oren Harris,

C7.(S. House of Representatives,

Committee on Interstate and Foreign Commerce, Washington, D.C.

Dear Mr. Harris: The Association of American Medical Colleges would

like to take this means of supplementing its statem ent in supp ort of the Medical 

library Assistance Act of 1965 (H.R. 3142 and H.R . 6001).
MEDICAL LIB RA RY ASSISTAN CE ACT OF 19 6 5 45

We rec ently completed a survey of all of the medical schools in which we asked each ins titu tion to tell us how much construction they needed to meet the ir medical library needs, how much the y estim ated the construction would cost, and how much they needed for the sup port of “ resources” as defined in the bills. Eig ht established medical schools and one developing school were unable to prov ide t he figures concerning construction or did not need additio nal construction for which they had not alread y made provisions. Seventy-nine established medical schools and 11 developing medical schools reported a need for construction to meet the needs of th eir medical libraries tha t they estima ted woulrl cost $98.7 million. It is my opinion th at these estimates will turn out to be somewhat low, since the y work out to an average cost of $33 per square foot. Several of the ins titutions have had but litt le experience in estimating cost of constructing and fully eq uipping libra ry space, and a num ber of people with such experience believe th at the cost will average about $40 per square foot. If th at turns out to be the case, the total cost for the construction would be approxima tely $119.4 million. If Federal grants provide 75 percen t of the construction cost, as the bills provide, the Federal share would be $74 or $89.5 million, depending upon which of the 

above estimates of costs turns out to be correct. Since the bill a s introduced authorizes an appropriation of $10 million for each of 5 years, the medical schools would have to provide more t ha n 25 percent of the construction costs, if the ir known needs are to be met. In response to the question concerning additional “resources” as defined in the bills, six of th e developing medical schools did not provide cost estimates. All of 

the existing medical schools plus six of the developing schools reported a tota l need for “resources” over and beyond those th at can be procured from the ir present budgets that they estimate will cost $31.3 million. The AAMC does not have accur ate figures concerning the needs for construction or resources in other eligible schools. We have some reason to believe tha t the needs for construction in the oth er health schools are sub stantially less than they are in medical schools, bu t th at the need for resources is perhap s even greater. Since the bills as written would authorize the app ropriation of $3 million for each of 5 years, it is obvious th at the schools will have to find very substan tial amoun ts of money from other sources if their needs for resources are to be fully met. We apprecia te the opportu nity to testify in support of this most important legislation and would like to repeat the hope th at your committee will report it 

favorably and that it will be ena cted soon.

Sincerely yours, Robert C. Berson, M.D.,

Executive Director.

The Chairman. Thank you, gentlemen.

Dr. Parks. Thank you, Mr. Chairman.

The C hairman. The next witness will be Dr. Alfred N. Brandon, 

president of the Medical Library Association, and director of the Welch Medical Library, Johns Hopkins University. Dr. Brandon, we will be very glad to have your statement.

STATEMENT OF DR. ALFRED N. BRANDON, PRESIDENT, MEDICAL

LIBRARY ASSOCIATIO N, AND DIRECTOR, WELCH MEDICAL

LIBRARY, JOHNS HOP KIN S UNIVERSITY, BALTIMORE, MD.

Dr. Brandon. Thank you, Mr. Chairman and gentlemen of the 

committee. I have submitted a formal written statement on the part of the Medical Library Association in support of this bill. I would like to 

orally emphasize certain sections of th at bill.

The C hairman. Thank you very much.

You may proceed.

Dr. Brandon. May I first direct attention to Section 394: Grants for Training in Medical Library Sciences: The most important ele­ ments in the success of any venture are the people who operate it. Funds for books, for buildings, for equipment (such as key punches,

5 3 -7 6 2 — 65 7
46 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

sorters, and computers) will avail little if we do not have knowledgeable, imaginative, and dedicated people to transm it them into live 

librar y service. I thin k it would be accurate to say th at we consider 

shortage of personnel plus shortage of training opportunities are our 

No. 1 problem. Dr. Dempsey has already alluded to this point, but 

to emphasize the magnitude of the problem I would like to point out 

tha t today there are seven head medical school library positions open. 

These are some of the top medical library positions in the country. 

It can easily be shown tha t subordinate positions and positions of 

lesser importance are also most difficult to fill with qualified librarians. 

It is the typical finding throughout the country.

The truism holds as elsewhere tha t people go where opportunity 

beckons. II.R. 3142 provides for most of the opportunities which we 

have long sought: assistance for developing programs in medical 

library science and in the general field of communication in the health 

sciences; traineeships and fellowships for students seeking graduate 

degrees in these areas; internship programs in medical libraries, and 

retraining for those already working in the health information area.

Section 396. Research and development in medical library sciences: 

In these modern times, the old cut-and-dried, haphazard methods for 

acquiring new knowledge and techniques in medical library science 

have failed. It is now necessary to adopt the methodology of the 

sciences and to formulate and prosecute programs of research and 

investigation which will yield information that will improve medical 

library techniques. In particular, funds are needed for research 

and development in the application of computers to the processing, 

storing, retrieving, and distributing of medical information. Such 

investigations have begun in some libraries, but money is sorely 

needed to train new investigators to support their investigations and 

to make available to them expensive equipment required for the 

development of new techniques. Thereby, the passage of H.R. 3142 

w ill contribute to the development of wholly new medical library 

systems.

Section 397. Grants for improving and expanding the basic resources of medical libraries and related instrumentalities is perhaps 

the most important part of this bill. Medical library collection needs 

based on suggested standards indicate a total of $102,732,952 would 

be needed to bring these libraries up to recommended strength. An 

analysis of needs would substantiate the propriety of suggesting a 

considerable larger annual appropriation for resources than the $3 

million the bill presently contains. Administered wisely, this provision can in some way reach every aspect of the medical community: 

student, researcher, and practitioner of all health professions. It is 

important to recognize the magnitude of this need and to understand 

tha t the appropriation authorized by this section would hardly begin 

to provide the solution.

Section 39S. Sections 397 and 39S of the bill recognize that c ertain 

larger medical libraries extend their service beyond their immediate 

constituencies to share resources with nearby hospitals, medical 

schools, publishers, municipal, State, and Federal governmental 

agencies, as well as other public and private institutions requiring 

access to medical litera ture. In many cases, the members of these 

regional resources facilities are carrying most of the costs even though 

their own use of the library is a small proportion of its service load.
MEDICAL LIBRARY ASSISTANCE ACT OF 19 65 47

The increasing amount of medical literature and the rising costs 

of operating a comprehensive medical library is outstripping the 

capacity of any one institution to furnish adequate support. The National Library of Medicine recognizes its inability to meet the medical literature needs of the entire Nation without support from a network of regional libraries. It is both economical and logical to prevent the deterioration of these reservoir libraries by furnishing Federal support in recognition of the vital function which they are already performing. Failure to secure greater support will result in less effective service which will jeopardize existing support. In many communities there are no other institutions able to meet these 

needs if existing regional libraries fall victim to rising costs and increasing demands without means of increasing income. In conclusion, the Medical Library Association, representing 

about 2,000 medical libraries and librarians throughout the world, 

wholeheartedly supports the provisions of this bill. The impact which Federal moneys, particularly grants for research and teaching in 

medicine, have had on U.S. medical libraries is profound. It has made the needs of the users far outstrip the abilities of the institutions with which the libraries are connected to support them. Unless the scientific information handling apparatus of the country is brought up to the level of the research, teaching, and patient care of this 

country, we may very well see either a decline in the status of our medical sciences, or find different and more expensive methods of reaching the same goals being attempted by society. We urge, 

therefore, tha t the House pass ILR. 3142, the Medical Library Assistance Act of 1965, speedily, and we hope tha t the necessary funds to 

implement it will be provided in the next Executive budget.

Thank you.

(Dr. Brandon’s full statement follows:)

S t a t e m e n t by Alfr ed N . B ra n d o n, P r e s id e n t, M e d ic a l L ib rary Ass ocia ­

t io n , an d Dir ec t o r, W el c h M ed ic a l L ib r a r y, J o hn s H o p k in s L n iv ersi ty

INT RO DU CTION

Mr. Chairman, gentlemen of the committee, my name is Alfred N. Brandon. I am president of the Medical Library Association; chairman of its Federal rela­ tions committee; and director of the Welch Medical Library, Johns Hopkins University, Baltimore, Md. The Medical Library Association has designated me to present its views and recom mendations on ILR . 3142. It is a privilege to ap pear before this distinguished committee to urge your recommendation of this bill which is of incalculable impo rtance in the revitalizing of medical libraries whose mission it is to preserve, organize, and transfer published knowledge re­ sulting from the research efforts that Congress has, itself, done so much to foster throug h its long and splendid support of health legislation.

Section 393

Des pite other programs of su pport for the construction of health-related facili­ ties, medical libraries have nev er received an adequate share of assistance. A recent survey of 116 establish ed medical, dental, osteopathic, and public health schools shows that 86 of their libraries were in need of funds for construction of new- facilities and 18 needed funds for renovating existing library quarters. During the last 8 years I hav e visited most of the medical school libraries in the United States. With few exceptions, I found them overcrowded with little, expansion possibilities in their present stacks. Seating capacities were generally low in relation to the clientele served and work areas for the librarians were a t a 

premium. The enactm ent of this bill w’ould do much to improve the physical facilities of medical libraries. The total estimate d need for construction for medical, dental, osteopathic, and public health schools, both established and new, at 75 percent
48 MEDICAL LIB RARY ASSISTAN CE ACT OF 19 65

matching, is over $96 million. This kind of sup port would represent a significant 

step toward meeting this critical need.

Section 394

The most imp ortant elemen t in the success of any ven ture are the people who 

operate it. Funds for books, for buildings, for equipment— keypunches, sorters, 

computers—will a vail little if we do not have knowledgeable, imaginative, and 

dedicated people to transmute them into live library service.

The critical shortage of qualified personnel in all are as of science information 

handling has been emphasiz ed over and over in reports of recent years on communication problems in science, notably in the Surgeon General’s Conference on 

Hea lth Communications (1962), the Preside nt’s Science Advisory Com mittee’s 

Science, Government and Information (1963), the Na tional Academy of SciencesNational Research Council’s Communication Problems in Biomedical Research 

(1964) and in the recommenda tions of the President’s Commission on He art 

Disease, Cancer and Stroke. The Medical Library Association has made the 

problem the pivot of its activities, e.g., its programs for continuing education, 

certification, and recruiting. I think it would be ac cur ate to say t ha t we consider 

shortage of personnel plus shortage of professional training oppo rtunities our 

No. 1 problem. This point of view is brought out well in “ Guidelines for Medical School Libraries” (1965) prepared by a jo int comm ittee of the Association of 

American Medical Colleges a nd the Medical Library Association.

The usual minimum professional preparation for libra rianship is a bachelor’s 

degree followed by a year of grad uate study for the ma ste r’s degree in one of the 

country ’s 33 grad uate librar y schools. Ten of these schools now offer a single 

course in medical librarianship varying from 30 to 45 semester hours. Three 

medical libraries offer post-ma ste r’s training programs with a total of eight places 

each year available. These offerings are tied in with the Medical Library Association’s certification plan. They are very useful, but the y do not go far in allevia ting the overall shortages—and there is nothing more except scattered courses 

in information science which are not directlv concerned with the health sciences 

field.

Information assembled by the President’s Commission on Hea rt Disease, 

Cancer and Stroke shows t ha t we are short at least 3,000 professional librarians 

in the 6,300 health science libraries at the present tim e.1

 We lose 150 through 

normal attrition each year and we bring in from the libra ry schools 100 of whom 

60 already hold medical libr ary positions. Thus only an approximate 40 new 

people, many of whom have neither subject background nor special train ing of 

any sort for the health sciences, are added annually. Positions are commonly 

open for 6 to 8 months, no t infrequently for a year or more even in top locations 

and situations. Veteran head librarians are flooded with requests for recommendations for vaca nt positions from every part of th e land. The well-qualified, 

sometimes even half qualified, are courted on all sides at all levels. There is 

con stant reshuffling of people and jobs. To fully appreciate existing conditions 

oik* must remember th at medical libraries are for the most part very seriously 

undermanned even when all positions are filled. The effects of such conditions on 

service are obvious.

Meanwhile the demands on libraries become both larg er and more complex as 

we struggle not only with the size of the literatu re, bu t also with its rapidly 

evolving interdisciplinary natur e which requires a whole realining of the trad itional concept of scope of collections and public services. Expansion and change 

in the literature are, of course, the direct result of expansion and change in research. personnel, the same personnel who account, in turn, directly or indirectly, 

for all calls on the library for larger collections and greater services. The cycle 

continually winds back on itse lf in wider and wider circles. A few of the larger 

libraries are beginning to at te m pt to hold this spiral in place by the automation 

of library operations and the pioneering of library-base d information and search 

centers, but these experim ents only increase the need for staff, highly qualified 

staff at that. Too, any success in finding new ways of handling information 

processing affects the profession as a whole and steps u p th e urgency of equipping 

everyone in it to take as much adva ntage as possible of the innovations. For 

example, the librarian in the field needs some insight into the system to obtain 

for his clientele full benefits from medlars. The more he knows about both 

medicine and data processing the better his insight will be.

1

 U.S. Congress. House. Com mittee on Appropriations. Depar tments of Labor and Health, Educa ­

tio n, and Welfare appropriations for 1966. Hearings before a subc ommittee of th e Committee on Appropri atio ns, House of Representatives, 89th Cong., 1st sess. Departme nt of H eal th, Education, and Welfare. 

Pt. 2, Public Health Service (exclusive of National Inst itutes of He alth), Washing ton, D .C., Government 

Pr intin g Office, 1965.
MEDICAL LIBR AR Y ASSIS TANCE ACT OF 19 65 49

Our personnel shortages then are in both number and kind. There is no choice 

but to find recruits with subject background in the sciences for many of our posi­ tions and recruits who are acquainted with at least the elements of data processing and information science for others. There must be people on the staff who can interpret the library to programers, systems designers, computer experts, etc., and work with them to devise new and better patterns and procedures. But can 

we indeed find these recruits? From what experience we have had, we know that students with appropriate subject background and academic qualifications can be drawn into librarianship and other areas of information work once they are aware the field exists. Aware­ ness increases as scholarships, fellowships, and traineeships become available, as new programs are offered in the libra ry schools and related institutions and as salary and status improve. Moreover, so far as shortage in kind of personnel is concerned, we are not without a backstop of able practicing librarians eager to learn as much as they can of the new technology, eager to improve their subject competence, and to add to their foreign language proficiency. This has been 

demonstrated by attendance at the association’s continuing education classes, in the organization of workshops and short courses in some parts of the country, 

and by individual enrollment in university courses. The truism holds as elsewhere that people go where opportunity beckons. H.R. 3142 provides for most of the opportunities we have long sought: assistance for developing programs in medical library science and in the general field of communication in the health sciences, traineeships and fellowships for students seeking graduate degrees in these areas, internship programs in medical libraries, and retraining for those already working in the health information area.

Seclion 396

Medical libraries are twice as old as medical schools, and during the long years of their existence, their librarians have accumulated a large store of experience which has served them well until the past decade. During the past 10 years, knowledge, including medical knowledge, has become central in our society, and there has been a tremendous increase in the urgency to have medical knowledge immediately available for the treatment of those ill, for the protection of those well, and for the research on which cure and protection rest. In these modern circumstances, the old cut-and-dry, haphazard methods for acquiring new knowl­ edge and techniques in medical library science have failed. It is now necessary to adopt the methodology of the sciences and to formulate and prosecute programs of research and investigation which will yield information tha t will improve medical library techniques. In particular, funds are needed for research and development in the application of computers to the processing, storing, retrieving, and distributing of medical information. Such investigations have begun in some libraries, but money is sorely needed to train new investigators to support their investigations and to make availab le to them expensive equipment required for the development of new techniques. Thereby, the passage of H.R. 3142 will 

contribute to the development of wholly new medical library systems.

Section 397

Section 397, “ Grants for Improving and Expanding the Basic Resources of 

Medical Libraries and Related Instrumentalities,” is perhaps the most important part of this bill. Medical library collection needs based on suggested standards indicate a total of $102,732,952 would be needed to bring these libraries up to recommended strength. An analysis of needs would substantiate the propriety of suggesting a considerable larger annual appropriation for resources than the $3 million the bill presently contains. Administered wisely, this provision can in some way reach every aspect of the medical community: student, researcher, and practitioner of all health professions. It is important to recognize the magnitude of this need and to understand that the appropriation authorized by 

this section woudl hardly begin to provide the solution. 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. National Institutes of Health research giants supported 1,695 projects in 1951. By 1964, NIH granted funds for 15,242 projects. Of the total national and private expenditures for health-related research in 1964, the Federal Gov ­ ernment provided 65 percent, industry 23 percent, and other non-Federal sources 

12 percent of the funds. The Federal Government provides two-thirds of the support for medical 

research and should rightly be concerned with seeing to it tha t the scientists performing this work have available to them needed tools and equipment including 

adequate libraries.
50 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

Section 398

Sections 397 and 398 of the hill recognize that certa in larger medical librarie s 

extend their service bey ond their immediate constituencies to share resou rces 

with nearby hospitals, medical schools, publishers, municipal, State and Feder al 

governmental agencies, as well as other public and private institutions requiring 

access to medical literature . In many cases, the members of these regio nal 

resources facilities are carryin g most of the costs even though their own use of 

the library is a small proportion of its service load.

Government gra nt support allocation for ove rhead goes to the ins titu tion 

where the principal inv est iga tor has his prim ary affiliation but does not reach the 

regional library to wh ich these inve stigators turn when the libraries of the ir own 

institutions prove ina dequate .

These sections of H.R . 3142 also recognize th at all medical libraries do not 

need to be self-sufficient (if, indeed, any medical lib rary could achieve com pleteness tod ay) . Smaller collections may satisfy a large percentage of imm ediate 

clientele needs and th ey may be effe ctiv ely supplemente d by a nearby regiona l 

library which can fill reque sts for less demanded but frequ ently very exp ensive 

material.

In different parts of the c ountry, this regional function is performed by differen t 

types of libraries; in some cases medical school libraries are serving the entire 

community, in oth er cases private hospitals, medical societies, and gov ernmental 

agencies an* performing this reservoir function.

The increasing am ount of medical literature and the rising costs of ope rating a 

comprehensive med ical library is outstripping the cap acity of any one institution 

to furnish ade qua te support . The Nat iona l Lib rary of Medicine recognizes its 

inability to meet the medical literature needs of the entire Nation with out sup port 

from a network of regional libraries. It is b oth economical and logical to pre ven t 

the deterioration of these reservoir libraries by furnishing Federal sup por t in 

recognition of the vi ta l fur ction which the y are alr ead y performing. Failu re to 

secure greater sup por t will result in less effe ctive service which will jeopar dize 

existing support. In many communities there are no other institu tions ab le to 

meet these needs if existing regional libraries fall victim to rising costs and 

increasing demands witho ut means of increasing income.

CO NC LU SI ON

Scientific libraries are one way which our society has devised for the purposes 

of diffusing inno vation and of preserving acc ura tely the information which has 

alrea dy been uncovered in the fields of science. As San tayana has noted, those 

who are ignorant of the past are condemned to repeat it, and where knowledge 

uncovered at one tim e or place is unknown to those who need to use it at ano ther 

time or place, the forw ard movement of all science is slowed down b y the nec essi ty 

for repetition of experim ental work and pragma tic solutions to problems. In a 

field as vital as medicine, moreover, information or methods uncovered in one 

part of the globe must be transmitted to all other parts of the globe. Health and 

disease know no political or geographical boundaries, and illness in rural areas of 

the United States requires as high a standard of treatm ent as illness in Bethe sda, 

Md., New York Ci ty, or Chica go.

H.R. 3142 con tains prov ision s which will aid scien ce in th e transmission of new 

knowledge and the met hod s by which it is preserv ed and brou ght forth when 

needed. It pro vides for research in meth ods of han dling scientific data, so that 

society can get the most efficient retur n for the mon ey it invests in m edical l ib ra ries; and it provide s for the training of people who will handle these data. It a llows for support of syn the ses of existin g knowledge so that each individ ual does 

not himself hav e to go thro ugh the entire record to ext ract the meaningful po rtions for his field, and it prov ides for the com pila tion of historical discussions of 

the means whe reby th e disco veries were made, thu s (hopefully) poin ting out more 

fru itfu l wa ys to inve stiga te problems in the future.

Since the results of medica l advance are now preserv ed in written form, the bill 

makes provision for the colle ction of such p ublica tion s in strategic positions around 

the country, as well as for the buildings and other storage depots which will co ntain these pub lica tion s. Bu t it also sees to it that the exciting new fro ntiers of 

the transm ission of med ical data, as exem pli fed by the medlars system at the 

Nat iona l Lib rar y of Medicine, are e xpanded and made available on a wider scale .

The Med ical Li br ar y Association, repr esen ting abou t 2,000 medical libr arie s 

and librarians throughout the world, wholehea rtedly supports the provisions of 

this bill. The imp act which Federal moneys, pa rti cu lar ly grants for resea rch and
MEDICAL LIBRARY ASSISTAN CE ACT OF 1 9 6 5 51

te ac hin g in m edici ne, ha ve h ad on U .S . medica l lib ra ries is pro fo un d. It ha s mad e 

th e ne ed s of th e users fa r o u ts tr ip th e ab ilities of th e in st it u ti o n s w ith which th e 

lib ra ries ar e co nn ec ted to su pport th em . Un les s th e scientifi c in fo rm at io n h a n ­

dlin g a p p a ra tu s of the c ountr y is b ro u g h t up t o th e lev el of th e re se ar ch , te ac hing , 

an d p a ti e n t ca re of th is co un tr y, we may ve ry well see eit her a de cli ne in th e 

sta tu s of our medica l scien ces, or fin d differen t an d more ex pe ns iv e m et ho ds of 

re ac hi ng th e same goals be in g a tt e m p te d by so ciety. We ur ge , th er ef or e, th a t 

th e H ou se pa ss II .R . 314 2, th e M ed ic al L ib ra ry Assistanc e A ct of 1965, spee dily, 

and we ho pe th a t th e ne ce ss ary fu nds to im pl em en t it will be pro vi de d in th e 

nex t E xec utive bu dg et.

The Chairman. Thank you very much.

Are there any questions?

Mr. O’Brien. I have one, Mr. Chairman.

The Chairman. Mr. O’Brien.

Mr. O’Brien. Doctor, you mentioned the critical shortage of medical librarians. Is the principal reason for that inadequate salaries?

Dr. Brandon. Partially, sir. There are, as I think is brought out 

in the President’s Commission on Heart Disease, Cancer, and Stroke, 

only 3,000 professional librarians in over 6,000 health science libraries 

at the present time and we are only recruiting about 40 or 50 a year 

to try to fill the gap and to create the replenishment tha t we need for 

those t ha t we lose by attrition, death, retirement, and so forth.

Mr. O’Brien. Are these people being siphoned off into other areas 

where their knowledge pays more?

Dr. Brandon. Yes, this has happened and is happening more all 

the time.

Mr. O’Brien. Thank you.

The Chairman. Are there further questions?

Mr. Rogers of Florida. Mr. Chairman, I have just one question.

The Chairman. Mr. Rogers.

Mr. Rogers of Florida. Are you saying in your testimony tha t 

you think we need 6,000 librarians?

Dr. Brandon. No; I am not saying that. 1 am saying that the 

President’s Commission on Heart Disease, Cancer, and Stroke shows 

tha t we were short at least 3,000 professional librarians in the 6,300 

health science libraries at the present time.

Mr. Rogers of Florida. Some of the testimony that we developed 

shows that in some of the hospitals which they include in the 6,000 

figure they may have medical journals or something tha t people very 

seldom use. I doubt if a person could spend full time in some of 

these hospital libraries as a librarian. Would you agree with that?

Dr. Brandon. I think there is a very definite need for what we 

might call the medical library technician, an individual who may not 

have a library science degree per se but someone who has had some 

training and experience in library methods. This individual in a 

small hospital library could very much better cope with the library 

problems than a secretary who is usually given a few hours a week to 

take care of this.

Mr. Rogers of Florida. I will agree with that. I would hope, too, 

tha t we would put more emphasis on our medical libraries in the hospitals, because a number I have seen or know of appear to not be 

used too frequently.

Dr. Landon. I think they have on the whole been quite inadequately cared for and I think if we could train some of these medical 

library technicians that could, for lesser salaries than a professional 

librarian might command, give attention to this matter. Perhaps
52 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

even under the direction of competent medical librarians in their 

community, these technicians could do much to help build up strong 

working collections in those hospital libraries which could then be 

backed up by the regional library from the more expensive material 

and the research type of material tha t might be needed by the staff 

of the hospitals.

Mr. Rogers of Florida. Give us a rundown for the record on what 

you think might be necessary for a technician to have in the field you 

have just described.

Dr. Brandon. Yes, I can cite some of the literature. I will be glad 

to append that to my report.

(The information requested follows:)

Annan, Gertrude L., Library technicians: need, training, potential. Bulletin 

of t he Medical Library Association, 52: 72-80, Jan uary 1964.

Mr. Rogers of Florida. Thank you, Mr. Chairman.

The Chairman. Mr. Macdonald.

Mr. Macdonald. My question is so basic, that I should be fearful 

to ask it.

What does a medical librarian do?

Dr. Brandon. It depends on the type of institution to which you are 

referring to as to how I can answer tha t question. Basically let us 

take a medical school librarian.

Mr. Macdonald. Let us take a hospital.

Dr. Brandon. All right. A hospital librarian should be an individual who has at least some training in library methodology, who has 

some knowledge as to how to retrieve citations to information requested by the practicing physician, or any hospital staff member.

Mr. Macdonald. You mean a doctor comes in and says to the 

librarian, I have a tough case, I don’t un derstand it but here are the 

symptoms and the librarian puts it through a computer or something 

and comes out with an answer.

Dr. Brandon. That may be for the future. It is not for the present.

Mr. M acdonald. Wha t happens at the present? Most doctors I 

know hate to admit they don’t know what is wrong. The average 

doctor seems to know the answers. Would there be the need for a 

highly skilled doctor to go to the librarian and say he has x number 

of symptoms, what is wrong with the patient?

Dr. Brandon. This is not the usual kind of question tha t the 

librarians get fortunately.

Mr. MacDonald. What is the typical question?

Dr. Brandon. The typical question is: I would like to know the 

most current literature in a specific subject area. Then the librarian 

can, through consulting the printed indexes, through homemade 

indexes, or through a current awareness service, checking each journal 

as it conies into the library, be able to give many citations to the m ost 

recent literature which will help answer the problem which he has 

presented.

Mr. Macdonald. Than k you.

The Chairman. Doctor, I thought what you and others had in 

mind was to provide assistance for these approximately 116 medical 

libraries in the medical institutions and so forth. Is that not true?

Dr. Brandon. Yes, we want to build up the professional staff who 

are capable of using new methodologies for searching out the literature 

as it is requested by the researcher, or by the physician.
MEDICAL LIBRAR Y ASSISTA NCE ACT OF 196 5 53

The Chairman. You don’t think it should be extended to provide 

assistance for 6,000 libraries?

Dr. Brandon. In one sense or another, it might through the 

establishment of regional libraries help all of the medical libraries.

The Chairman. It will require more money than anybody has 

suggested. Probably more money than we will be able to get.

Doctor, thank you very much.

Mr. Kornegay. Mr. Chairman.

The C hairman. Mr. Kornegay.

Mr. Kornegay. How much will this bill cost, Dr. Brandon?

Dr. Brandon. Totally?

Mr. Kornegay. Totally, yes.

Dr. Brandon. I think it is $23J£ million per year.

Mr. Kornegay. Dr. Brandon, I think yours is a fine statement 

and the statement I am going to make is not directed to you. I got 

here a little late. I attended an executive session of another committee. I wanted to get here in time to talk to some of the witnesses 

for the administration. I see my good friend Dr. Dempsey is here. 

This is not exactly in his de partment but he is a representative of the 

administration and I would like for him to hear this.

This year this committee has spent a considerable portion of its 

time considering and acting upon and passing out bills tha t deal 

with public health, and which authorize the expenditure of hundreds 

of millions of dollars. Last Satu rday I had a telephone call from the 

dean of one of the leading medical schools of this country, and which 

happens to be affiliated with wha t I consider to be one of the best 

VA hospitals. The dean of the medical school told me that unless 

something was done and done rather quickly insofar as upgrading the 

medical care in this particular YA hospital, the medical school was 

going to withdraw its affiliation. Because of the parsimonious 

attitude of the Bureau of the Budget and the administration in 

providing for this particular VA hospital, the medical school, in 

view of its reputation, could not much longer afford to remain affiliated 

with it. Th at was quite concerning to me because, as I understand it, 

the VA hospital system has trained about 30 percent of the Nation’s 

interns and residents in the past 5 years and certainly is one of the 

most significant factors in medical education in the country today.

My point is, while I am not opposed to this bill and all the others 

that we have passed out, what are we doing here when we constantly 

report out here and pass new legislation and spend a lot of money 

when apparently the Government is failing to take care of those 

plans and those plants that we already have. I just want to get that 

in the record. I have not had a chance yet to get into it and do a 

lot of studying about it and get a lot of facts but I did want to call 

that to Dr. Dempsey’s attention over there. While he does not have 

anything officially to do with VA hospitals he is affiliated with the 

administration and might be able to give this word back to them that 

there is growing discontent throughout the country. Understand 

this is not this one situation that I know about but it may be true 

in other cities.

Thank you very much.

Mr. Younger. Just for the record, I did not get your figure of the 

cost or your estimate.

Dr. Brandon. Of the bill itself? The only estimate tha t I gave 

in my figures here had to do with section 397: Grants for Improving
54 MEDICAL LIB RARY ASSISTAN CE ACT OF 19 65

and Expanding the Basic Resources, where I mentioned that the 

medical library collection needs, based on the suggested standards, 

indicated a total of over $102 million would be needed to bring them 

up to recommended strength.

Mr. Younger. I think the bill itself provides for $19,900,000 a year 

for a 5-year program, round numbers, $100 million.

Mr. Kornegay. If the gentlemen will permit, I have been advised 

by the staff $50 million is only for construction. The total cost of 

the bill is $117,500,000 for the 5 years.

Thank you for letting me use you as the fall man, Dr. Brandon.

The Chairman. Dr. Brandon, I am sure the others who are interested will get the hint from Mr. Kornegay and provide the information he would like to have.

Thank you very much.

Miss Germaine Krettek.

I believe you are representing the American Library Association 

here in Washington.

Miss Krettek, we are very glad to have you and we are glad to 

have your statement.

STATEMENT OF MISS GERMAINE KRETTEK, ASSOCIATE EXECUTIVE DIRECTOR, AMERICAN LIBRARY ASSOCIATION, WASHINGTON, D.C.

Miss Krettek. Tha nk you, sir.

My name is Germaine Krettek. I am associate executive director 

of the American Library Association.

The American Library Association is in favor of the Medical Library 

Assistance Act of 1965, H.R. 3142—Harris, and H.R. 6001—Fogarty: 

legislation designed to assist in the development of adequate medical 

library services and facilities in the United States. We feel that this 

measure is necessary and vital to the health of the Nation.

I have a brief statement, Mr. Chairman. In the interest of time, 

if you prefer, I would like to have it made a part of the record and 

to read excerpts from it.

The C hairman. It may be included in the record. You may proceed. I note it is a very short statement.

Miss Krettek. Then I will go ahead and read it.

In taking its favorable stand on this proposed legislation in the field 

of medical libraries and librarianship, the American Library Association would point out that it considers the provisions embodied in the 

medical bill, important as they are, as a supplement to the Higher 

Education Act of 1965, H.R . 9567, wisely passed by both the House 

and the Senate. In our judgment, this measure in support of basic 

higher education is of vital importance as a means of helping to solve 

the pressing current deficiencies in our college and university libraries, 

and to alleviate the alarming shortages in competent personnel to man 

our libraries of all types—college, school, public, and other.

Along with its position on this fundamental Higher Education Act, 

the American Library Association, as the oldest and largest library 

organization, is concerned also with the shortcomings in medical 

libraries and services. The association, moreover, has two constituent 

units which are particularly concerned in the development of medical 

libraries and related areas. One is the Association of College and 

Research Libraries, and the other is the Association of Hospital and
MEDICAL LIBRARY ASSISTANCE ACT OF 19 65 55

Institution Libraries. Both of these constituent organizations, which 

have special responsibility in these fields, endorse the proposals for 

medical library legislation. At its meeting on January 27, 1965, the Association of College and Research Libraries board voted its approval of the proposed medical library assistance bill, noting that many institutions with medical libraries are members of ACRL and would benefit under the provisions 

of this bill. The Association of Hospital and Institution Libraries also has expressed formally its concern for the pending medical library services bill. At the July 1965 Detroit conference, the AHIL Board went on record as strongly supporting the provisions of H.R. 3142 and 

urging its passage. Various reports and documents prepared by medical committees, societies, and libraries show convincingly the great shortages in medi­ cal library resources, services, and buildings. These deficiencies are seriously affecting medical research, medical teaching, and medical practice. It is a matter of national concern to have them corrected. In addition, the Special Projects Committee of the Association of Hospital and Institution Libraries at a recent meeting set forth the 

following additional deficiencies in the field of medical libraries: Inability to maintain properly collections, preserve materials, and 

keep abreast of literature and trends because of the rising cost of medical literature, abstracting services and equipment, and lack of adequate and properly trained personnel to perform these services 

and duties. Lack of coordination of resources and efforts to make readily acces­ sible the materials to physicians and paramedical personnel, such as psychologists, social workers, and rehabilitation workers, as they 

are needed. The Association of Hospital and Institution Libraries also advocates: The establishment of regional medical libraries: Books, journals, photostats, reference, and bibliographic services would be quickly accessible to medical and ancillary staff, such as nurses and therapists, in hospitals, clinics, mental health centers, and nursing homes in 

outlying communities were such regional libraries situated throughout 

the Nation. In addition, we feel that the provisions concerning the establishment of regional libraries covered in section 398(b) are highly important because of the need for continuing education by all practicing physicians, especially those located in more remote places. Medicine has changed and continues to change so rapidlv tha t an ever-widening gap stretches between the work of the medical researchers and the 

practice of medicine by the physician. The role of the medical library is to help the practicing physician narrow that gap and keep pace with the acceleration in research and the health needs of the 

population. In the field of medical research, the growth in funds has been steadily and encouragingly upward: $45 million in 1940; $148 million in 1950; $715 million in 1960; and a projected rise to $3 billion in 1970. This tremendous increase should have been accompanied by a corresponding one in the amount spent for medical library book and 

periodical resources, services, training of medical librarians, and build­ ing to bulwark such a program. But such has not been the case. 

If it is to be successful and fruitful, research in medicine and allied
56 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

fields mu st be su pp orted by a solid foundatio n of librar y mate ria ls 

an d by some meth od of quick retri ev al of the inform ation when 

needed.

Recent rep ort s be ar o ut clearly the sad stat e of the relative a mo unt 

of funds allotted by th e Dep artm en t of He alth, Ed ucation, and We lfare to medical lib rary service. For exam ple, in 1964 the Dep ar tm en t 

rece ived in a pp ropriat ion s $5.5 billion, of which $36.1 million, appro ximately 0.65 of 1 pe rcen t, were dev oted to scientific and tec hnica l 

inform ation, bu t less th an $1 million was assigned directly or in ­

direc tly to the su pp ort of medical lib rary activitie s.

Th e tas k is treme ndous, especially when we conside r th at there are 

some 4,000 libraries opera ted by med ical research insti tutio ns , 

med ical schools, me dic al societies, schools of nursing, ph armacy, 

ve terin ary medicine, osteo pathy, pub lic he alth agencies, and ot he r 

segments of the me dic al and health comm unity. These libraries an d 

th eir significance to th e Na tio n can r ead ily justify their claim for as sis tanc e from the Fe de ral Government.

Th e American Lib ra ry Associatio n the refore strongly sup ports th e 

Medica l L ibrar y Assistan ce Ac t of 1965 and urges th at this comm ittee 

ac t favora bly upon th e measure.

Th an k you, Mr. Ch airm an and members of the com mittee, for 

allow ing me to presen t this testimony .

Th e Chairman. Tha nk you very much, Miss Kr ett ek .

Are there any question s?

We app reciate ha ving y our sta tem en t.

Mr. Younger?

Mr. Youn ger. On pag e 3, Miss Krette k, th e est imate of fun ds 

which you gave there for 1940, 1950, 1960, and an est imate of $3 

billion in 1970; where did those figures come from ?

Miss K re ttek. Th ese are total natio nal exp enditure s for medical 

research and include ap propria tio ns of the Dep ar tm en t of Hea lth , 

Ed ucation, and We lfare. These figures are from the Jo urna l of 

Medica l Ed ucation, volum e 38, Ma rch 1963, pag e 146.

Mr. Younger. From the Fed eral Go vernm ent?

Miss K rettek. Yes, sir; the re is a tre me ndous am ount of research 

th at is going on. In orde r for this research to be properly car ried 

on and the effect of th e rese arch made available to those who n eed it, 

it is essential th at th er e be good librar y service to control the inf orma tion and make it avail able to those who need it most.

The C hairm an. Than k you very much. We are glad to ha ve 

yo ur s tat em en t.

Dr. Logsdon, with th e Association of Resea rch Libraries, Colum bia 

University.

STATEMENTS OF DR. RICHARD H. LOGSDON, DIRECTOR OF L IBRARIES OF COLUMBIA UNIVERSITY AND FORMER CHAIRMAN

OF T HE ASSOCIATION OF RESEARCH LIB RARIE S; AND JAMES E.

SKIPPER, EXECUTIVE SECRETARY, ASSOCIATION OF RESEARCH

LIBRARIES

Dr. L ogsdon. Mr. Ch air ma n, it is a ple asu re, indeed, to ap pe ar 

in support of this leg islation.

The C hairman. Doc tor, I am going to suggest th at you inc lud e 

yo ur statem en t in th e rec ord because of the tim e and you give us a 

brief sum ma ry of y ou r sta temen t.
MEDICAL LIB RA RY ASSISTANCE ACT OF 1965 57

Dr. L ogsdon. T hat is wha t I had hop ed to do. We have a l ong er 

stat em en t for the rec ord. I will highlig ht only a few points, perha ps 

offering Dr. Skipper, who is with me, the exe cutive secreta ry of our 

ass oci ation, an op po rtu ni ty to pick up on an y po in t or points th at I 

may miss.

Ou rs is an asso ciation of some 74 libraries. Six tv-one are un iversities , and I think of pa rtic ul ar importance to this legislation, 47 of 

tho se univer sities op erate, finance, and su sta in major pro grams of 

medic al research and me dic al edu cation . As these are the larg er and 

more com prehensive of th e med ical rese arc h and ed uc ati on cen ters of 

the co un try , our me mb ers rep res ent a ve ry su bs ta nt ia l pa rt of the 

to ta l universe of ac tivi ty in this field.

F o r th at reason ou r memb ers are in a pa rtic ul ar ly good position to 

bring to this committee an d to the Con gress fir sth an d evidence of the 

rea l need fo r sub sta ntially lar ge r s up po rt of medical l ib ra ry activities .

A t the insti tutio n I know best, the Columbia Pr es by teria n Medical 

Ce nter, you will find th e fir sth an d evidence of t he influence of figures 

th at have been pre sen ted by othe r witnesses t oday. In m y testimo ny I 

re fe r to an increase of ro ug hly fifty fold in Fe de ral Gover nm ent suppo rt of bio-medical research since 1947. Other fig ures have been given 

su gg estin g a twe lvefold increase since 1951. D ur in g th is period of 

eno rmously increased ac tiv ity in rese arch it has been extrem ely difficu lt to improve lib ra ry resources and services to kee p pace.

Th is has caused ar reag es of need t o develop in eve ry pha se of ac tiv ity 

to be support ed by this b il l; in phy sical f acilities , pers onnel , and t ra in ­

ing. No t only do we have th is sho rtage in numb ers of m edical libr arian s bu t the re is also th e fact th at m any individu als com ing in to th e 

libr ar y profession have backgro unds in hu man ist ic studies. To 

pr ep ar e them adequately fo r high-le vel services in medical lib rar ies 

req uir es addit ion al tr ain in g which this bill will he lp provide .

Ve ry im po rta ntly, it offe rs the op po rtu nity fo r substan tia lly in ­

crease d research and develop me nt e xpendit ure s in medic al lib rary a nd 

inform ation services. W hile th is section o f the bill rel ate s specifically 

to medical libraries, i t is c er tain th at any resea rch o f t hi s k ind relating 

to one field will hav e benefits for oth er fields of libra ry service.

Th e ultim ate objective of this and rel ate d leg islati on is imp roved 

pa tien t care. I am sur e t h a t throu gh the id ea o f develo pin g a net wo rk 

of med ical lib rar ies and me dic al inf orma tio n servic e we will find the 

la rg er ins titution s working more effectively wi th th e smaller in stitutio ns bringing to them an d to ind ivi dual physici ans the benefits of 

first-class, h igh-level in fo rm at ion service.

I t is a pleasure to endorse this leg islation an d to ask th at Mr. 

Sk ip pe r be giv en an op po rtun ity to su pplement my statem ent .

Th e Chairma n. Very well. We will be g lad to h ea r from you, Mr. 

Sk ippe r.

Mr. Skip per. Mr. Cha irm an and mem bers of th e committee, I am 

Ja mes Skipp er, executive sec retary of the Assoc iation of Res earc h 

Li braries. I would like to tak e a m omen t to sug ges t th at in ad dit ion 

to he lping m edical lib rarie s rec tify the imb alance between supp ort for 

medical research a nd lib ra ry service, I b elieve th at the bill un der consid erati on has great sign ific ance for th e entire libra ry community , not 

just lib rarie s concerned with medicine. Th e Na tio na l Lib ra ry of 

Medicine h as establis hed its preeminence as the pion eer in dev eloping
58 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

new techniques to successfully explo it the inc rease in pub lish ed medical i nfo rmation.

These inn ovatio ns have grea t poten tial in being app lied to the non - 

rnedical sector in our research libraries . Th us it is my conviction th at 

the support and enco uragem ent given to medical lib rar ies will be m ul ­

tip lie d man y times by the appli cat ion of these new tech niqu es an d 

service concept to g enera l inf orma tio n needs.

Th an k you, sir.

The Chairman. Tha nk you very much, gentlem en. We are very 

glad to have your statem ents.

Are ther e any question s ?

Mr. Macdonald. I wa nt to compliment b oth of you on the re str aine d 

an d educational s tatem ent. One question does come to m y m ind : TTow 

will thi s do wh at you say it will do, on page 3? I think one of th e 

problems th at the Fe de ral Gov ernm ent is faced with is the inc rea sin g 

instances of needless dupli catio n of research . I t has always been a 

prob lem. N IH could not use the amount of mon ey we gave it one 

year. It set a record in sending some money back.

Dr. Logsdon. Th e th in g we are faced with is the acceleration in 

th e amount of resea rch a nd p ublishin g ahead of ou r being able t o kee p 

t rack of all th e in form ation th at is rep orted. W e do not always know 

wh at has already been done. It is precisely th at kind o f objective that 

these new levels and new concepts of info rm ation ha nd lin g are designed to achieve. W e will be more certain once we have a really 

thorou gh system of a na lys is of pub lished lite ra tu re , a proper sub ject 

heading system s, an d imp roved mac hine ha nd ling of thi s sub ject 

an d b ibliog rap hic al inform ation. We will be more certain of w hat lias 

alr eady been done so th at c urrent research can really be on th e fron tier 

an d n onduplicating .

Th ere is a frequ en tly quoted story in research circles that it is o fte n 

cheap er to rep eat th e res ear ch than to search the lit eratur e. Th is ma y 

lie true in some cases bu t all too often lar ge sum s may be wasted or 

im po rta nt data ov erlooked.

Mr. Macdonald. My question is th is: Would it not be more econom ical, instead of ha vi ng 6,000 or wh ate ver was suggested as the 

figure for con struction , to have just one cen ter in which this rese arch 

would be put together an d have the cen ter send it out to the various 

ho sp ita ls and schools an d the oth er plac es where it is needed instea d 

of hav ing regio nal cente rs all over the co untry ?

Dr. Logsdon. I th in k the basic work of an alyz ing the lit er atur e, 

being sure of wha t is in it, shou ld be done in one place, and th at is 

precisely what is develop ing wi th the med lar’s prog ram and the 

med lar’s relate d pr og ram. Bu t in orde r to bring this inf orm ation 

quick ly to the indiv idu al use r at these various cente rs thr oughout the 

co un try we m ust have a loca l staff, the equip me nt to h and le requests, 

an d of course books an d journa ls conta ining it. You have to provide 

th e art icle or articles for the u ser locally.

Th e basic intellectual work of indexi ng, catalog ing, and so on. can 

be done more efficiently at a central point. That is the won derful 

contr ibuti on throug h th e years of such pu blica tio ns as “Index Median s,’’ and now th ro ug h the me dla r's prog ram. Does that answer 

yo ur question ?

Mr. Macdonald. In some measure, th an k you.
MEDICAL LIB RA RY ASSISTANCE ACT OF 19 65 59

Dr. Logsdon. We must get this hard work centrally and we are 

moving very fast in that direction.

Mr. Macdonald. You don’t think it will be more economical to do 

it in place and have it distributed from that one place ?

Dr. Logsdon. Yes, I agree it is more economical to do some things 

centrally; but I think th at is what we are working toward in present 

programs and in programs projected by this legislation. But doing 

these thing s centrally will not be a substitute for competent reference 

librarians at the local level. You need both.

Mr. Macdonald. Thank you.

The Chairman. Are there further questions?

Thank you very much, gentlemen. We are pleased to have your 

statement.

(Dr. Logsdon’s statement follows:)

State men t by Richard II. Logsdon, Director of Libra ries. Columbia University, Representing the Association of Research Libraries

I am Ri ch ard H. Logsdon, di re ct or of lib ra rie s of Colum bia Un ive rsity and 

fo rm er ch airm an of the As socia tio n of Resea rch Li braries, th e organiz ation 

which I am rep res entin g tod ay. Ap pearing with me is James E. Skipper, executiv e se cr etar y of the ass ociation .

Th e Associatio n of Re search Libraries , estab lished in 1932, com prises 74 

in st itut io na l members, th e la rg er academ ic, public, an d special lib rarie s which 

collect com perlien sive ly in su pp or t of research. Sixty-o ne of th e members are 

Am eri can unive rsity lib ra rie s, 47 of which op erate me dic al schools and 

me dic al research cen ters. Ou r member insti tutio ns accor din gly ar e carry ing a 

su bs ta nt ia l par t of th e to ta l respon sib ility for nu rtur in g biomedical resear ch 

an d me dic al education. They are sim ila rly in a good position 'to ass ess pre sen t 

sho rtcom ing s of the who le in fo rm atio n complex an d in tu rn to assess also the 

op po rtu nity offered to the Congres s in thi s bill to str en gthe n med ical librar y 

resources an d services. Th is testi mon y is based no t only on 17 years of dir ect 

exp erien ce in the a dm in istratio n an d finan cing of l ib ra ry services to one of these 

medical research ce nters (the Colum bia Presby ter ian Medica l Ce nte r including 

the College of Physicians and Su rgeo ns) but also on kno wledg e of the pre ssu res 

wh ich a re being felt by medical libr ar ie s generally.

The ca se fo r this bill can be st at ed briefly un der fo ur he ad ing s :

(1 ) Prog rams of ed uc ation an d res earch in medicine an d the hea lthre la te d fields will be effect ive only if sup porte d by ad eq ua te lib rary and 

inform ation services.

(2) Medical lib ra ry resource s and serv ices ar e not now adeq uate to the 

needs of th e res earch co mm unity.

(3) The gap between pr es en t levels of support and adequacy is too lar ge 

to b e closed qu ickly if at all fr om n ong ove rnm ental sour ces.

(4 ) The pro gram set fo rth in H.R. 3142 and II.R. 6001 is soundly conceived and would achieve a dr am at ic and balan ced dev elopment of medical 

libr ar y resources.

One of th e bes t gu aran tees th a t fu nd s avail ab le fo r rese arch will be spe nt 

effe ctiv ely is thro ugh t he provision o f a dequ ate libra ry resour ces. Medical libra ries form a vi ta l link in the ch ain of com municatio n of ide as an d inf orm ation in 

the he al th sciences. They serve as custo dia ns of rec ord ed kn ow led ge: the 

recip ien ts of a virtua l to rr en t of publi catio ns repo rti ng the re su lts of cu rren t 

re se ar ch ; and as the principa l mea ns thr ough which me dic al schoo l tea ching 

is kept up to da te and research gu ide d to new fro nt iers of discovery and un de rsta nd ing . Only through well-o rga niz ed, com prehensive an d read ily available 

col lection s is it possible fo r the re se ar ch er to know wha t ha s bee n done in his 

field of spe cialization, the direction of cu rre nt researc h and th e ar ea s needing 

fu rt her stu dy. The findings of re se ar ch mu st be repo rte d and pu t to use if the 

origi nal o bje ctives of r ese arc h gra nts a re to be achieved.

Th e ul tim at e obje ctive is. of cours e, be tte r pa tie nt ca re an d here. too. the 

lib ra ry p lays an im po rta nt role by bridg ing the dis tan ce between the findings of 

rese arch and the pra cticin g p hy sic ian .

T ha t fu nd s available fo r bio me dic al res ear ch have inc rease d much fa ster 

th an ap pr op ria tio ns fo r medica l libr ar ie s is. I believe, well estab lished. Fu nds
GO MEDIC AL LIBRARY ASSISTANCE ACT OF 19 65

from th e Fed er al G ov er nm en t alo ne ha ve rise n fr om som e $27 million in 1947 

to an es tim ated $1.3 billi on . Th is em ph as is on th e p a rt of Gov ernm en t co up led 

w ith fu nd s from no ng ov er nm en ta l so ur ce s ha s. in a re al sen se, cr ea te d th e 

li b ra ry pro ble m by g enera ti ng th e so-ca lled ex plos ion bo th in pu bl ic atio n outp u t 

and th e nu m be r of u se rs to be served . Sim ilar ly in cr ea si ng sp ec ia liza tion in 

re se ar ch ha s br ou gh t dem an ds fo r li b ra ry an d oth er in fo rm at io n se rv ices of a 

mu ch m ore s op his tica te d n atu re callin g fo r su bj ec t analy si s in de pth an d m ac hin e 

han dl in g of bi bl io gr ap hic al reco rds. Tak en to get her th es e inf lue nces ca ll fo r a 

hig her pr op or tio n of to ta l fu nd s fo r in fo rm at io n se rv ic es a t a tim e whe n li b ra ry 

su ppo rt is alm os t c ert ain ly fa llin g beh ind on a per ce nta ge basis.

Th e logi c of F edera l su pport fo r st re ngth en in g m ed ic al li bra ry se rv ices is, 

I believe, un co nt es tabl e. Not o nly is th e ga p so la rg e as to p reclud e ea rl y corr ec ­

tion fro m pri vat e so ur ce s but th e Fed er al G ov er nm en t it se lf is lik ely to be th e 

pr in ci pa l benefic iar y. Im pr ov ed in fo rm at io n se rv ic es will, as st re ss ed earl ie r, 

in cr ea se the effectiven es s of Fed er al fu nd s fo r re se arc h an d in ad ditio n, dec re as e 

th e inc ide nce of ne ed less du pl ic atio n of re se ar ch . Tim e is, of course, im p o rt an t 

in th a t each year of dela y ri sk s the los ses which can be ge ne ra te d by a poo r 

co mmun ications net w ork .

Th ose resp on sibl e fo r th e dra ft in g of th is bill are to be comm end ed fo r th e 

care an d appro pri at en es s w ith wh ich th e se ve ra l ke y as pe ct s of a good m ed ic al 

li b ra ry pr og ra m are co ns id er ed . I shou ld now like to co mm en t brief ly on th ose 

se para te p rovisio ns w hi ch dea l part ic ula rl y w ith m ed ic al li bra ry ser vic es.

CONSTRUCT ION OF FA CILITIES (SE C. 393)

I t seems to be es pec ia lly difficult to s ec ur e const ru ct io n fu nd s fo r li b ra ry buil ding s. A t Co lum bia , as is tr u e of ot he r pri vate ly su pp or te d in st itutions, th e 

mo ney mus t be so ug ht f ro m in di vi du al do no rs or fo unda tions. A med ical li b ra ry 

are a plan ne d years ag o fo r a re la tive ly sm al l co lle ctio n an d be fore th e d ra m ati c 

ex pa ns ion in bi om ed ical re se ar ch is sim ply not m ee ting cu rr ent ne ed s fo r co llec tio ns, staf f ac tivi ties , and ser vic es. W hile som e fu nds are in han d fo r a ne w 

bu ild ing, it may be se vera l yea rs be fore co nst ru ct io n co uld beg in from p ri v ate 

fu nd s alone. A m atc hin g gra nt, on th e oth er ha nd , wou ld mak e it po ssible to 

begin im med iate co nst ru ct io n. I am su re th a t th is si tu ati on could be duplica te d in do zens of o th er univ er si ties an d med ical li bra ri es.

TRAIN ING IN TH E MEDICAL LIBRARY SCIEN CES (SEC . 39 4)

The sh ort ag e of li b ra ry pe rson ne l ge ne ra lly an d of pe rson s qu ali fie d in sp eci al iz at io ns lik e med ical li bra ri ansh ip ha s been a cri ti cal ha nd icap in th e m ain ­

te na nc e of good li b ra ry se rv ice. Th e in ve st m en t in tr ain in g prov ided fo r in 

se ction 394, in cl ud ing th e pr og ra m fo r in fo rm at io n sp ec ia lists, wo uld be ex ­

trem el y he lpfu l in re cru it in g th e staf f ne ce ss ar y fo r ac hi ev in g high st an d ard s 

of servic e.

RESEARCH AND DEVE LOPM ENT IN MEDIC AL LIBRARY SCIE NCE (SEC. 39 6)

It is gra tify in g to see th e em ph as is giv en in th is bill to re se ar ch an d de ve lopmen t. Lib ra ri es ha ve bee n so hard pres se d th ro ugh th e yea rs to pr ov id e th e 

es se ntial s in ac qu is itio ns , or gan iz at io n of co lle cti on s an d re fe re nc e se rv ices th a t 

th ere ha s been al l too li tt le at te nti on giv en to re se arc h in th e natu re of th e 

li bra ry op er at io n itse lf. T he pr og ra m her e pr op os ed wou ld go a long w ay 

to w ard co rrec tin g th is la ck of em ph as is in th e p ast an d wo uld co ntr ib ute to th e 

im prov em en t an d eff iciency of li bra ry op er at io ns not on ly in med ical li b ra ri es 

but libra ri es g en erally.

IMPROVING an d EXPANDING TH E BASIC RESO URCES (SEC. 39 7)

T his sec tio n offers th e pro m is e of th e ki nd of dir ec t st re ngth en in g of re so ur ce s 

an d service s a t th e loca l leve l wh ich could br in g im m ed ia te benefits to re se arc h 

pr og ra m s. It sh ou ld hel p to co rr ec t th e pre se nt im bal an ce be tw een th e leve ls 

o f loca l su pp or t fo r re searc h an d fo r med ical libra ri es .

REG IONAL MEDICAL LIBR ARIES (SE C. ,39 8)

Ther e is grow ing ev id en ce an d conv ict ion th a t th e to ta l in fo rm at io n ne ed s of 

th e society will fin ally be m et on ly th ro ug h th e cr ea tion of a ne tw or k of l ib ra ri es 

ea ch prov id ing a lev el an d qua lity of serv ice ap p ro p ri ate to the ge og ra ph ic al
MEDICAL LIBRAR Y ASSISTANC E ACT OF 19 65 61

a re a an d cl ie nt el e served . T he pro gra m he re en visa ge d wou ld es ta blish ju st 

th a t ki nd of p att ern of in te rr ela ti o n be tw ee n a loc al serv ice, a mor e comp rehe ns iv e ba ck st op colle cti on fo r a la rg e r are a an d. of co urse, th e ca pst one of the 

N at io na l L ib ra ry of Me dic ine . A ch ie vi ng th is kind of net w ork fo r bio medica l 

li te ra tu re wou ld be a big st ep to w ard th e ultim at e goal.

RE GIO NA L BRANC HES OF T H E N A T IO N A L LIB RA RY OF M ED IC IN E (S EC . 3 7 8 )

The pr op os al to am en d the Publ ic H ealth Se rvice Ac t to en ab le th e Nationa l 

L ib ra ry of M ed icine to es ta blish re gio nal br an ch es si m ilar ly su pport s the ide a 

of a netw ork of med ica l li b ra ry se rv ic e men tio ne d above. The co nc ep t is consi st en t w it h em er ging id ea s of good li b ra ry pl an ni ng and de se rv es su pp or t.

CONCLU SI ON

Mr. C hair m an an d mem be rs of th e co mmittee . I ap pre ci at e th is opp or tu ni ty 

to appea r be fo re you in su ppo rt of su ch a vi ta l le gi sl at iv e pr op os al .

I wish to re em ph as ize th e im port ance of th is bil l in co rr ec ting th e im ba lanc e 

which has be en cr ea te d by exte nsi ve Fed er al as si st an ce to m ed ic al re se ar ch 

w ithout co rr es po nd in g su pp or t fo r m ed ic al in fo rm at io n. Thi s im bal an ce th re aten s to be come even gre ate r under th e re ce nt ly en ac te d m ed ic ar e pr ogra m .

The pu rp os e of th e bil l under co ns id er at io n is to ass ure th a t doct ors an d me dica l sc ie nti st s are prov ided w ith th e es se ntial kn ow led ge which th ey re quir e in 

do ing th e ir work. In fo rm at io n is a n es se nt ia l in gre die nt in m ed ic al prog ress 

an d II.R . 3142 an d H. It. 6001 will pro vid e the su pp or t re qu ired .

Dr. Logsdon. Thank von, Mr. Chairman.

The Chairman. Dr. Pearlm an. Doctor, I believe you are here representing the American Denial Association and the American Association of Dental Schools.

STATEMENT OF DR. SH0L0M PEARLMAN, REPRESENTING THE

AMERICAN DENTAL ASSOCIATION AND THE AMERICAN ASSOCIATION OF DENTAL SCHOOLS

Dr. P earlman. Tha t is correct, sir. For the record, to qualify myself, I am the secretary of the Council on Dental Research of the 

American Dental Association. I am also a member of the National Research Council and of the Advisory Committee on Scientific Publications of the National Library of Medicine.

It is my privilege to appear before you on behalf of the American 

Dental Association and the American Association of Dental Schools, 

to testify in support of this bill II.R. 3142. In addition to my oral 

comments I should like to file for the record a prepared statement which 

indicates the position of both organizations.

The Chairman. It may be included in the record.

Dr. P earlman. Thank you sir.

(The statement follows:)

Sta tem en t of t h e Am er ic an D en ta l Ass oci ati on an d t h e A mer ic an

A ss ocia ti on of D en ta l Sch oo ls

IN TR ODUCTI ON

Th e A m er ic an Den ta l A ssoc iatio n, whi ch re pr es en ts 105,000 denti st s, an d th e 

A m er ic an Assoc iatio n of D en ta l Sc ho ols, wh ich re pre se nts th e 50 denta l sch ools 

in th e I' n it e d St at es , ar e plea se d to hav e th is o pp ortuni ty to re co rd th eir su pp or t 

fo r II.R . 3142, a bill to am en d th e P ublic H ea lth Se rv ice Ac t to pr ov id e fo r a 

pro gra m of g ra nts to ass is t in m ee ting th e ne ed fo r ad equate m ed ic al li bra ry 

se rv ices a n d fa ci lities . In re co rd in g th is su pp or t, th e as so ci at io ns m ak e a basic 

as su m pt io n th a t th e in te nt of th is le gi sl at io n is to prov ide, w ithin ea ch of th e 

pro gra m s au th or iz ed in th e bill, ass is ta n ce to al l biom ed ical li b ra ry and com-
62 MEDICAL LIBR ARY ASSISTAN CE ACT OF 196 5

m un icatio n ac tivitie s, in cl ud in g thos e re la te d to d en ti st ry an d to th e fu n d a ­

m en ta l a nd ap pl ie d sc ie nc es rela te d th er eto.

The ch ai rm an of th e co m m itt ee has on ce again de m on st ra te d an in fo rm ed 

in te re st an d se nsi tivity to a m ajo r prob lem confr onting th e hea lth pro fe ss io ns of 

th e co un try . As do cu m en te d so co nv incing ly in vo lum e II of “A N at io na l P ro ­

gr am To Con qu er H e a rt Dise ase, Can ce r, an d Str oke,” in the sp ec ial re p o rt 

pr ep ar ed by th e Su bc om m itte e on F acil it ie s of th e P re si dent’s Co mm iss ion , th e 

de velop ment of a larg e- sc al e, co or di na ted, nati onal pr og ra m to im pr ov e co m ­

mun icatio n an d re se arc h in th e b iol og ica l an d healt h sci ences ha s com e to be on e 

of th e mo st urg en t nee ds co nf ro nt in g th e pu blic an d p ri vate agencie s co nc er ne d 

w ith ou r N atio n’s h ealt h. Althou gh th er e is yet muc h to lie don e, th e su pport 

which th e F ed er al G ove rn m en t ha s give n to th e co nst ru ct io n of hos pi ta l and 

he al th res ea rc h fa cil it ie s has aide d im m ea su ra bl y in a ch ie vi ng sign ifi ca nt p ro gre ss 

in th e un de rs ta nd in g, tr eatm ent, an d pre ve nt io n of dise as e. Mo re re ce nt ly , th e 

H ea lth Pro fe ssio ns E ducati onal A ss istanc e Act of 1963 has en co urag ed th e expa ns io n of ed uca tion al fa cil it ie s fo r th e pre p ara ti o n of pr of es sion al h ealt h p e rson nel. In a dd itio n t o th es e pr og ra m s or ie nte d to w ard specific prob lems of h ealt h 

fa ci lities an d m an po w er , th e Natio na l In sti tu te s o f H ealth has an d co nt in ue s to 

prov ide much-needed an d ex pa nd ed su ppo rt fo r re se arc h an d re se ar ch tr ain in g 

as eviden ced by th e m ore th an $1 billion appro pri ate d fo r th es e pu rp os es duri ng 

th e la st fiscal y ea r.

As im po rtan t an d be ne ficial as th es e fe der al ly su pp ort ed pr og ra m s ha ve be en , 

howe ver, re la tive ly li tt le has bee n acco mplish ed in ex pa nd in g an d st re ngth enin g 

th e vi ta l life line of a ll of th es e de ve lopm en ts— na m el y, th e ex pa ns io n an d m od ­

er ni za tion of th e sy st em s ne ed ed to co m m un icat e biom ed ical li te ra tu re to th e 

co mmun ity of healt h pra cti ti oners an d re se ar ch sc ie ntist s. W ith th e ex ce pt io n 

of the mod estly su pport ed pr og ra m of th e N at io nal L ib ra ry of Medicine, th e re 

ha s been no concentr ate d ef fo rt to de velop a co he sive an d co or di na ted n ati o n al 

prog ram of biom ed ical co mmun ication co m m en su ra te w ith th e gre at ly expan ded 

de man ds wh ich are pla ce d on th e hea lth scien ce li b ra ri es of to da y. W ith ra re 

excepti on , thos e pu blicl y or pr iv at el y su pp or ted h ealt h ce nt er s wh ich ha ve be en 

dev elo ped or wh ich a re no w develop ing ha ve no t be en ab le to in co rp ora te w it h in 

th ei r pl an s th e kin d of co mmun ications sy stem s and fa ci lities which w ill be 

needed in cr ea sing ly in th e fu tu re . In th e vie w of th e as so ciatio ns , ad op tion of 

II. R. 3142 wo uld be a m ajo r st ep in th e di re ct io n of st re ngth en in g th e co m m un ica tio n of scientific kn ow ledg e— one of t he w ea ke st el em en ts of t he N at io n’s to ta l 

he al th eff ort.

D ur in g th e past 3 yea rs , th e American Ass oc ia tio n of D en tal Sc hools and 

th e Am eri can D en ta l Assoc iatio n ha ve de vo ted ex te nsi ve effo rts to st udyin g 

th e way s an d m ea ns of deve loping more effecti ve continu in g e du ca tio n pro gra m s 

fo r de nt al pra cti ti oners . Alth ou gh th e fo rm ats and tech ni qu es of pro vid in g 

co ntin ue d pr of es si on al ed uc at io n are m an y an d vari ed, th e over ridi ng obj ec tive 

of an y ac tivi ty of th is kin d is to as si st th e den ta l p ra cti ti o n er in bring in g to his 

pat ie nts th e ve ry bes t ora l hea lth car e av ai la bl e. Thr ou gh th e co oper at iv e 

effo rts of den ta l scho ols, oth er ed uc at io na l in st it uti ons. Sta te an d loca l d en ta l 

so cieti es an d st ud y club s, mo re th an 35 per ce nt o f th e N at io n’s ac tive d en ta l 

pra ct itio ner s annuall y en ga ge in som e form of co ntinuin g ed uc ation. T his is 

ind eed en co ur ag in g b u t we ca nn ot an d m us t no t be sa tis fie d until ev er y p ra c ti ­

tion er finds it po ss ible to ke ep abre ast of th e pro gre ss which is be ing m ade 

thro ug h de nt al re se arc h an d th ro ug h im prov ed m et hod s of ora l hea lth car e. 

Thi s goa l, we firml y be lie ve , will be mo re a tt ain ab le if fin an cial su pp or t su ch as 

(h at pro po sed in H.R . 3142 is mad e av ai la ble fo r th e co ns truc tion of ex pan ded 

de nt al li bra ry and o th er co mmun ica tio n fa ci lities , fo r th e tr ain in g of sp ecia li st s 

in th e co mm un ication sci ences, fo r th e su ppo rt of re se ar ch an d de ve lopm en t of 

new tech niqu es a nd e qu ip m en t re la te d to the d is tr ib u ti o n of new in fo rm at io n an d 

fo r th e ex pa ns ion of pu bl is he d rev iew s, ab st ra cts an d bibliogr ap hies.

Be fore co mmen tin g on som e of th e spe cific ne ed s of den ta l libr ar ie s, th e ass oci at io ns wo uld lik e to comm end th e ch ai rm an on th e br oa dl y ba sed ap pro ac h 

which ha s been pr op os ed fo r solving th e pr ob lems of biom ed ica l co m m un icat ion. 

Al tho ug h th er e are s pe cific p roblem s wh ich re la te u ni que ly to me dic ine , den ti st ry , 

pu blic he al th , and th e se ve ra l bio log ica l and physi ca l scien ces re la te d to h ealt h, 

it is in cr ea si ng ly ap p are n t th a t re al pr og re ss to w ard re al iz in g to ta l h ealt h care 

fo r all of ou r peop le w ill be achie ved mos t effe ctiv ely by an in te rd is cip li nary 

ap pr oa ch to re se ar ch , ed uc at io n, an d th e co m m un ic at io n of new kn ow led ge . It 

shou ld be em ph as ized , th er ef ore , th a t al th ou gh we w ill comm ent pri m ari ly up on 

thos e ac tivi ties w hi ch re la te to den ta l ed uc at io n, re se ar ch , an d th e co m m un ic ation of de nt al kn ow ledg e, th es e commen ts are in te nded to 1 e w ithin th e co mpr e-
MEDICAL LIB RA RY ASSISTAN CE ACT OF 1965 63

hensive fram e of reference proposed by H .R . 3142 supporting the need for a greatly expanded system of communication among all of the sciences related to 

heal th.

LIBRARY FA CI LI TY NEEDS OF TH E DENTAL SCHOOLS

The re are three ba sic types of l ibra ries which serve dent al schools today. One is an integral part of the dental sch ool; the second is eithe r a combined medical- dental libr ary or a health science libra ry and the third is a par t of a main uni­ versity library. At present, 21 of the 50 dental schools operate separate libraries. Of the remainder, most are conduct ed as medical-dental or health science faci li­ ties. There are, of course, advanta ges and d isadva ntages to each o f these adm in­ istr ativ e arrangem ents, but irres pective of the orga nizat ionl patte rn, the libra ry is considered as an essen tial ingredient of any acceptable program of dental 

educa tion. According to a recent survey, the present average size of the library in those inst itutions which conduct a sepa rate fac ilit y is 1,430 square feet. This same survey indicated that, were it posible to do so, these inst itut ion s would expand their exi stin g fac ilit y to at lea st 9,000 square fee t per inst itution, indic ating that the present dental school libr ary is operating at about 13 percent of the 

size that is considered desira ble. Thes e estimates are reinforce d by recent inform ation submitted by dental schools now being planned in whi ch the average amount of space projected for the libra ry fac ilit y is about 9,000 square feet for an enter ing class size o f 100 stude nts. A space alloca tion of this amount represents between 5 and 0 percent of the tot al space planned for the denta l educat ional program in new in stitutions presently under consideration—a modest allowance indeed when considering the 

multiple responsibilities of the modern health science libr ary . Wi th reference to physical facil iti es , it is apparent tha t the majo rity of exis t­ ing dental schools utilize libr ary fac ilities which are a part of the total health center . As additional health center complexes are constructed , it seems likely tha t there will be an incre asing trend toward the shar ing of library and scientific communication fac ilities . In addition to the reasons already cited, such sha ring will become incre asingly important as more complex and sophisticated system s of informatio n accumu latio n and retrie val are developed. As the com­ mittee recognizes, however, the cost of c onstructing, equipp ing, and maintaining multipurpose biomedical communicat ion fac ilit ies will increase proportionately, thus it is urged that the suggested appropriations in II .R . 3142 be supported 

at the levels presented.

LIBRARY RESO URCE NEEDS OF DENTAL SCH OOL S

One of the measures of the adequacy of a dental libr ary is the size and quality of its book and perio dical collection. The average size of the book colle ction presently avai lable in the 21 separate dental school libra ries is 13,0<M) volumes. It has been estim ated conserva tively tha t the minimum need of a dent al school library is at leas t 25.000 volumes, thus there is an average deficit of 12.000 volumes in each of thes e dental libraries at the present time. Rased on an averag e acquisition cost of $13 per volume, it would be necessary for Ihe 21 institutions which hav e separate dental librarie s to invest over $3.25 million in order to bring their collections up to an accep table standard. In addi tion, each of the new dent al schools now being planne d or constructed can anti cipa te an expend iture of $325,000 in order to esta blish an acceptable libr ary collection , based on the standa rds cited above. Thes e estimates of expenditures are based only on tex t and reference book acquisitio n and do not provide for periodical subscriptions, the purchase and maintenanc e of microfilming equipment, and the use of the many inform ation ind exing and retrieval systems which are now availa ble . It is apparent, ther efore , that the dental school libra ries presently in opera tion and those which are to be constructed and placed in operation within the next several years have an urgent need for the type of improvement and expansion grants proposed in section 397 of H. R. 3142. The American Association of Dent al Schools is presently underta king a comprehensive cost study of den tal education which, when completed in Novem­ ber 1965. will provide explicit infor mati on on the vario us cost elements involved in condu cting a dental educ ation al program. Altho ugh the final figures from the cost study are not yet available, prelim inary informa tion indicates tha t dental school libraries are supported at the seriously in adequate level of approxi­ mate ly 825.000 per year in publ ic institu tions and at slig htly less than 819.000 

a yea r in privately supported schools. Cost figures cited previously in thi s
64 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

st at em en t w ith re sp ect to th e fu nd s ne ed ed to de ve lop an ad eq ua te te xtb ook 

collection in di ca te a n av er ag e need of more th an $ 150,000 in each of th e 21 d en ta l 

sch ool s wh ich m ain ta in se par at e li bra ry fa ci lities . The re is no re as on to be liev e 

th a t th is ne ed is not a t le ast as gre at in th os e d en ta l libra ri es which are a p a rt 

of th e he al th scienc e cente rs of univ er si ty co mplex es. It is ap pa re nt, th ere fo re , 

th at th e li bra ry acti v it y is in cri tica l ne ed of fina nc ia l as si st an ce fa r ab ov e th e 

lev el wh ich it ha s th u s fa r bee n po ssible fo r th e denta l school to ac hiev e. W e 

ur ge nt ly re qu es t th e co mm itt ee to plac e th e hig hes t po ssibl e pri ori ty on th e 

le gi slatio n unde r co ns id er at io n an d, spec ifica lly , to see k th e fu ll au th o ri zati o n 

rec om me nd ed fo r th e im prov em en t an d ex pa ns io n of ba sic re so ur ce s o f bio ­

me dic al libr ar ie s.

DE VE LO PM EN T OF LIBR AR Y PERSON N EL

As is tr u e in all as pects of de nt al ed uc at io n an d re se ar ch , th e u lt im ate eff ectiv en ess of th e acti vit ie s of the den ta l li bra ry is de te rm in ed by th e av ail ab il it y 

of a suf ficien t nu m ber of high ly qu alifi ed pe rs on ne l. Th e science of m ed ic al 

libr ar ia ns hip , in cl udin g all of th e ra m ific at io ns of scien tific co m m un icat io n, 

is no les s ex ac ting and spec ializ ed th an an y o th er field or en de av or in th e 

hea lth pr of ession s. Alth ou gh we do no t ha ve cu rr en t st ati st ic s on th e sh o rt ­

ag e of qu ali fie d m ed ic al an d den ta l li b ra ri an s, in fo rm at io n th a t h a s been 

com piled by th e N ational L ib ra ry of Medicine in dic at es th er e is a net gai n o f 

only 40 tr ain ed m ed ic al li bra ri ans an nu al ly avail able to in st it uti ons en ga ge d 

in he al th sci ence ed uc at io n. Th is pr od uc tion m ust be ex pa nd ed m an if old if 

we are to ha ve avail able th e nu mbe rs an d ca liber of in di vi du al s al re ady ne ed ed 

in ou r hea lth ed ucati onal in st itut io ns. The a tt ri ti o n of curr entl y tr ain ed 

pe rson ne l an d th e addit io n of new in st it uti ons m ak es th e de m an d fo r ne w ly 

trai ned m ed ical li b ra ri a n s ev en more a cu te.

RE SE AR CH AN D DE VEL OPM EN T

One of th e im p o rt an t ob jec tiv es of II.R . 3142 is to ma ke po ssible th e im ­

pl em en tatio n of m od er n au to m at ed sy stem s of st oring, proc essin g, an d re tr ie v ­

ing in fo rm at io n fr om pu blicatio ns re la te d to biom ed ica l sci ences. T he need 

fo r th es e sy stem s is im per at iv e if th e pu blic is to rece ive op tim um be ne fit from 

rese ar ch e ffor ts w hi ch a re be ing co nd uc ted in th is field.

Tod ay ’s in adequate stor ag e an d re tr ie val sy stem s, which fa il to m ake us e 

of mod ern d a ta pro ce ss in g tec hn ique s, fo rc e th e co ns cien tio us re searc h er to 

spe nd ne ed less hours , da ys , or even we ek s se ar ch in g fo r re port s of re la te d re ­

search . Ev en th en a re port co nt ai ni ng val uab le in fo rm at io n may be unav ai la bl e or, be ca us e it is un ca taloge d, und et ec te d. Th e ph en om en al gro w th 

wh ich ha s ta ken pla ce du ring th e past de ca de in bio medica l re se ar ch and th e 

eq ua lly ast oundin g pr og re ss wh ich h as been m ad e in th e fields of au to m ati c 

in fo rm at io n pro ce ss in g vir tu all y de man d th a t th e pr om pt an d ex te nsi ve co rre la tion of th es e concurr ent de ve lopm en ts be ex pe di te d. Thi s is no t, in th e 

view of ou r as so ci at io ns, an att ain m ent which ca n be re alized w it hout su bst anti al ass is ta nce fr om th e Fed er al Gov ernm en t. I t is, of co urse, ap p are n t to 

the co mm itt ee th a t th e ap pl ic atio n of mod ern in fo rm at io n pr oc es sing te ch niq ue s 

in th is field ho lds th e pot en tial no t on ly fo r im pr ov in g th e am ou nt an d quali ty 

of sci entific in ves ti gati on but can also be ex pe ct ed to ac compli sh su b sta n ti al 

eco nom y in th e sa vin g of man -h ou rs an d ph ys ic al sp ac e re qu irem en ts. W e en ­

do rse th e co ntr ib uti ons wh ich II.R. 3142 wo uld m ak e to w ar d th e de ve lo pm en t 

of a mo dern in fo rm ati on storag e, ca taloging , and re tr ie val sy stem s fo r th e 

li te ra tu re of the bio m ed ic al sc iences.

Fin al ly , we urg e su pport of a gre atl y ex pan ded pr og ra m of re se arc h an d 

de ve lopm en t in m ed ic al li bra ry scien ce an d re la te d fields. Th e nec es si ty fo r 

co ntin uo us st u d y of im prov ed te ch ni qu es fo r co mm un ication is so ob viou s as 

to need no fu rth e r su pp ort . It shou ld be in dic at ed , howe ver, th a t th e es se nti al re se ar ch an d de ve lopm en t which is ne ed ed in th e scien ce of co m m un ic atio n in th e h ealt h fie lds has no t kep t pa ce w ith th e ot her im port ant phase s of 

he al th re se ar ch , th u s th e mod est co ntr ib ution rec om men de d in II.R . 314 2 is 

part ic ula rl y and u rg en tl y ne eded.

It is our u n d ers ta n d in g th a t th e p ro gr am s we a re su pp or tin g wi ll, as w e ha ve 

sai d, benefit m ed ic ine, den tist ry , os te op athy , and pu blic hea lth. We have no 

do ub t th a t th is is th e co mm itt ee ’s unders ta ndin g as well. Exc ep t w ith re fe renc e to se ct ion 304, ho wev er, th is in te ntion is n o t clea r. Amen dm en ts dir ecte d
MEDICAL LIB RA RY ASSISTAN CE ACT OF 19 65 65

to th is end, then , wo uld be des ir ab le . In part ic ula r, we be lie ve th a t th e term “med ical li b ra ry ” an d “m ed ic al li bra ry fa cil it ie s” sh ou ld be defin ed to includ e denta l libra ri es an d th e te rm “p hy si ci an s” shou ld be defin ed to includ e de nt ists. In co nc lusio n, th e Am er ic an Assoc iatio n of D en tal Sc ho ols and th e American D en ta l Assoc iatio n urg e th e co m m itte e to giv e pro m pt and fu ll su pport to th is im port ant legi slatio n in th e in te re st of the im pr ov ed healt h o f th e peop le of th e 

U ni te d S ta te s a nd , ind eed, of th e e n ti re w orld.

I)r. P earlman. Th e ov era ll pur pose of thi s bill is to improve commu nic ation of health information, in t he pu blic inte res t.

Comm unication is the key to progress in denta l he alth service and 

pra cti ce, in research , and in education. For serv ice can be improve d 

an d bro adened to mee t the expand ing needs of a gr ow ing population 

only to the exten t th at new un derst andin g, new methods, and new 

ap proaches th at are evolved throug h rese arch are ra pi dl y communicated t o the practition ers an d healt h ad minist rators w ho can pu t th em 

int o effec tive p ractice.

In de nti str y, as in other areas of health, ou r ca pa bility has alread y 

falle n beh ind the needs created bv the grow ing dema nd fo r service 

an d th e rapi d increase in th e ou tput of inform ation fro m the contin ua lly expanding ac tiv ity in denta l rese arch. W e have been doing 

ou r b est to cope with these needs, b ut we do need su bs tantial assistance 

wi th res pect to lib rary spa ce and facilities, resources, pers onnel, in ­

fo rm atio n services, and res earch and develop men t.

O f the 48 ex isting dental schools, 21 no w h ave s ep arate l ibrarie s; 27 

share a lib rary with either a m edical school or a medical complex. In 

ad ditio n the re are live new de ntal schools now in process of deve lopment. Rec ent surveys show th at the ave rage size of denta l librar ies 

is ap prox im ately 1,430 s quare feet, altho ug h at leas t 9,000 square feet 

are req uir ed fo r o ptima l functio n. We d on ’t have, at this time , a precise e stima te o f the cost of up gr ad ­

ing the se fac ilities to an adequate level. Our e stima te rou ghly would 

J>e $350,000 to $400,000 each fo r the d enta l schools. I would estim ate 

roug hly in the neigh borho od of $10 million in total will be required 

fo r th is p urpose. I would like the pri vil ege of su bm itting la te r a table w hich will p ro ­

vide to you more detailed estim ate s of the cost of construction.

Th e ave rage size of the collection s in the 21 separa te denta l lib rar ies 

rang e broadly in size fro m a low of 3,700 volum es to a hig h of over 

40,000, avera gin g ap prox im ately 13,000 volumes pe r lib ra ry alth ough 

25.000 is a minimal reco mm end atio n. Ra sed on this average deficiency of 12.000 volumes f or th e 21 schools 

and an average cost of about $13 p er volume, there is a need for $3.25 

mi llio n in the e xis tin g schools alone ju st to build th ei r collections to 

adequate size. Co nside rin g th at the 27 denta l lib ra ries th at are now 

sh ared wi th medical facilities need abo ut the same, th e total cost of 

ra isin g existing collections to minim al levels of ade quacy would be 

abou t $6.5 million. In ad ditio n each of the 5 new denta l schools can 

expect to spen d abo ut $325,000 to acquire the bas ic 25,000 volumes, a 

total of approx im ate ly $1,625,000. Accordingly, i t w ould tak e $8 million to establish minim ally ade qua te denta l libr ar y reso urces across 

the country . These figures are. exclusive of the cost of perio dic als and serials, 

whi ch in the denta l field are conti nuing to increase bo th in numb er 

and in usage.
66 MEDICAL LIB RARY ASSISTAN CE ACT OF 196 5

The shortage of libr ary personnel will he alleviated substantially 

with the passage of this Dill. Schools of library science are able to 

graduate only about 100 medical librarians per year. Sixty of these are 

already employed upon graduation, leaving only about 40 for whom 

medical and dental schools must compete. Each dental school should 

have at least two topnotch librarians. On that basis, the 21 existing 

schools plus the 5 new schools would absorb 31 of the available 40 

immediately. Grants fo r training personnel would clearly be helpful.

There is a steadily increasing demand for library services from 

students, research scientists, from dental practitioners in general, and 

from physicians and hospital staff who seek information about diseases 

of the oral structures. Research and development of better library 

techniques are essential for dramatic improvement of such service.

There is a great and important need for research in communication 

and the transfer of information. Research is needed also in indexing 

and cataloging; in storage and retrieval methods and service; in 

improvement of reproduction of materials and of the distribution or 

disseminative services.

There is a need for more extensive microfilming, to provide secondary storage of material, quick access for reproduction and distribution 

and, secondarily, a method of saving space on volumes that may he 

discarded and on copies of borrowed material.

Special bibliographies and selected packages of material are needed 

regularly for use in the continuing education of the dentist, for research investigators and for others who demand them. Every dental 

library faces these pressures.

In addition, it seems highly desirable to begin now to establish 

regional libraries in certain areas if it is not practical immediately to 

have full-scale independent libraries at each school in the area.

The objective of the dental profession, in supporting TT.R. 3142, 

is to benefit the public by providing better health service. This can he 

achieved only by closing the gap between research and development 

and the provision of better service by the practitioner and public health 

agencies.

In conclusion, the American Dental Association and the American 

Association of Dental Schools are pleased to support this bill and the 

important programs it would make possible. I should like to make 

one important point, however. It is our understanding that this hill 

is intended to cover medicine, dentistry, osteopathy, and public health 

in each and all of its sections. It is believed, however, that with respect to sections of the bill other than section 394 this intent is not 

entirely clear, and clarifyin g amendments would be extremely desirable. In p artic ular we believe that the terms “ medical library” and 

“medical library facilities” should be defined to include dental libraries 

and the term “physicians” should be expanded to include dentists.

The timeliness and necessity of this bill are quite obvious and have 

been noted by others who have testified before you. There has been 

exceptional expansion of research during the past several decades. 

There is continuing growth in the number of schools, which places 

heavier demand upon the dental libraries in terms of both quantity 

and activity. And the dentist himself needs to keep in touch with new 

information as well as he can in the face of a growing population 

which places more and more demands upon his time.
MEDICAL LIBRARY ASSISTANCE ACT OF 19 65 67

Mr. Ch airm an and mem bers of the committee, we believe this is 

des irable legislation an d should be e nacted.

I am at yo ur disposal, Mr. Ch airm an , to rep ly to an y questions 

you may have.

Th e Cha irm an. Th an k you ve ry much , Dr. Pe arlm an , fo r your 

presen tatio n here in behalf of th e Am eric an De nta l Assoc iation and 

the A me ric an Association of De ntal Schools. Ar e the re an y questions 

by members o f th e co mmittee ?

AV e are v ery glad to have yo ur statem ent.

Pe rm it th e Ch air to inq uir e: Is there anybody here who is going to 

ap pe ar in opposition to this leg islati on ?

If not, we w ill have Dr. Go rdon Hea th.

STA TEMENT OF DR. GORDON G. H EA TH , PROFESSOR OF OPTOMETRY.

IN DIAN A UN IVE RSITY , BLOOMINGTON, IND ., RE PR ES EN TING

TH E AM ERICA N OPTOMETRIC ASSOCIATION

1 )r. II eath. Th ank you, Mr. C ha irm an .

Th e Chairm an. Dr. Heath, we a re very glad to hav e yo ur sta tem ent. 

I am go ing to suggest, however, as I have to the oth ers, th at you r 

statem ent be filed fo r the reco rd a nd you sum marize it.

Dr . H eath. I intend to do just t hat , Mr. Chairm an. Tha nk you.

The C hairm an. Very well. Yo u m ay proceed ac cording ly.

Dr. IIeath. Ju st to identify my sel f, I am a pro fes sor of optom etry 

at In di an a Un ivers ity , and c ha irm an of the grad ua te school pro gra m 

in physiolo gic al optics the re. I am also servin g on two com mittees 

fo r the Am eri can Optom etric Assoc iation, which or ga niza tio n I rep ­

rese nt today. One of thes e com mittee s is the com mittee on new 

academic facilitie s.

So, we have been great ly con cerned with the pl an ning fo r. amo ng 

other things , the lib rary fac ilitie s at new pro spectiv e schools of optom etry throug ho ut the co untry.

I am also pa st pre sident of the Ass ocia tion of Scho ols & Colleges 

of O ptom etr y.

Now both of these organiz ations, the American Op tometr ic Association an d t he Association of Scho ols & Colleges of O ptom etry, are concern ed abo ut the present wo rding of the bill. AAre su pp ort the bill, 

bu t we are conc erned abou t the defin itio n within the bill of “sciences 

relate d to hea lth. ”

Th is definition states th at it includes medicine, osteopathy , 

de nti str y, pu bli c hea lth, and fu nd am en tal and appli ed sciences when 

rel ate d th ere to.

AATe do not believe that it was th e intent of the au tho rs of the bill 

to exclude opto me try from any o f th e provisions of the bill, bu t in terpr etation of the pres ent wo rding could om it this he alth care s pec ialty, 

and therefore we respectfuly req uest th at on pag e 3, section 391, line 

22, af te r the word “den tis try ” th e word “optom etr y” be inserte d. 

Th is am endm ent will in no way change the inten t of the bill, but 

sim ply co ntinues the p rece dent t hat Con gress e stablis hed in the H ealth 

Profe ssions E du catio nal Assistan ce Ac ts of 1963 an d 1965.

Xow lib rarie s in the optom etry schools and colleges are uniqu e because the y are so very interd isc iplin ary. The mate ria ls in these li ­

brari es are selected from a gr ea t ma ny other discip lin es, physics, 

ma the ma tics, biolo gical sciences, as well as the strictly op tome tric
68 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

publications. So, a properly constituted optometry library represents 

a very careful and very specialized collection of both volumes and 

periodicals.

Currently our optometry libraries have been developed and main ­

tained almost exclusively in the optometry schools and the universities 

that have schools of optometry. These libraries are used widely by 

others than optometrists. Any individual working in science Helds 

in research or in the applied visual science areas very frequently tap 

these optometry library sources simply because the personnel are there 

and are familiar with the materials and are able to render more 

specialized aid than they can obtain through the central libraries.

Mr. Chairman, you have requested also that we supply data in terms 

of dollar needs. T have supplied some data on the sizes and facilities 

of libraries in my submitted statement. I would like the privilege of 

submitting later to you a summary so fa r as it can be determined from 

our schools of their needs translated into dollars for the purposes of 

your committee.

The Chairman. ITow much time would you need ?

Dr. Heath. I think within the next week I can submit that.

'fhe Chairman. That will be too late.

Dr. Heath. Within the next 3 days ?

'Fhe Chairman. Yes, we would want it this week.

Dr. Heath. All right. I will endeavor to get those figures for you.

(The information referred to follows:)

Estimated library facilities needed by optometry, next 5 years

Se ction n u m b e r C u rr en t pro vis io ns

E st im ate d

ne ed

A d d it io n al

co st

(all sc ho ols)

393—C o n str u c ti o n .. _ 1,600 s quar e f e e t 1 ____

2 3 6,000 $1, 54 0,000

394—T ra in in g (p er so nn el ):

(1) G ra duate w o r k .. . . . . . . . . N on e 10 35 ,00 0 

(2) R e tr a in in g .. . . . . . . . . .d o ___ 5 12,50 0

(3) T ra in in g i m p ro v em e n ts _______ . . .

(4) In te rn sh ip s_____ . . . _____ . N o n e. .. 3 15,00 0 

15,00 0 

45,00 0

395—Sp ec ial pr oj ec ts . . ____ ____ $2,500 (1 school) 3

396— Res ea rch an d d ev e lo p m en t. . N o n e _____ . . . . . . 5

397—Im pro vem en t an d e xp an si on :

(n) Boo ks ______ . . _____ . 3,000 1 2

 7, 500

2

 1,000

540,0 00

10,00 0 

50,00 0 

150, 000

Jo u rn als _____________ ___ . 600 >

(6) C at al ogin g______ . . . . . . N o t av ailab le

(c) E q u ip m e n t. . . . . . . . . . ___ _ _ .d o ___ .

398—Reg iona l li bra ries . . . . . . . . .

399—P u b li cati o n s. . ___ . . ______ . . . $50,000_______________ $80,000 30 ,00 0

T o ta l_____________________________ . . 2,442, 500

> C u ir e n t pr ov isio ns f or e ac h of p re sen t 10 sch ools an d col leg es of o p to m etr y .

2

 E sti m ate d n ee d for eac h o f p resen t 10 scho ols an d col leg es of o p to m etr y .

3

 Squ ar e fee t.

N o t e.—Fig ur es ba se d on pro vis io ns co nta in ed in H .R . 3142 (M ed ic al L ib ra ry A ss is ta nc e A ct of 1965).

Dr. Heath. Now our plight is severe in the optometry libraries. 

It is a great deal smaller than tha t for the medical schools simply 

because we are numerically smaller and our holdings are smaller. 

So, in terms of dollars this is perhaps only a very small p art of the 

total bill, the total need, but nevertheless to those working in this 

area it is an important feature.

Now we do heartily endorse the aims of this bill, and we respectfully urge its adoption and the adoption of the amendment tha t we 

have proposed.
MEDICAL LIBRAR Y ASSISTANC E ACT OF 1965 69

Thank you, Mr. Chairman.

(Dr. He ath ’s full statement follows:)

Sta te men t by Gordon G. H ea th, O.D., P h . I).

Mr. C hair m an an d mem be rs of th e co mm itt ee , I am Go rdon G. H eath an d I 

liv e a t 1206 Longwo od Driv e, Bloom ingt on , Ind. A t In dia na U niv er si ty my 

po sition is th a t of pr of es so r of opt om et ry , an d I also se rv e as chair m an of th e 

g ra d u ate s ch oo l pr og ra m in ph ys io lo gi ca l op tics.

I am here to day as a re pre se nta ti ve fo r th e A merican O pt om et ric Assoc iatio n. 

Tw o ass oci at io n co mmitt ee s on whi ch I se rv e are th e co m m ittee on vi su al prob ­

lem s of chil dre n an d yo ut h an d th e co m m itte e on new ac ad em ic fa ci lities . Th e 

ac ad em ic fa cil it ie s co mmittee w ork s fo r th e mu ch ne ed ed est ab li sh m en t of 

se ve ra l ne w scho ols an d c ollege s of o pto m et ry a t appro pri ate univ er si ties .

Also , I am p ast pre si de nt of th e A ssoc iatio n of Sc hools an d Colleg es of 

Optom etry , an as so ciatio n of th e sc ho ol s an d colleg es ac cr ed ited by th e Co uncil 

on O pt om et ric Edu ca tio n. T hi s co un ci l is rec og nized by th e N ational Com ­

m ission on A cc re di ta tion an d th e U.S. Office of E duca tion as th e ac cr ed itin g 

bo dy fo r op to m et ri c ed uc ation.

Bot h th e Amer ican Optom etric A ss oc ia tio n an d th e A ss oc ia tio n o f Sch ools 

an d Co lleges of Optom etry are co nc er ne d ab ou t the cu rr en t w ord in g of ILK . 

3142. As no w w ritten the bill de fin es th e term “ ‘scien ce s re la te d to healt h* 

incl ud es m ed icine, os teop athy , d enti st ry , an d pu blic hea lth, an d fu ndam en ta l, 

and ap pl ie d scienc es wh en re la te d th ere to .”

We be lie ve th e bil l shou ld in cl ud e op to m et ry in all of it s pr ov isio ns . In te rpre ta ti on of th e pr es en t wor ding co uld om it th is hea lth car e sp ec ia lty. Ther efore, we re sp ec tfully re qu es t th a t on pa ge 3, section 391, line 22, a fte r th e w or d 

“d en ti st ry ” th e w or d “opt om et ry ” be in se rted .

The am en dm en t in no way ch an ge s th e pu rp os e of th is le gis la tion, but in stea d 

co nt in ue s th e pr ec ed en t Co ng ress es ta bli sh ed wh en it reco gn ized opt om et ry as 

a hea lth c a re pr of es sion by in cl us io n in the H ea lth Pro fe ss io ns Educ at io nal 

A ss ista nc e A ct of 1963. Optom et ry is also inclu ded in th e H ealth Pr of es sion s 

E ducati onal A ss ista nc e Amen dm en ts of 1965, le gi slatio n on w hi ch th e Se na te 

he ld heari ngs on ly la st wee k. We fe el th a t th e in se rtio n of th e w or d “op tom etr y ” w ill pre vent a ny f utu re m is unders ta ndin g of c on gr es sion al inte nt.

The pu rp os e of t his bill, as we see it , is to im prov e co m m un icat io n. Co mmun ica tion b etw ee n ed uc at io na l in st it uti ons and h ea lth c ar e p ra c ti ti o n e rs ; co mm uuica* 

tio n be tw ee n mem be rs o f va riou s healt h care d isciplines ; c om m un ic at io n be tw een 

stud en ts , re se arc hers , an d ed uc at or s, an d th e po pu latio n. Thi s bi ll sh ou ld he lp 

bu ild com m un ic at io ns be tw een dis ci plines m os t co nc erne d w ith th e a r t a nd scie nce 

of visio n.

L ib ra ri es in op tom etry sch oo ls an d co lle ge s are un iq ue be ca us e of th e in te rdis ci plinar y n a tu re of the pr of es sion . O ur ne ed s ca nn ot be se rv ed by a ge ne ra l 

co lle cti on , b u t re qu ir e in st ea d care fu l selecti on from su ch fie lds as physics , 

psycho logy , and phy sio log y, as we ll a s th e st ri ctl y op to m et ric publ ic at io ns .

The w ide ra nge of m at er ia ls whi ch ev er y op tometry sch oo l sh ou ld ha ve availab le is ex em plifi ed by th e att ached li st in g (a tt ac hm en t A ). Com piled by th e 

Li on el Top az Mem orial L ib ra ry of V isua l Science a t Oh io S ta te U niv er si ty 

School of Optom etry , th e li st in g in cl udes an atom y of th e eye an d ne rv ou s system , ph ys ic al optic s, m et allu rg y, and vision in a r t an d in dust ry , to men tio n 

ju st a few .

T h at op to m et ry libra ri es se rv e a h e a lt h service are a of unusu al im po rtan ce 

is il lu str ate d by ac tio n take n la st y e a r by th e In dia na U niv er si ty F acult y Lib ra ry Com mitt ee . W ith adm in is tr ati ve sta tu s eq ui va le nt to th e 13 oth er un iv er ­

si ty br an ch li b ra ri es on campu s, th e univ ers it y es ta bl ishe d an op to m et ry li bra ry 

bra nch w ith a fu lly quali fie d li b ra ri an in ch arge . The ac tion is m ore sign ific an t 

be ca us e th e op to m et ry co lle cti on re p re se n ts only 4.000 ite m s— ex pe ct ed to do ub le 

w ithi n th e n ex t 10 ye ar s— in a u n iv ers it y li bra ry sy stem of al m ost 5 mi llion 

vo lumes an d ov er 100 ac ad em ic d epart m ents an d sch ools. It sh ou ld be no ted 

th a t th e opto m et ry br an ch li b ra ry is th e firs t ad di tion by th e co m m itte e in 27 

ye ar s.

C ur re ntly, op to m et ry libra ri es have be en dev eloped an d m ain ta in ed alm os t 

ex clus ively in co nn ectio n with opto m et ri c tr ain in g pr og ra m s. Thro ugh co op eration of an op to m et ric li b ra ri an s’ as so cia ti on an d in te rl ib ra ry loan arr an gem en ts , 

th ey ha ve pr ov id ed a reso ur ce fo r v is ual sci ence in fo rm at io n not pr ov id ed by 

ev en the L ib ra ry o f C ongre ss or th e N ational L ib ra ry o f M edicine.
70 MEDICAL LIB RARY ASSISTAN CE ACT OF 19 65

M an y ag en cie s, re se ar ch er s, an ti st ud en ts , un ab le to obt ai n de sire d in fo rm atio n else whe re , re gu la rly ta p th ese op tom etry libr ar ie s. In 1954 un de r the 

au sp ic es of th e Assoc iatio n of Sc ho ols an d Colleges of Optom et ry , th e libra ries 

of th e m em be r in st itutions dr ew up an ag re em en t wh ereb y ea ch ag re ed to—

(1 ) G at her an d pr es er ve a ll se ri al pu bl ic atio ns pu bl ishe d in an as sig ne d 

ge og ra ph ic al are a pri m ar ily re la te d to an y or al l ph as es o f vi su al scienc e; 

and

(2 ) Make th es e pub lica tion s av ai la ble to al l oth er li b ra ri es thro ug h the 

in te rl ib ra ry loa n ar ra ngem en t.

W ell ov er 200 pe rio dica ls are th u s re gu la rly pr es er ve d and m ad e av ai la bl e to 

oa ch li bra ry . Som e of th e publica tions are op ht ha lm ic ho us e orga ns , ot he rs 

publ ic at io ns of pr of es sion al so ci et ie s an d or ga ni za tion s of th e blin d, an d ot he rs 

pro m ot io na l pe rio dica ls d is tr ib u te d by op ht ha lm ic su pp ly la bora to ri es wh ich 

oft en c onta in v alua ble t ec hn ic al info rm ati on and st ati st ic s.

W hi le se rv in g as ed itor of th e In d ia n a Jo urn al of Optom etry . I became a cu tely 

aw are of th e im po rta nc e of li b ra ry ho ldings. The re were se ve n ea rl y issu es of 

th e Jo u rn a l mi ssing, an d a 3- ye ar se ar ch fa iled to tu rn up th e m issing pu blicatio ns . W e we re, th er ef or e, unab le to c om plete our se t and re lu cta n tl y conclud ed 

avail able co pie s s im ply d id n ot e xis t.

Any on e fa m il ia r w ith libra ry de ve lopm en t kn ow s th a t to est ab lish an d mai nta in a w or th w hi le libra ry bo th fu n d s an d h ard wor k are ess en tial . W hile libra ri es of op tom etry schools an d co lle ge s mak e a dilig en t an d co ns cien tio us e ffo rt 

to acquir e cu rr ent pu bl ic atio ns an d bu ild th eir co lle cti on s, th ey simply do no t 

ha ve th e fu nds to do al l they sh ou ld . A ttac hm en t B sh ow s to ta ls of li bra ry 

m ate ri als as of 1964. A t be st, opto m et ry s cho ol libra ri es to day of fe r only lim ite d 

fa cil it ie s.

In th e fu tu re th er e will be m ore de m an ds from st ud en ts , fr om re se ar ch personn el, and fro m pra ct itio ner s fo r li b ra ry ser vic es. To fill th e de m an ds libr ar ie s 

m ust de ve lop an d im pro ve th e ir fa cil it ie s an d co lle cti on s. The y mus t retine 

th e ir sy st em s fo r ind ex ing an d ca ta lo gi ng . Th ey m us t de ve lop pr oc ed ur es fo r 

ho us in g di sc ar de d volum es an d re pro duct io n of m at er ia ls . To pr ov id e th e v ision 

ca re th e Am erican peo ple ha ve ri g h tf u ll y com e to ex pe ct, we m ust ha ve the 

tool s to p ro vi de bo th th e ca re a nd th e r es ea rc h so e ss en tial to th a t ca re . Lib ra ries 

in th e healt h ca re field shou ld be eq uipp ed to pr ov id e th e ne ed ed info rm ation.

W heth er it be mi cro filmi ng fo r dis ca rd ed vo lumes or d a ta pr oc essin g fo r 

ca ta lo gi ng , th e fac ilitie s m us t b e avai la ble .

B ec au se of the need fo r im pr ov ed and up -d ated li b ra ry fa cil it ie s a t ea ch of 

th e co untr y’s schools an d co lle ge s of op tometry , w e st ro ngly urg e ad op tio n 

of the p ropo sed am en dm en t an d pass age of t he amen de d le gi slat io n.

Att ac hm en t A

E ss entia l Opto m etric R es ea rc h Ma te ria ls

(C om piled by Lion el Top az M em orial Lib ra ry o f Visua l Scien ces,

Ohio S ta te U niv er si ty Sch ool of O pt om et ry )

1. A na to m y of th e eye a nd n er vo us sys tem .

2. Ph ys io lo gy of t he ey e a nd n er vous syste m.

3. C om pa ra tive an atom y an d p hy siolog y of th e eye an d co m pa ra tive psycho logy 

of vision .

4. Ph ys io lo gi ca l op tic s, in cl ud in g se ns or y mec ha nism of vi sion , th e fu nc tio ns 

of th e in tr aocula r an d ex tr ao cu la r mu scl es, an d th e im ag e- fo rm in g me ch an ism 

of th e e ye.

5. E xper im en ta l psy cholo gy, in cl udi ng psyc ho logic al op tics.

6. E duca tional an d i n d u str ia l p sych olog y.

7. P hysi cal optics.

8. M eteo rologica l optics.

9. Phot og ra ph y.

19. Geo m etrica l optics .

11. Des ign, use, an d m anufa ctu re o f o pt ic al i nst ru m en ts .

12. M an ufa ctu re a nd di sp en sing of ey ew ear.

13. M anufa ctu re a nd te st in g o f o pti cal gla ss.

14. M et al lu rg y, w ith sp ec ial re fe re nce to m et als us ed in th e de sign of ey ew ea r 

an d opti cal in stru m en ts.

15. E ye ex am in at io ns a nd v is ual te st in g a nd trai nin g.

16. D is ea se s o f t he eye an d orb it a nd o f t he ne rv ou s syste m.
MEDICAL LIBRARY ASSISTANCE ACT OF 1965 71

17. Illuminating engineering, including colorimetry.

18. Vision in a rt and industry. 19. Social, legal, economic, and professio nal aspects of eye care. 20. Dictionaries , handbooks, and books on statistics and mathem atic s used 

by rese archers in the field of visual science.

At t a c h m en t B

Library holdings of 10 schools and colleges of optometry fo r 1964

N am e o f i n sti tu ti o n

O hio S ta te U n iv ers it y ___________

Lo s A ng el es Colle ge of O p to m e tr y .. .

S o u th ern College of O p to m etr y --------

U n iv ers it y o f H o u st o n -----

P en n sy lv an ia Col le ge of O pto m etr y..

Illinoi s College of O p to m e tr y _______

U n iv ers it y o f C ali fo rn ia ____________

M assa ch u sett s Col le ge o f O pto m et ry .

Pac ific U n iv e rsit y ................. .................

In d ia n a U n iv ersit y ..................................

T o ta l_________________________

Bo ok s an d 

m on og ra phs

P er io dic al s O th er

1,560 870 .50

3.2 00 700 400

4,37 8 767 31

200 100 200

6,800 1,0 00 100

5.300 550 2,50 0

2, 000 500 100

3,0 00 600 300

1,400 580

2 ,100 400 1,000

29,938 6,06 7 4,681

The Chairman. Thank yon very much. I am sure that you can, 

and will be given able asistance by the young man sitting to your 

right whom you have not yet identified.

Dr. Heath. This is Mr. William McCracken. I think he is well 

known to all the members of this committee. He serves as W ashington counsel for the American Optometric Association.

The Chairman. We are glad to have you again.

STATEMENT 0E WILLIAM McCEACKEN, WA SHI NGTON COUNSEL, 

AMEEICAN OPT OMETR IC ASSOCIATION

Mr. McCracken. Thank you, Mr. Chairman.

As I listened to the testimony th is morning, I could not help but be 

impressed with the fact tha t vision is the keystone of the utilization of all the libraries, whether it is medicine, law, education, or what. Op­ tometry is the science of vision. So I think it should be included.

The Chairman. Very good.

Mr. Springer. Mr. Chairman, I would like to ask, Doctor, in your 

attachment B, Illinois College of Optometry has more than half of all the other library holdings under “other.” Is there a reason for that?

Dr. H eath. This is a summary th at the schools put together without 

careful definition of all items that might come under “other.” So this perhaps represents a categorical switch. You see, some of these might be classified as periodicals by the other schools. On the other hand, the Illinois College of Optom etry also serves as a repository for 

the archives of several optometric associations or groups within op­ tometry and the Association of Schools and Colleges of Optometry, 

for example, has its archives deposited in that library. Tha t would be one reason for an unduly large number of “other" 

materials at that particular repository.

Mr. Springer. Thank you.

The Chairman. Mr. Pickle.
72 MEDICAL LIB RARY ASSISTAN CE ACT OF 1 9 6 5

Mr. Pickle. I just want, to add my word of thanks to I)r. Heath 

and Mr. McCracken for being with us. I think your request is in 

line, and I hope the committee will keep that in mind when it considers it.

Mr. Van Deerlin. Dr. H arry Malin, who is your association spokesman in San Diego, Calif., called me to say tha t they wanted this 

language included that you have indicated. He says that, even without this language, lie would expect that optometry would automatically 

be included. This would be an assumption on their part. This is an 

assumption on which you don’t rely too strongly ?

Dr. H eath. That is correct, sir.

Mr. Van Deerlin. You would like to have it spelled out?

Dr. Heath. We think that to be specifically included avoids any 

possible later misinterpretation of congressional intent.

Mr. Van Deerlin. Thank you.

The Chairman. Thank you very much. We are pleased to have 

your statements.

I thin k we will give opportunity, if there is no objection, to anyone 

who would like to file a statement for the record or who would like 

to supplement his statement for this record. The record will he held 

open l his week for that purpose.

The next witness will he Mr. Charles O. Reville, Jr., vice president 

in charge of sales, and you have with you Mr. Lyle Ixxlwick, director 

of marketing of the Williams & Wilkins Co., Balt imore.

STATEMENTS OF CHARLES 0. REVILLE, JR., VICE PRESIDENT IN

CHARGE OF SALES, AND LYLE LODWICK, DIRECTOR OF MARKETING, WILLIAMS & WILK INS CO., BALTIMORE, MD.

Mr. Reville. Mr. Chairman, mine is a summary statement.

The Chairman. Your statement which you have passed around will 

be included in the record.

Mr. Reitlle. Yes, sir. And since it contains some points tha t have 

not been touched on before, I will read partially from it, hut in 

consideration of the people who will follow me, I will skip a good 

deal of it.

The Chairman. All righ t.

Mr. Reville. I am Charles O. Reville, Jr., and with me is my colleague Lyle Lodwick. I am vice president for sales and Mr. Lodwick 

is director of marketing of the 'Williams & Wilkins Co., of Baltimore, 

Md., which is a private corporation devoted prima rily to the publication and distribution of medical books and journals.

Medical education and communications, as represented by books 

and journals, are our stock in trade, and medical libra ry facilities are 

essential links in this chain of communications. Obviously the passage of H.R. 3142 would have a direct and desirable effect on our 

financial well-being. A portion of increased funds available for 

book and journal acquisition—dependent on the value of our publications and our abilities to produce and distribute them—would certainly show up favorably in our sales figures. Even if we did not 

agree entirely with the compelling philosophical, educational, and 

humanistic arguments for this bill, the effect of it on our own profit-
MEDICAL LIBRARY ASSISTANCE ACT OF 19 65 73

and-loss statement would incline us toward at least considering endorsement. All considered, we are more than inclined.

The Williams & Wilkins Co., like so many of our good friends in 

medical education, strongly supports the intent and purposes of H.R. 

3142.

We would ask, however, th at an amendment be added as follows in 

section 397 on page 18 following line 24:

(C) to re fr ain from purc hasi ng fro m fo re ig n bo ok se ller s thos e pu bl ic at io ns 

ori gin ati ng ou tsid e th e U ni te d S ta te s wh en th es e publica tions are av ai la ble 

th ro ugh rec og nized tr ad e ch annels domiciled w ithin th e U nited St ates .

This amendment is quite frankly aimed at a practice in the publishing industry known as “buying ’round." Buying ’round occurs when 

a publisher or agent such as ourselves contracts with a foreign publisher to sell a book or a series of books in the United States, such titles 

being originally published outside the United States. And, after the 

agent assumes in one way or another all risks and cost of importing— 

including duties—plus warehousing and extensive promotion, we are 

bypassed or brought 'round by the book buyer and the sale is consummated not by us, the agent, but by a bookseller in London or somewhere else outside the 1 'nite d States. Estimates in the medical library 

market alone range from $200,000 to $400,000 annually in this type of 

business. Xow this may seem a very minor amount of dollars in this 

era of the “megabuck,” but it all depends on whose ox is being gored. 

At the moment, along with other U.S. publishers and booksellers, our 

corporate ox is being gored by a frisky yearling. But, given the passage of this bill, which we endorse—coupled with such factors as the 

almost algebraic increase in scientific information and the need to retrieve it—we will wind up being wounded by a full-grown bull.

Beside this threat to our own pocketbook, we feel there are very 

•clear principles involved.

First of all, the practice of buying 'round by librarians, institutions, and others contributes to the dollar drain and, even if in a small 

way, to the depletion of our country’s gold reserves. We’re sure it is 

not the intent of H.R. 3142 that these funds be spent directly outside 

"the United States.

Secondly, when books are purchased directly from overseas by 

libraries, while in theory the books are dutiable, in practice rarely is 

any duty collected by the post office. But, as purchasers of large lots 

for resale, we must pay a duty currently set at 4 percent. Increased 

buying ’round continues to remove this source of revenue from the 

U.S. Treasury.

Thirdly, when we import unfinished books—as is our majority 

purchase—the finishing of these products supplies good taxpaying 

jobs. The allowance or even the tacit endorsement of direct sales from 

-overseas to our libraries removes this wage-earning potential. It is 

common practice to have a “buv American” clause in Federal contracts. Why not in a bill supporting medical libraries?

Fou rth, as a small business we are part of a distribution system of 

small businesses. On this very committee the States represented by 

you gentlemen account for 60 percent of the active medical schools 

in the United States. Each one of these is served by a local bookstore 

•or dis tributor who is bypassed if a library buys directly from overseas. Isn’t it desirable that Federal funds allocated locally should be,
74 MEDICAL LIB RA RY ASSISTANCE ACT OF 1965

wherever possible, expended locally, creating employment and tax 

revenue locally ?

From the economic point of view, the medical book distribution 

industry in the United States has been a strange sort of an hermaphrodite by necessity rather than design. The manu facturer (i.e., publisher) is forced to sell directly to the purchaser as well as through 

bookstores. A strong bookstore-distributor complex seems desirable 

for medical communication as well as for local enterprise. We as a 

corporation have made positive efforts in this direction. Certainly 

it is not the intent of ILK. 3142 to condone the weakening of local, 

small business by tacitly allowing buying 'round.

Fifth , we feel that without a restrictive amendment to II.K. 3142, 

scientific communication will suffer indirectly. As mentioned above, 

the much-needed bookstore complex will be discouraged. But also 

the efforts of the U.S. agent/publislier makes known by direct mail, 

advertising, Library of Congress cataloging, and other sources the 

availability of various publications. When publications are bought 

’round, the fruit of these efforts by U.S. publishers and bookstores go

directly outside the American economy.

Aside from contributing t o the economy by the sheer mechanics of 

“making known,” we are also contributing to the scientific societies 

bv advertising imported publications in their periodicals and display ing them at their meetings. Increased buying ’round can significantly decrease or even eliminate these meaningful promotion expenditures. Will commensurate efforts and expenditures come into 

the United States from booksellers overseas? Not likely.

Sixth, it would seem to be in the general interest of the libraries 

and the medical community in general to discourage buying 'round. 

With the increasing threat removed or diminished, publishers could 

afford to import larger quantities, promote with more assurance and— 

with the added sales now escaping over the transom—lower prices.

In summary I would like to say that we urge this amendment be 

added. It would reduce th e U.S. dollar drain, increase customs revenue, encourage small business.

We are here to answer any of your questions. Thank you.

(Mr. Keville’s full statement follows:)

Statement of the Will iams & W ilkins Co., by Charles O. Reville, J r.

Mr. C ha irm an a nd mem be rs of th e comm ittee, I am C har le s O. Re vil le. Jr ., an d 

w ith me is my colleague, Ly le Lo dw ick. I am vic e pre si dent fo r sales an d Mr. 

Lod wic k is di re ct or of m ark eti ng of th e W illiam s & W ilkin s Co., of Baltim or e. 

Md ., whi ch is a pri vat e co rp ora ti on devo ted pri m ari ly to th e pu blicatio n an d 

dis tr ib u ti o n o f m ed ical book s a n d jou rn al s.

M ed ical ed uc ation an d co mm un ications , as re pre se nte d by bo ok s an d jo urn al s, 

a re o u r sto ck in tr ad e, an d m ed ic al li bra ry fa ci li ti es are es se ntial link s in th is 

chain of co mmun ica tio ns . O bv ious ly th e pa ss ag e of H.R . 3142 wo uld ha ve a 

d ir ect an d de sira ble effect on o u r fin an cia l well-being . A po rt io n of in cr ea se d 

fu n d s av ai la ble fo r book an d jo u rn al ac qu isiti on (d ep en den t on th e va lue of our 

publicati ons an d ou r ab il it ie s to pr od uc e an d dis tr ib u te th em ) wo uld ce rt ai nly 

sh ow up fa vo ra bl y in our sa le s fig ures. Ev en if we did no t ag re e en tire ly with 

th e co mpe lli ng ph ilo soph ic, ed uc at io nal , an d hum an is tic ar gum en ts fo r th is 

bi ll, th e eff ect of it on our ow n pr of it an d loss st at em en t w ou ld incline us to w ar d 

a t le ast co ns id er ing en do rs em en t. All co nsidere d, we are m or e th an inc lin ed.

T he W illiam s & W ilki ns Co., like so ma ny of ou r good fr ie n d s in med ical ed uca ti on. st ro ng ly s up po rts th e in te n t a nd p urpo se s o f H.R. 3142.

W e wou ld ask. ho we ver, th a t an am en dm en t be ad de d as fo llo ws in secti on 39 ? 

on p ag e 18 fo llo wing li ne 24:
MEDICAL LIB RA RY ASSISTANCE ACT OF 196 5 75

“ (C ) To re fr ain from purc hasi ng fro m fo re ig n bo ok se ller s thos e pub lica tion s 

ori gin ati ng ou tsid e th e U nited Sta te s wh en th es e publica tions are avai la ble 

th ro u g h rec oginz ed tr ad e ch annels do mi cil ed w ithin th e U nited Sta te s. ”

T his a men dm en t is quite fr a n k ly a im ed a t a pra ct ic e in th e pu bl ishi ng in dust ry 

kn ow n as “ bu ying ’ro un d.” B uyin g ’roun d oc cu rs w he n a publish er o r ag en t su ch 

as ou rs elve s contr ac ts w it h a foreign pu bl is her to se ll a boo k or a se ri es of 

bo ok s in th e United Sta te s, su ch ti tles be ing ori gin all y pu bl ishe d ou tsid e th e 

U nited St at es . And, a fte r t h e ag en t as su mes in o ne w ay or anoth er al l ri sk s a n d 

co st of im po rtin g (i ncl udin g duti es) , plus w ar eh ousi ng an d ex tens ive pr om otion, we are by pa ss ed or bou ght ’round by th e book buyer and th e sa le is co nsu m m at ed no t by us, th e ag ent, but by a bo ok se lle r in Lo nd on or somew he re els e 

outs id e th e United S ta te s. E st im at es in th e m ed ical li b ra ry m ar ket al one 

ra nge fro m .$200,000 to .$400,000 an nu al ly in th is ty pe of bu sin ess. Now th is 

m ay see m a very m in or am ount of do llar s in th is er a of th e “m eg ab uc k,” bu t it 

all de pe nd s on wh ose ox is bei ng gored . At th e mom en t, al on g w ith oth er U.S. 

publi sh er s an d bo ok selle rs, o u r co rp or at e ox is be ing go re d by a fr is ky ye ar ling . 

B ut. giv en th e p as sa ge of t h is bi ll— wh ich we e nd or se —co up led w ith such fa cto rs 

as th e alm os t al ge br ai c in cre ase i n scien tific in fo rm at io n an d t h e ne ed to re tr ie ve 

it — we wi ll wind up be ing w ou nd ed by a fu ll gr ow n bu ll.

Bes id es th is th re a t to o u r ow n pocketb ook, wye fe el th ere are ve ry cle a r 

pri nci ple s inv olv ed.

F ir st of all , th e pra ct ic e of bu ying ’ro un d by li b ra ri an s, in st itutions, and 

oth ers co nt ribu te s to th e d o ll ar dra in an d, even if in a sm al l wa y, to the de pletion of ou r co untr y’s gold re se rv es . W e're su re it is not th e in te nt of II.R . 

3142 th a t thes e fu nd s be sp ent dire ctly ou ts id e th e U nited St at es . Secon d, 

w he n books are pu rc ha se d dir ectl y from ov er se as by li b ra ri es, wh ile in th eo ry 

th e book s are du tiab le , in p ra cti ce ra re ly is an y duty c ol le ct ed by th e Pos t Office. 

B ut. as pu rc ha se rs of la rg e lo ts fo r resa le, we m ust pay a duty cu rr en tly se t 

a t 4 pe rcen t. In cr ea se d buy in g ’round co nt in ue s to rem ov e th is source of 

re ve nu e from th e U.S. T re asu ry .

T hir d, wh en we im por t un fini sh ed boo ks (a s is our m ajo ri ty purc has e) , th e 

fini sh in g of th es e pr od uct s su pp lies good ta xpay in g jo bs . Th e all ow an ce or 

ev en th e ta cit en do rs em en t o f di re ct sa les from ov er se as to ou r libra ri es re ­

mov es t h is w ag e- ea rn in g pote nti al. It is comm on pra ct ic e to ha ve a “B uy Americ an ” cl au se in F ed er al contr acts . Why not in a bi ll su ppor ting med ical 

li b ra ri es?

F o u rt h , as a sm all bu si nes s we ar e p art of a dis tr ib u ti o n sy stem of sm all 

bu sine sses . On th is ve ry co m m itte e th e S ta te s re pre se nte d by you ge ntlemen 

acco unt fo r GO pe rc en t of th e ac tive med ical scho ols in th e U ni ted Sta le s. 

E ac h on e of thes e is se rv ed by a loc al bo ok store or d is tr ib u to r wh o is by pa ss ed 

if a li bra ry buys dir ec tly fr om ov erseas. Is n ’t it desi ra ble that. Fe de ra l fu nds 

al lo cate d locally sh ou ld be, w here ver possible, ex pe nd ed lo ca lly , cr ea ting e mp loym en t an d t ax r ev en ue loc al ly ?

Fro m th e eco nom ic poin t of view, th e med ical book dis tr ib uti on in dust ry 

in th e U ni ted Sta te s has be en a st ra nge so rt of an her m aphro dit e by ne ce ss ity 

ra th e r th an desig n. The m an u fa ctu re r (i.e.. publi sh er ) is fo rc ed to sel l dir ec tly 

to th e purc has er as we ll as th ro u g h bo ok sto res . A st ro ng bo ok st or e- dis trib uto r 

co mplex see ms de si ra bl e fo r med ical co mm un ication as well as fo r local ente rpri se . We as a corp ora tion have mad e po sitive ef fo rts in th is directi on . Certa in ly it is no t th e in te nt o f IL R. 3142 to co nd on e th e w ea ke ni ng of loc al, 

sm al l bu sine ss by ta cit ly a llow in g buy ing ’ro un d.

F if th , we fee l th at, w it h o u t a re st ri cti ve am en dm en t to II.R . 3142, sc ientifi c 

co m m un icat ion will su ff er in dir ec tly. As men tio ne d ab ov e, th e much-needed 

boo ks to re comp lex wi ll be di sc ou ra ge d. B ut al so th e ef fo rts of th e U.S. a g e n t/ 

publi sh er mak es know n by d ir ect mail, ad ve rtis in g, L ib ra ry of Co ng res s ca ta lo gin g and ot her source s th e av ail ab il it y of var io us pu bl ic at io ns . W hen pu bl ic ati ons a re bo ug ht ’roun d, th e fru it s of thes e ef fo rts by U.S. pub lish er s an d bo ok ­

st ore s go di re ct ly outs id e th e American econom y. Asid e fr om co ntr ib uting to 

th e econom y by th e sh ee r m ec han ic s of “m ak in g kn ow n,” w e a re also co ntr ib utin g to th e sci entific so ci et ie s by ad ver tisi ng im po rted publ ic at io ns in th eir 

pe ri od ic al s an d di sp la yi ng th em a t th eir mee tin gs . In cre ase d bu ying ’rou nd 

ca n sign ifi ca ntly de cr ea se o r ev en el im in at e th es e m ea ni ng fu l prom otion expen diture s. W ill co m m en su ra te ef fo rts an d ex pen diture s co me in to th e U nited 

S ta te s from bo ok selle rs over se as ? Not likely .

Six th , it wo uld seem to be in th e ge ne ral in te re st of th e li bra ri es an d th e 

m ed ic al co mmun ity in gen er al to disc ou ra ge bu yi ng ’rou nd . W ith th e in cre as-
76 MEDICAL LIB RARY ASSISTAN CE ACT OF 196 5

in g th re a t rem ov ed or dim in is he d, pu bl ishe rs co uld affo rd to im po rt la rg er 

quanti ti es, prom ote w ith m or e ass ura nce a nd—w itl i th e ad ded s al es now e scap ing 

ov er th e tran so m —low er pr ic es .

It mig ht be well to sp ea k ab out pr ices at th is po int. Are im po rted boo ks 

pr ic ed hi gh er wh en bo ug ht in th is co unt ry th an whe n bo ug ht di re ct ly fro m 

ab ro ad? Of co urse th ey ar e, on an av er ag e of ab ou t 35 ix* rcent high er. If they 

w ere n’t, wh y then a good de al of th e reas on s fo r bu ying ’ro und w ou ld be rem oved. 

And wh y are th es e pr ic es h ig h er? For alxi ut th e sa m e re as ons th at we pa y 

m or e in th e United S ta te s fo r Volkswa gens, Sc otc h whi sk y, and inde ed fo r ho sp it al beds, ap pe nd ec tomies an d th e se rv ices of li bra ri ans, as we ll as th e wa ge s 

of pu bl ishe rs . Sp ea king of V olks wag en s an d Sc otch w hi sk y, ca n an y one of us 

o rd er by mail eit her of th es e co nu no dies an d ha ve them se nt to us dut y fr ee a t 

th e pri ce c ha rg ed in th e countr y of or ig in? I do ub t it. B ut a med ical or scientif ic book can be bo ug ht in pre ci se ly th a t man ne r.

Is it th e in te nt of H.R. 3142 to en co urag e such pra ct ic es ? We th in k no t. 

T here fo re we ur ge th a t yo u co ns id er th e ad op tio n of th e af or em en tion ed pr opo se d am en dm en t. Such ac ti on wou ld—

(а) Reduce t he U.S. d o ll ar dra in :

(б ) In cr ea se cu stom r even ue colle cte d by th e B ure au o f C ustoms :

(c ) En co urag e an d pr om ote sm all bus in es s;

(d ) En ha nc e the m ed ic al pu bl ic atio ns dis tr ib uti on sy stem an d hence 

m ed ical co m m un ic at io ns ; an d

(e ) Ulti m at ely lower th e li st price of im po rted bo ok s dis trib ute d in th e 

U ni te d States.

Also, su ch efforts ag ai nst buy in g ’ro un d ha ve th e en dors em en t of ov er se as p ub ­

lish ers . In some cas es, th e T'.S. m ar ket ac co un ts fo r 40- to 50-pe rce nt of th e 

en ti re fo reign pu bl ishe rs’ outp ut. Most st at em en ts in dic at e th a t thes e fo re ig n 

publish er s feel th at strong , un en cu m be re d U.S. ag en ts are de sira bl e.

F in al ly , we ’re ce rt ai n th e W illiam s & W ilki ns Co. as well as ot her U.S. pu blish er s. will benefit an d fo r th is we'd he gra te fu l.

Mr. Cha irm an an d m em be rs of th e co mmittee , we hav e ap pr ec ia te d an d en ­

jo ye d th is op po rtun ity to pre sen t our vie ws on th is ve ry im port ant le gi slatio n. 

W e w ill glad ly at te m pt to an sw er an y qu es tion s th e co m m itte e ma y have.

Mr. O’Brien. Mr. Ch airm an , I t hink one question s hould be asked : 

Are you aware of the pro vis ion on page 18 which pro vid es that gr an ts 

un de r this section shall be made only to medical lib ra rie s which agre e 

to make available ph otod up lic ated or facsimile cop ies of biomedical 

mate ria l which qualified req uesters may obtain? You are pub lish ers 

of biomedical hooks and journa ls. Do you re ga rd th is service by li ­

br ar ie s as good or bad fo r yo ur business?

Mr. TjOdwick. I would like to ans wer that . We have been previously 

te st ifyi ng on a com pletely dif fer ent bill, the c op yright law, and .photodu pl icatin g is a live issue. Tf the lib rar ies are going int o economic compe tition with the autho rs, scientific societies or pu blish ers who are pu blis hi ng scientific books an d journa ls which the lib ra ries use, I think 

then ap prop ria tio ns f or th is section should be reviewed very care fully.

I t hi nk really the respo nsibility is on the N ati on al Li br ar y of Medicin e, the Asso ciatio n of Me dic al Colleges, the Medical Li brary Associa tio n, to insure th at books and journals will no t go out of business 

because of this economic comp etition by the ph otod up lic ating and 

ot he r facsimile m achines.

Mr. O’Brien. You t hi nk it is m ore a m atter o f agreem ent , c ourtesy, 

an d un derst andin g than t o attempt to dra ft any specific lang uag e ?

Mr. L odwick. Preci sel y, sir.

Mr. O’Brien. Th an k you.

The Chairman. Tha nk you v erv much.

Mr. R eville. Th an k you, M r. C hairm an.

Mr. Macdonald (p re sidi ng ). The edit or and s ecret ary o f th e C ouncil on Education of the Am erican Po di at ry Associatio n, Dr. Rubin.
MEDICAL LIBRAR Y ASSISTA NCE ACT OF 19 65 77

STATEMENT OF DR. ABE RUBIN, EDITOR AND SECRETARY OF THE

COUNCIL ON EDUCATION, AMERICAN PODIATRY ASSOCIATION,

WASHINGTON, D.C.

Dr. Rubin. With your permission, sir, if I may have the full statement incorporated in the record, I will limit my remarks to a very 

short summation. I am Abe Rubin, D.S.C., a doctor of podiatry, executive secretary of the Council on Education of t he American Podia try Association and editor of Journal of the American Podiatry Association. With me is 

Mrs. Thomas Boyd, B.S., M.L.S., librarian of the Stickel Memorial 

Library of the American Pod iatry Association. Our colleges and our associations support fully this legislation. Aware of the very wide support, for the legislation, we have limited our presentation to a discussion of podiatry college needs and the 

extent of this need. This is presented in the table in exhibit A. We also raise the same question that some of the others voiced here as to whether or not this legislation extends the opportunity for Fed­ eral support to our libraries. We are suggesting two minor amend­ ments should they be necessary to assure this opportunity to our colleges to help them better serve our students, faculties, practitioners, 

and through them the health of the Nation. We thank you for the oppo rtunity of presenting our views to you 

and will feel privileged to answer any questions you may have.

Mr. Macdonald. Are there any questions ?

Thank you very much for your statement, sir.

Dr. Rubin. Thank you, Mr. Chairman.

(Dr. Rubin’s statement follows:)

Sta tem en t of t h e Am er ic an P od iatr y Ass ocia ti on, by D r. A be R ubin

Mr. C hai rm an an d mem be rs of th e co mm ittee, I am Abe Rub in , D.S.C., a 

do ctor of po di at ry , ex ec ut ive se cre ta ry of the Co uncil on E duca tion of the A m er ic an P odia tr y Assoc iatio n, an d edit or of Jo urn al of th e A m er ic an Podia tr y Assoc iatio n. W ith me is Mr s. Tho m as Boyd, B.S.. M.L.S., li b ra ri an of the 

Sticke l M em or ial Lib ra ry of th e A m er ic an Podia tr y Assoc iatio n. The A m er ic an Podia tr y A ssoc iatio n is a vo lu nt ar y, no np rofit fe der at io n of 52 

co mpo ne nt so cieti es. The as so cia ti on’s coun cil on ed uc at io n, whi ch I re pr es en t her e to da y, is list ed by th e Com m ission er of Edu ca tion , U.S. D ep ar tm en t of H ea lth, E du ca tion , an d W el fa re as th e na tiona l ac cr ed itin g ag en cy fo r th e five podia tr y colle ges. Thr ee of th e co lle ge s are mo re th an 50 years old . One cele­ bra te s it s 50 th an niv er sa ry nex t yea r, and one will gra duate it s 1s t cl as s in 1907. The co lle ge s are al l priva te , in de pen den t, no np rofit in st it uti ons. The minim al 

ed uc at io n pro gra m is 4 ye ar s of p o d ia tr y college a ft e r 2 yea rs of underg ra duate 

wo rk. We appear be fo re you to da y to e xpre ss th e inte re st a nd su ppor t of th e po dia try pr of es si on and it s colleges in th e le gis la ti on you are co ns id er in g as H.R. 3142 

an d si m il ar and r el at ed le gislation. In 1960. th e podia tr y pr of es sion es ta bli sh ed a spec ial co mmissio n to ex am in e in de pt h th e w ho le pr og ram of pod ia tr y ed uc ation. Thi s co mmiss ion w as chai re d by 'W illi am K. Selde n, LL. D., ex ec utive se cr et ar y of th e N ational Co mm iss ion on A cc re ditat io n. Be sid es th e chair m an, th is co mmiss ion co ns iste d of th re e ed uc at ors fr om th e field of hig he r ed uca tion (n onpodia tr is ts ) ; on e do ctor of med icine (a medi<*al ed uc at or ) : an d a mem be r of th e bo ar d of tr u st ees of a p o d ia tr y c ollege. Thi s comm iss ion w as orga nize d to ex am in e fr om a br oa d po in t of vie w, th e pr of es sion ’s ed uca tional pro gra m an d ad vise on st ep s ne ce ss ar y to im pr ov e th is prog ram. In fu lfilling th e la tt er p art of th is obliga tion —i.e..
78 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

reco mmen da tio ns fo r th e fu tu re , th e Se lde n co mmiss ion ma de th e fo llo wing 

st at em en ts on li bra ry nee ds :

It is r ecom me nd ed t h a t ea ch college o f podia tr y—

(а ) In cr ea se th e sp ac e in th e li bra ry to pr ov id e ad eq ua te ly fo r re ad in g 

an d re fe re nc e pu rp os es , and fo r s he lv ing of books ;

(б ) In cr ea se th e num ber of vo lum es and per io dic al s on a selec tiv e b asis ; 

(c) Bi nd a nd file bac k is su es of p eri odic als ;

((I) Catalog and i ndex a ll li bra ry h old in gs; an d

(e ) Em ploy a pro fe ss io nal ly tra in ed lib ra ri an on a fu ll- tim e b asis.

Rec en tly , th e st af f of th e coun cil on ed uc at io n m ad e a stud y of th e five 

podia tr y colleg es in ord er to co mpa re ex is ting co nd itio ns w ith th e re co m m en da ­

tions of the Se lde n co mm ission mad e in 1961. Th e fa c t re m ai ns th a t pr og re ss is 

be in g mad e but a t a pa ce ala rm in gly slow. F ig ure s on th e at ta ch ed ex hib it A 

sh ow t h at li bra ry c onditio ns in ou r colleg es ha ve a n avera ge d efi cit in sp ac e ne ed s 

of 4,097 sq ua re f e e t; an a vera ge d efi cit in vo lume ne ed s, of 8,541.

The need to ex pa nd th e libra ri es in ou r podia tr y co lle ge s is vita l. In th e la st 

5 yea rs ou r college en ro llm en ts ha ve rise n 40 per ce nt, oper at in g costs ha ve ri se n 

131 pe rcen t, an d av er ag e co st of ed uc at io n per st udent has nea rly doubled . O ur 

st udents mus t, in mos t ca se s, tr avel co ns id er ab le dis ta nces to av ail them se lv es 

of ad eq ua te li bra ry fa cil it ie s be ca us e th e podia tr y co lle ge li bra ri es ca nn ot m ee t 

th e ir ne eds—an o bv ious ly u nsa ti sf acto ry arr an gem en t.

O ur 5 colleges of p odia tr y ha ve a to ta l en ro llm en t of 625 stud en ts. To pr ov id e 

th e nu m be r of podia tr is ts ne ed ed by 1980, podia tr y co lle ge s wi ll ha ve to g ra duate 

about 600 st ude nts annuall y be ginn ing w ith 1968. T his is ap pr ox im at el y th re e 

ti m es th eir pr es en t ca pac ity.1

 One ve ry re al fa cto r in th e nee d fo r mor e 

podia tr is ts is th e ra pid ly ex pa ndin g o lder p op ul at io n. 2

 Tw o- th irds of al l p ati en ts 

re quir in g po di at ry ca re a re ov er 45 yea rs of age. The libra ri es in ou r podia tr y 

colle ges mus t grow an d m ust grow ra pi dl y. 3

 Bas ic co llec tion s need to he re vi se d 

an d enla rg ed; bu dg et s m u st be ex pa nd ed to p urc has e all la te st li te ra tu re on fo ot 

h e a lt h ; an d addi tion al pro fe ss io nal pe rson ne l m us t be em ploy ed to or ga ni ze and 

ad m in is te r such li bra ri es .

The H ea lth Pro fe ss io ns Edu ca tiona l Ass istanc e Ac t o f 1963 pr ov id es podia tr y 

co lle ge s w ith th e opport unit y to part ic ip ate in su pport be ing prov ided by th e 

F ed era l Gov ernm en t fo r ex pa ns io n an d im prov em en ts in ed uc at io n fo r th e healt h 

pr of es sion s. We ur ge th a t yo ur co mmittee am en d th e lang ua ge of th e pre se nt 

le gis la tion to pr ov id e th e sa m e op po rtun ity fo r th e ir li bra ri es as pr op os ed by 

H .R . 3142. This can be ac co m plishe d w ith tw o simple am en dm en ts an d th es e a re 

att ached in e xh ibit B.

The po di at ry pr of es sion fu ll y su pp or ts th e need of th e le gi slatio n kn ow n as 

M ed ical Lib ra ry A ss is ta nc e Act of 1965 an d th anks yo u fo r th e op po rtunity of 

pre se nti ng th is opin ion to yo u.

It w ill be a pr iv ile ge to a n sw er an y qu es tio ns yo u m ay ha ve .

E xh ib it A

Library deficits for the 5 p odiatry colleges {lst-year enrollment ranges from

1/0 to 60 stud ents )

Pre sent 

average size

Suggested 

standard i

Average

deficit

Average 

co st 2

Total cost

Spa ce__________ _______ . . . 3 1,903 3

 6,000 3

 4,097 $163,880 $819,400

Lib rary collection_____ ______ « 1,459 <10,000 <8; 541 111,033 555,165

1

 Based on council on ed ucation ’s suggestions for minimal library req uirements.

2

 Based on OSA figures from “ Program for Developing Medical Lib rar ies,” Pre sident’s Commission on 

Heart Disease, Cancer, a nd Strok e, Febru ary 1965.

3

 Square feet.

« Volumes'—which means books an d serials (serials includes perio dica ls,.a nnual reports, yearbooks, proceedings, and transactions of societies).

1

 B lauc h, Llo yd E., Ph. D. Num be r of podia tr is ts ne ed ed . Jo urn al of th e American 

P o d ia tr y As socia tio n. 55 : 356- 35 9, 1965.

2

 R ub in, Abe. D.S.C. E nro ll m en t, spaces, m an po wer sh ort ag es an d pr ojec ted podia tr y 

co nst ru ct io n. Jo urn al of th e Am er ican Podia tr y Ass oc iatio n. 54 : 70 9-71 2, 1964.

3 Fu ch sb er g. Ro be rt R. R eport pr es en te d to th e 196 5 annual mee tin g of th e Am erican 

P o d ia tr y As so ciation (in p re p ara ti o n fo r pu blica tion). (M r. Fuc hs ber g is on th e st af f of 

th e N at io nal Cen te r fo r H ea lt h S ta ti st ic s.)
MEDICAL LIB RARY ASSISTAN CE ACT OF 19 65 79

E xhib it B

Proposed A me nd men ts to H.R. 3142

Pag e 3, line 20, aft e r th e w or d “d en ti st ry ” ad d tli e wor d “p o d ia tr y ”.

Pag e 14, line 19, a ft er th e w or d “p hy si ci an s” ad d th e w or ds “a nd podia tr is ts .” .

Mr. Macdonald. Mrs. Phy llis V. Parkins, Director, BioSciences 

Information Service, Philadelphia.

STATEMENT OF PHYLLIS V. PARKINS, DIRECTOR, BIOSCIENCES 

INFORMATION SERVICE, PHILAD ELPHIA, PA.

Mrs. Parkins. Mr. Chairman, members of the committee, I am very 

pleased to be able to present a brief statement on behalf of Biological 

Abstracts, as representing one of those biomedical publications I think 

are referred to in section 399 of the proposed legislation.

I do not know whether an abstracting and indexing service is very 

familiar to the members of the committee or not. Our chief product 

is a journal published semimonthly and covering well over a hundred 

thousand, tha t is, analyzing and publishing abstracts of yvell over a 

hundred thousand research articles in the life sciences. So you can 

see it is a very large area of world literature that is covered and much 

of it is biomedical in importance.

Approximately half of our supporting subscriptions come from 

abroad. I think perhaps the committee might like to know that 

Biological Abstracts, in this country, is the world’s largest and most 

importa nt abstracting service in the life sciences, located in Philadelphia, and more precisely, on the campus of the University of 

Pennsylvania where Dr. Luthe r Terry will be residing in the near 

future.

We have been greatly concerned that financial support of those 

existing services that are widely used to further the dissemination of 

inform ation in the medical sciences would not be included under the 

provisions of this act. Our fears may be groundless. The wording 

m section 399, as I pointed out in my submitted statement, refers 

only to those publications th at are associated with institutions of 

higher education; yet there are many nonprofit, active information 

disseminating services that are not directly associated with institutions 

of highe r education.

In general, and certainly I can say it more boldly tha n that, we do 

endorse this legislation as being a very forward move in furth ering 

the communication of information in the medical sciences, which is 

very important to the future advance of medical practice.

Mr. Macdonald. Thank you very much.

Are there any questions?

Mr. Van Deerlin. Mr. Chairman, I did not get what the witness’ 

fear was.

Mrs. P arkins. It is presented in detail in my formal statement, 

sir, and perhaps we had better no t use the time for readin g it precisely.

Mr. Van Deerlin. Thank you.

(The statement presented by Mrs. Parkins follows:)
80 ME DIC AL LIBRARY ASSISTANC E ACT OF 196 5

Sta te men t of B io Sc ie n c es I nf or mat ion Ser vi ce of B iol ogica l Abst racts , b y

P h y l l is V. P a r k in s, D ire ctor

Mr. Cha irm an , and mem be rs of th e co mm itt ee , in ge ne ral, H.R. 3142 (H a rr is ) 

re pr es en ts an ex tr em ely fo rw ar d- look in g ef fo rt to w ard st re ngth en in g th e healt h 

serv ice s of th is co un tr y, in ou r opini on . Com m un ication of new kn ow ledg e in 

th e me dical an d re la te d sci ences is inde ed ba sic to it s ap pl ic at io n in b ett eri n g 

th e he al th o f o ur own citize ns a nd p eople s e ve ry w he re .

On be ha lf of Bio Sc ienc es In fo rm at io n Se rv ice of Biolog ica l A bst ra ct s, ho wever. an d in th e in te re st of ot he r no np ro fit org an iz at io ns an d so ci et ie s in a 

si m ilar si tu ati on w it h re sp ec t to th e prop os ed legi slatio n, I w ish to bri n g to 

yo ur atten tion w ord in g in II.R. 3142 (H a rr is ) th a t wo uld ap pea r to be in co nflict w ith th e sta te d p ur po se of t his bill.

Pl ea se re fe r to se ct io n 399— “F in an ci al S upport of Biomed ica l Sc ientifi c P ublica tio ns ,’’ pa ge 20. line s 18 to 25, co nt in ue d as li nes 1 an d 2 of pa ge 21. Mo re 

spe cifically. I wou ld ca ll to yo ur at te nti on line s 21 an d 22. be ginn ing “c o n tr acts 

w ith , pu blic or p ri v a te no np rofit in st itutions of hig her ed uc at io n an d in div id ual 

sc ie nt ists * * Sinc e se ve ra l of th e “b iom ed ical pu bl ic atio ns of a no np ro fit 

nat ure .” an d “w ri ti ng, ed iting , an d pu bl ic at io n of rev iew s, ab st ra cts , in ­

de xes * * ♦” a re alm ost wh olly sp on so red by sc ie nt ific socie tie s an d (o r) p ri v ate 

no np rofit org an iz at io ns, ra th er th an by “in sti tu ti o n s o f hig he r educa tion an d 

indi vi du al sc ie nti st s. ” th e pr es en t w or ding of th e bill wo uld ex clud e a la rg e 

nu mbe r of so ci et ie s an d or ga ni za tion s sp on so ring ex is ting bio med ica l publi catio ns a nd in fo rm at io n serv ices fro m r ec eiving fina nc ia l as si st an ce in th e p ro po se d 

prog ram. As a co ns eq ue nc e of th eir ex clus ion th e pu rp os es of th e bi ll under 

co ns id er at io n wou ld be seriou sly im pa ired . In ac tu ality , a p a rt from li b ra ri e s 

an d libra ry se rv ic es , ve ry few in fo rm at io n acti vit ie s (n on profit scientifi c jo u rn a ls 

or ab st ra cti ng an d (o r) inde xi ng pu bl ic at io ns ) a re spon so red or co ntr olled by 

in st itutions of hig h er e du ca tio n.

Per m it me to us e Biologica l A bs tr ac ts as on e ex am pl e of a no np ro fit org an iz ation th at mig ht be in el ig ib le fo r aid in fu rt h eri n g th e co mmun ication of bio ­

med ica l in fo rm ati on— und er th e pr ov isions of th e bi ll as it is wor de d a t pre se nt. 

Yet in 1965 o u r ch ie f pu blicatio n, Biolo gic al A b st ra cts an d it s inde xe s, pu blish ed 

semim on thly, wi ll pre sen t inde xe d abst ra cts of a t le ast 110,000 re se ar ch art ic le s, 

th e bu lk of whi ch ca n be cla ssed as biom ed ica l in co nten t. In additio n, a pu blic atio n to appear fo r th e first tim e th is m on th — BioRes ea rch T it le s w ill in dex 

an d includ e c om pl ete re fe re nc es f or a noth er 20,000 re se ar ch ar ti cle s no t re p re se n ted in Bio log ica l A bst ra ct s. For 1966— 120,000 in de xe d abst ra cts are p la n n e d ; 

60.000 ad ditio n! ’! a rt ic le s will be re pre se nte d in Bio Res ea rc h Titl es .

Bi olo gic al A b st ra cts has been pu blishe d co nt in uo us ly sin ce 1926, and is no w 

th e w or ld ’s la rg est an d mo st co mpr eh en sive ab st ra cti n g an d in de xi ng se rv ic e 

of its kind . I t is w id el y used as an in fo rm ati on too l in biom ed ica l re se arc h, 

both he re and a br oa d.

In view of th e si za ble effo rt re qu ired to su pport biom ed ica l sc ientifi c publi ca ­

tio ns, and in th e in te re st of th e nat io nal eco nomy , I feel cer ta in i t w as not th e 

in te nt io n to de ny fina nc ia l as si st an ce to exis ti ng pu bl ic at io ns of vit al im po rta nc e to biom ed ici ne . Ther e are a gre at man y, bo th pri m ar y an d se co nd ar y, 

th a t can co ntr ib ute su bst anti all y to th e ai m s and go als re pr es en te d by Bi ll 

II. R. 3142 (H a rris ).

As evide nce, p erm it me to su bm it copie s of Bi olog ica l A bs tr ac ts , c u rr e n t 

abst ra ct issu es and inde xe s, fo r ex am in at io n of th e comm ittee. In cl ud ed , als o, 

are an ou tlin e of su bj ec ts covered in Biologica l A bstra ct s, an d a br ea kdo w n 

of pr op or tion at e co ve ra ge by su bj ec t fo r th e pre ce di ng ye ar .

Mr. Macdonald. Mr. William Budington, Special Libraries Association, Chicago, Ill.

STATEMENT OF WILLIAM S. BUDINGTON, SPECIAL LIB RARIE S 

ASSOCIATION, CHICAGO, ILL.

Mr. Budington. Thank you, Mr. Chairman.

I would like to make three very brief points which are amplified in 

the statement which I trust may be included in full in the record.

Mr. Macdonald. Without objection, th at may be done.

(Thestatement follows:)
MEDICAL LIBRARY ASSISTANCE ACT OF 19 65 81

S tateme nt of Will iam S. Bud ingt on , in Beh al f of th e Spe cial Libraries

Asso cia tio n

My na me is W ill iam Bud ington . I am as so ci at e li b ra ri an of th e Jo h n C re ra r 

L ib ra ry in C hi ca go ; th is is a pri vate org an iz at io n pr ov id in g fr ee pu bl ic libra ry 

se rv ices in scien ce, tec hnolo gy, an d med icine, an d is th e la rg est su ch public 

li bra ry in th is co un try. I am her e to pre se nt the view s of th e Spe ci al L ib ra ri es 

Assoc iatio n, of wh ich I am th e p ast pr es id en t. Thi s as so ci at io n is com pos ed 

•of som e 6,1(M) mem be rs who are li b ra ri a n s an d in fo rm at io n sp ecia li st s em plo yed 

in pri vate and pu blic or ga ni za tion s an d in st itut io ns, in cl ud in g in dust ri al, ac ademi c, as so ci at io n, a nd ind ep en de nt n on pr of it ac tivi ties .

O ur as so ci at io n wishe s to ex pr es s it s w ho le he ar te d su pp or t of II. K. 3142. In 

it s "d ec la ra ti on of policy an d st ate m en t of pu rpos e.” th e bil l it se lf pinp oi nts 

th e ne ed s fo r ac tio n. It is har dly nec es sa ry fo r me to sp ea k agai n of th e ra te 

a t which sc ie nt ific re se ar ch is outp ac in g itse lf, in te rm s of uti li zati on of know n 

fa cts , old an d new . In the hea lth scienc es, th is is es pe cially cri ti cal in to da y's 

co nte xt of co nc er n fo r ou r N at io n’s h ealt h an d th e co nt in ui ng w elf are of ou r 

citiz en s. W hi le we ar e ac cu sto med to su pp ort re se ar ch ac tivity, we ha ve no t 

pr ov id ed adeq uat el y fo r di ss em in at io n an d avai la bility of gen er at ed re su lts . 

To in su re pr om pt an d eff ectiv e us e of our new sk ills an d kn ow ledg e, it is 

es se ntial th a t th e crea tio n, reco rd ing, bibl io gr ap hi c co nt ro l an d avail abil it y of 

m ed ical kn ow ledg e be a ssu re d ; th is re quir es fede ra liz ed , co ord in at ed su pp or t 

a t ea ch ph as e of th e co mmun icative ch ain in th is vital ar ea .

Of all are as of sci entific co m m un icat io n, medici ne is pre se ntly se ei ng pe rh ap s 

th e mos t in te re st in g ad va nc em en t, th ro ugh wo rk a t th e N at io nal L ib ra ry of 

Medicine. Thro ugh ex pe rim en ta tion , an d in curr en t ap pl ic at io ns , we are w itne ss in g ap plica tion of co mpu ter tech no lo gy an d m ec ha ni za tion to th e stor ag e 

an d ra pi d di ss em in at io n of data an d id ea s. Th e prop osed le gis la tion will pr omot e a net w ork of fa ci lities which w ill l>e larg ely au to no m ou s and sou nd ly 

p re p are d : yet th ey wi ll be co nt in ual ly in fu se d an d m utu al ly su pport iv e in seein g 

th a t th e ne ed ed , co rr ec t an d la te st in fo rm at io n is alw ay s re ad y, an yw he re 

in o ur c ou nt ry .

Support of libra ri es an d in fo rm at io n act iv ity is comm on ly seen as bu ild ing 

m or e bu ildi ng s an d bu yin g more books. Th ese are inde ed ba sic . B u t pr es en t 

an d fu tu re ne ed s refle ct eve n mor e bas ic ch an ge s. It is no t su ffici en t to bu y a 

book , sh elve it an d m ai nt ai n silenc e aro und it. T oday 's li b ra ri an s an d in ­

fo rm at io n sp ec ia li st s are only se co ndar ily in te re st ed in a hoo k as a conta in er; 

th ey are v it all y co nc erne d w ith it s conte nt an d. as ex pr es se d by our as so ci at io n 

slo ga n, w ith “p utt in g k no wledge to w ork .” C re atio n of su ch conte nt and kn ow ledge in th e biom ed ical sciences has be en sp urr ed by F edera l exp en d it u re s; in 

th is su bj ec t a re a alo ne, suc h su pport no w to ta ls more th an ,$1 bi llio n per yea r 

in sp on so re d re se ar ch . In vir tu all y no in st an ce s ha ve th es e g ra n ts pr ov id ed fo r 

li b ra ri es or fo r in cr ea se d fa ci lities in th e su pp ly an d flow of in fo rm at io n. Ope rati ng bu dg et s and ad de d spac e fo r li b ra ri es ha s ha d to come fr om in st it uti onal 

fu nd s, an d yo u will be ha rd pu t to find muc h evide nc e of any su pport from local 

re so ur ce s. If mo ney w as n’t to be had fo r li bra ri es be fo re th e gra nt, it is n’t 

th er e a ft erw ard , ei th er .

The bil l sp ea ks— an d one n atu ra ll y th in ks—of med ical sch oo ls, loca l pra ctition er s, and in sti tu te re se ar ch er s as be ne fitin g mo st. In re al it y, th e inf lue nce 

is mu ch bro ad er . Th e mem be rship o f our own as so ci at io n in cl ud es bu t 580 

mem be rs in it s bio log ica l scien ces div isio n. In th e sp ac e scienc es, nu cl ea r 

scien ces, tec hn olog y, ch em istry an d si m il ar are as a re an oth er 2.800. An d all of 

them ha ve n ee d of m ed ical in fo rm at io n ra ngin g f rom ca su al to co nst ant. Re call, 

if yo u wi ll, su ch topi cs as ae ro sp ac e ph ysiology , ra dia ti on haz ar ds, to xic ity of 

m at eri als , a ir jio llu tio n an d th e lik e. An a ir c ra ft co mpa ny may hav e a good 

te ch ni ca l lib ra ry ; it mus t dei>end on o th er sour ce s fo r m ed ical do cu m en ts an d 

in fo rm at io n. W hi le s uch in dust ry n a tu ra ll y t u rn s to. say, a loc al m ed ic al school, 

th is li bra ry is sel dom eq uip ped to se rv e th es e de man ds in ad di tion to it s own 

st af f an d st uden ts . Prov ision of re gio nal me dical li b ra ry ce nte rs w ill th us 

be ne fit in d u str y in ad di tion to ex is ti ng med ical sch ool fa ci lities . I t will als o 

in su re su ch re so ur ce s in are as w he re no to pf ligh t med ical li bra ri es of an y kind 

are n ow to be fo un d.

To som e exte nt, th e pre se nt bill is a im ed a t cu ring p re se nt ills. W e ne ed bet te r 

li bra ri es an d li b ra ry fa ci lities now. W e ne ed bet te r tr ain ed st af f now. gr ou nd ed 

in th e su bje ct m att ers of med ical sc ie nc e an d li bra ry or in fo rm ati on scienc e. 

We need ra dic all y new tech ni qu es now , to cope with a pre se nt flood of in fo rm atio n an d pu bl ic at io ns. B ut if we ne ed th ese thin gs now . an d ba dly, w h at is in
82 MEDICAL LIBRARY ASSISTANCE ACT OF 196 5

store for the future , as our resea rch effort and sup por t cliuiibs literally astro ­

nomically? Above all, we need action now so th at we will not be completely 

engulfed and eternally helpless. Today’s preparatio n, as embodied in the prov isions of this bill, will prov ide tomorrow’s resources. Resources for efficient 

medical research, resource s for adequate education, resources for use in all the 

fields touched by medical implications and advances. Information at the rig ht 

time, at the right place, for the right person in the rig ht form will be vitally 

needed. If we make no provision for these resources, we had better save ou r 

curre nt research outlay, for its results will be perm anently and irrevocably 

buried.

A particu larly important fea tur e of this bill is th at its implementation, while 

including educational ins titu tions, is not res tric ted to them. In our cu rre nt 

concern for maximum advancement of education al programs at all levels we 

may overlook the fac t th at information needs and flow and learning occur 

thro ughout our economy and our geography, not solely in the teaching process 

and institution. I have mentioned the needs of industry. One must remember 

also the needs of scho lars in other fields tha n medicine, at nonmedical insti tutions. One must especially remember the practitio ner and the hospital. These 

people may be far removed from a medical scho ol; yet their daily needs are increasing. The doctor mu st continue his education. Il is practice, and the work 

of this hospital staff, need more than ever the close conta ct with th e la test la bor atory development and the new clinical or surg ical techniques. The regional 

medical library can best serve the ir needs, with services developed on a very 

broad scale. These services may include support of teachin g and medical education, indeed. But they go fa r beyond, in providing a tailored, automatic, 

prompt, and continuing flow of information to all who need it.

This also requires specialists in medical info rmation work, who are traine d 

for this specific field and hav e not ju st drifted into it. The curricula of librarianship and information science are reflecting these needs. Attention is now’ given 

in several professional schools to thorough traini ng in medical librarianship. 

We cannot find enough such sj>eeialists no w; the supply must be stepped up.

In conclusion, I wish to reite rate the supp ort of our association for this bill. 

We believe it provides sound elements for expansion of facilities, available personnel, and improved medical comm unications. Tha nk you for the opportunity 

of appearing in behalf of th is legislation.

Mr. Budixgtox. Fir st, we have been accustomed in recent years to 

supporting general research in the sciences to a very large extent, but 

no provision whatsoever has been made for the dissemination of the 

information generated in this research and particularly so through the 

medium of libraries, abstracting services and other similar means.

Second, I would emphasize that this bill has very broad effects 

beyond those of the education field typified by the libraries in industry 

represented in our association. Everyone knows now the many effects 

of cross-fertilization of fields and industrial libraries have considerable 

need occasionally for medical information for biological information 

and at the present time they cannot rely completely upon medical 

school libraries as a source.

The regional medical library action can help to supplement these 

sources which they need.

Third, T can only reiterate again the need for immediate action in 

these fields about which we have been talking this morning. Estimates currently are that there are something in the order of 200,000 

articles yearly in the field of medicine and 10,000 monographs. It is 

almost impossible to control these now and to disseminate the information contained in them. It is only through the additional facilities 

provided in this bill that we have any hopes of succeeding.

Thank you, sir.

Mr. Macdoxald. Tha nk you very much.

Are there any questions of the witness ?
MEDICAL LIBRARY ASSISTANCE ACT OF 196 5 83

Mr. O’Brien. Mr. Chairman, I would just like to make this statement. This I assume is the conclusion of the hearings. I don’t recall 

since I have been on the committee any legislation which has such 

solid, enthusiastic, across-the-board support as this particular legislation has.

I might add further that I think all of us learned something this 

morning, that through the years we have built a gigantic reservoir of 

research knowledge. One of the witnesses said it would cost $3 

billion a year by 1970. I think that, unfortunately, in building the 

reservoir we also are depending on a 1-inch main to get the stored materia l out to the public.

Thank you, Mr. Chairman.

Mr. Macdonald. Thank you, Mr. O’Brien.

Without objection, I will include in the record a t this point a statement by William N. Hubbard, Jr ., M.D.

(The statement follows:)

Sta te m ent of W il l ia m N. H ubbard, J r., M.D.

Mr. Chairman, I thank you fo r this opportunity to express my wholehearted 

support of the Medical Library Assistance Act of 1965.

Many distinguished national associations concerned with the health of the 

American public have supported this act. The Pre sident’s Commission on Heart 

Disease, Cancer, and Stroke has included several recom mendations which would 

he supported by this act and has emphasized the importance of these matters by 

st at in g:

“The Commission feels strongly th at unless major attention is directed to improvement of our natio nal medical library base, the continued and accelerated 

generation of scientific knowledge will become increasingly an exercise in 

fu tility .”

The National Advisory Health Council of the U.S. Public He alt h Service has, 

on two recent occasions, made formal resolutions supporting programs which 

would be implemented under the provisions of this act.

My own testimony is based on 15 y ears of ac tivity in adminis trative posts suppor ting medical education, hea lth-relate d research and medical care. As the 

dean of the University of Michigan Medical School, a member of the executive 

council of the Association of American Medical Colleges and the Board of Regents of the National Library of Medicine, I have a privileged perspective of the 

communication needs in medicine and the rela ted health sciences. The opportunity of serving on committees advisory to Fed eral agencies concerned with 

hea lth problems has led me to a full appreciatio n of the importance of the role of 

the Federal Government in securin g the health of the people.

SECTION 39 0. DECLARATION OF POLICY AND STATEM ENT OF PUR POSE

This section reflects the complex variety of users th at a modern libr ary of the 

hea lth sciences must serve. Requirements of the gra duate or professional stu ­

dent, the researcher, the facu lty, the hospital inte rns and residents, the postdoctoral fellow, the community practitioner , industry, and, not least, the requests 

of oth er h eal th science libraries must all be met.

Although weekly and monthly ser ial journals now make up the bulk of the 

holdings of medical libra ries, textbooks and monographs continue as important 

reference documents. Without diminishing the importance of these more tra ditional holdings, television tapes, photographic films and slides, audiotapes and 

visual disp lays are becoming of inc reasing importance a s means of storing scientific information. Modern electronic forms of handling this info rmation through 

the use of computers and microreproduction hold the promise of more efficient 

and more economical access to this stored information. Such electronic devices 

also allow access to the holdings of the library from dis tant area s and form the 

basis of predic ting the development of a n ational network.

The policies enunciated in section 390 recognize the bre adth and complexity 

of the problem of communications in the health sciences and the importance of 

the evolving library as a means of providing essential improvements in these 

comm unications.
84 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

SE CT ION 3 9 2 . N A TIO N A L ME DICA L LI BRARIE S A SSIS TA N C E HOARD

T hi s section re pre se nts a n ex tens ion of th e ex is ting fu nc tion of th e B oa rd of 

Reg en ts of the N at io na l L ib ra ry of Me dic ine. I do no t sp ea k fo rm ally fo r th a t 

Boa rd , bu t wo uld a ss ert th a t th e moo d of t he mem be rshi p is t o ac ce pt th e re sp on ­

si bilitie s defined under th is section as re pr es en ting a pro per ex pa ns ion ra th er 

th an a d igression from t h e ir e st ab lish ed re sp on sibi lit y.

SE CT ION 3 9 3 . A SSIS TA N C E FOR CO NS TR UC TION OF FA C IL IT IE S

The nee d fo r in cr ea se d m an po wer in su pp or t of th e healt h of th e N at io n is 

w el l do cu men ted. No t only ph ys icians , den tist s, an d nu rs es , but an a rr a y of 

re la te d h ea lth w or ke rs o f in cr ea si ng im po rtan ce to the sy stem o f d elivering h ealt h 

se rv ic e m us t be ed uc at ed in ou r colleges, univ er si ties , an d teac hing h o sp it a ls ; 

all of wh ich re qu ire li b ra ry fa ci lities beyond t hose no w av ai la bl e. F urt herm ore 

th e need fo r m ai nte na nce of our he al th -r el at ed re se ar ch ef fo rt re qu ires th e im ­

prov em en t an d ex tens io n of our li bra ry syste m. As th e post gra duat e ed uc at io n 

ef fo rts th a t are so 'sorel y ne ed ed on be ha lf of th e co m m un ity pra ct it io ner a re 

real ized , he, too, will seek c ontinuin g acce ss to th e lib ra ry .

I t c an fa ir ly b e said, th en , th a t to ac hiev e the im pr ov ed he al th service t h a t th e 

Amer ican people des er ve a n d de man d, th e capit al ex pan si on o f o ur libra ry s ys tem 

is e ss en tia l. In my op inion, we m us t prov ide fo r capit al ex pa ns io n of t h e li bra ry 

sy st em as it ex is ts to da y a s th e fo un da tion fo r it s ev ol ut io n in to th e healt h sc ien ce in fo rm at io n ce nte r th a t is needed. It will th ere fo re b e im po rtan t to m ak e a 

ju di ci ou s div ision of th e avail able fu nd s fo r capit al im pr ov em en t so th a t we do 

no t me rely ex pa nd li b ra ri es as they ha ve b ee n tr ad it io n all y con ceive d as re po si ­

to ri es fo r pr in te d in fo rm ati on but includ e pr ov ision fo r th eir ra pi d ev ol ut io n 

in to “inf or m at io n cente rs ” th a t ta ke advan ta ge o f all th e pr es en t-d ay im pr ov em en ts in co mm un ications tech ni qu es .

I t i s my op inion th a t th e $10 mi llion a yea r fo r th e fis ca l yea r en ding Ju n e 30, 

1966, th ro ug h th a t en di ng Ju n e 30, 1070. is appro pri ate in ord er th a t th e pr og ra m 

ca n be rev iew ed a t th a t tim e. I wo uld pre dic t th a t a t th e tim e of review in 

th e fu tu re it will be fo und th a t sign ific an tly la rg er su m s ca n be effectively 

ex pe nd ed in th is ca te gor y as mos t va lu ab le co ntr ib uti ons to th e hea lth of th e 

pe op le of th is c ou nt ry .

SE CT ION 3 9 4 . GRAN TS FOR TR AIN IN G IN MED IC AL LIBR AR Y SC IENCE S

O ur me dical libra ri es ne ed man y mo re li bra ri ans th an are now av ai la ble or 

a re lik ely to becom e avail able w ithin th e fo re se ea ble fu tu re un less a s tr ong e ffor t 

is m ad e to st re ng th en an d ac ce le ra te our p ro gr am fo r tr a in in g in medica l li bra ri - 

an sh ip . Th ese new li b ra ri a n s m ust no t on ly ha ve th e es ta bl ishe d co mpe tenc e 

of or ga ni zi ng p ri n te d m a te ri a ls so th a t th ey a re re adil y ac ce ssible to re ad er s, 

b u t m us t become fa m il ia r w it h re ce nt de ve lopm en ts in elec tron ic t ec hn olog y and 

in fo rm at io n theo ry whi ch w ill pr ov id e a new kind of bibl io gr ap hy co ntro l ov er 

th e gro wing an d ch an gi ng m as s of know led ge p ro du ce d by our re se ar ch pr og ra m s 

an d clin ical expe rie nc e. I t is sa fe to sa y th a t th ere a re few fields whe re te acher s. re se ar ch er s, an d ad m in is tr ato rs ag re e so co m pl et el y w ith li bra ri ans on th e 

im po rtan ce of a tr ain in g p ro gr am .

Thi s sec tion reco gn izes th e ne ed no t on ly to pro vid e im prov ed tr ain in g fo r 

ne w de gree c an did ate s in li b ra ry sci enc es, but als o a llow s fo r ex is ting li b ra ri an s 

and sp ec ialis ts in in fo rm ati on scien ces re la te d 'to h ealt h to be giv en su pport in 

le arn in g of th e new de ve lo pm en ts in th e field of el ec tronic in fo rm at io n st ora ge 

an d re trie va l.

The ad ditio n of an in te rn sh ip pr og ra m to th e tr a d it io n a l pe rio d of li b ra ry 

tr ain in g wi ll all ow th e re cent gra duate to ente r th e co m m un ity mu ch bett er pre ­

pa re d to un der ta ke o p era ti n g re sp on sibi lity th an ha s li as been in the pa st.

T hi s sec tion, then , pro vid es fo r th e ne ce ss ar y im pr ov em en t an d ex pa ns ion of 

tr ain in g of th e m an po w er resp on sibl e fo r th e oper at io n of medica l li bra ri es in 

th e fu tu re .

SE CT IO N 3 9 5 . A SSIS TA N C E TO SP ECIA L S C IE N T IF IC PR OJEC TS

T hi s sec tion fills a mos t im port an t need in th a t it pro vi de s th e op po rtun ity fo r 

ph ys ic ia ns an d sc ie nt is ts to ut iliz e li bra ry re so ur ce s to th eir fu lles t de pth in 

w ri ti ng up the origi na l contr ib utions th a t th e ir ef fo rts hav e pro du ced. A t th e 

pre se nt tim e, th es e pe op le hav e to st ea l tim e from th e ir rese ar ch , tea ch ing, and 

p ati ent car e du ties in o rd er to utilize in de pt h th e re so ur ce s of th e li bra ry .
MEDICAL LIBRAR Y ASSISTAN CE ACT OF 19 65 85

The se sp ec ial fello wsh ips w ou ld en ha nc e th eir opport unity to ut iliz e th e un ique fa cil it ie s of th e N at io nal L ib ra ry of Medicine as we ll as su pport in g ‘‘in dep th " 

li te ra tu re rev iew s. In te nsi ve utiliza tion also gi ve s an op po rtun ity to u n d ers ta n d more cl ea rly th e li m it ati o n s of th e pre se nt li b ra ry syste m. To th e ca su al use r of th e li bra ry , th es e li m itat io ns may no t be ev id en t an d he may th ere fo re fa il to ob tain w ith pr ec is io n an d de pth th e in fo rm ati on wh ich he shou ld ha ve . Fr om ex pe rie nc e in th e n ee ds o f i nt en sive c on su m er s of li bra ry s er vi ce i t w ill be po ss ible to pr ov id e 

m or e pr ec isely fo r im pr ov em en ts in prov iding th a t serv ice .

SEC TI ON 3 9 6 . RE SE AR CH AN D DEV EL OP MEN T IN MED IC AL LI BRARY SC IE NCE AND 

RELAT ED FI EL DS

T he im po rtan ce of re se arc h and de ve lopm en t in li b ra ry scien ce ha s been alluded to al re ad y in my te st im ony. At th is po in t I wou ld su gg es t th at co n­ si dera ti on be giv en to th e est ab li sh m en t of a sm all num ber of he alth-scien ce in fo rm ati on ce nt er s which co ul d se rv e as pr ot ot yp e mod els fo r th e f ulles t ex pl oi ­ ta ti o n of a va ilab le m od ern te ch niq ue s in in fo rm at io n pr oc es sing . In my op inion, th e de ve lopm en t of a fe w su ch mo dels is of a ve ry high de gr ee of im po rtan ce . I t wou ld allow fo r pra ct ic al ex pe rien ce i n a field which is no w f ull of spe cu la tio n about ‘‘w hat mig ht ha pp en .” I f th es e mo del unit s w er e es ta blish ed in are as w ith long ex pe rie nc e w ith th e m or e tr adit io nal li bra ry org an iz at io n, then some ­ th in g akin to a co ntro lle d experi m ent could be co nd uc ted w hic h all ow ed ob jective co m pa riso n of the advanta ges and sh or tcom in gs of th e tr a d it io n a l as co mpa red to th e elec tron ic ally ba se d m et ho ds . Once es ta bl ishe d, su ch a pr ot ot yp e in fo r­ m at io n ce nte r in th e healt h sc ie nc es wo uld pr ov id e th e re so urc es fo r re se ar ch , tr ain in g , an d ex pe rien ce in se rv ic e wh ich will be es se ntial bef ore a co mpr eh en ­ sive nati onal li bra ry ca n be m ost eff ectiv ely de sig ne d. T he es ta bl is he d sy stem s of th e N at io na l L ib ra ry of M ed ic ine mak e it un iq ue ly co m pe te nt to lead such 

de ve lopm en ts. T here are only a fe w in sti tu ti o n s wh ose li b ra ri es are in a po sitio n to carr y on th is ki nd of re se ar ch an d de ve lopm en t but th e ir ro le as mod els is of cr uci al 

im port an ce to th e N ation.

SE CT IO N 3 9 7 . GR AN TS FOR IM PR O V IN G AN D EX PA NDIN G T H E BASI C RESO UR CE S OF 

MED IC AL LIB R A R IE S AN D RELATE D IN ST R U M E N T A L IT IE S

T his se ction rec og nize s th a t we are no t u n d ert akin g a di ss olut ion of the exis ti ng li bra ry sy ste m but ra th e r seek ing fu ll advanta ge of it s op tim um po ten - ti al w hile ad di ng to it th e m od er n elec tro ni c de ve lopm en ts which wi ll giv e a new 

di m en sion to it s powe r. T he pr ov isions in th is se ct io n will all ow fo r th os e m ed ic al li bra ri es which ha ve he re to fo re bee n una ble to ta ke ad va nt ag e of w el l-es ta bl ishe d metho ds of im pr ov in g libra ry se rv ice to ac quir e th is en ha nc ed pote nti al. Such a sim ple m a tt e r as be ing un ab le to photo du pl ic at e ra pid ly art ic le s in jo urn als so th at th e vo lumes them selves do n o t ha ve to ci rc ula te is a dis tres si ngly freq ue nt de fe ct in ex isting m ed ical li b ra ri es. It is a ra re m ed ical li bra ry th at ha s a bu dget fo r th e ac qu is itio n of m ag ne tic ta pe s an d film s and th e fa ci lities fo r 

usi ng them . W hile I rec og niz e th a t we m ust plan im m ed ia te ly fo r th e deve lopm en t of an el ec tron ic co mpu ter-ba sed n ati o n al syste m fo r co m m un icat io ns , I wo uld ass ert th a t we sh ou ld no t fo rg et th a t we ha ve in ex is te nc e a li b ra ry sy ste m wh ich , if gi ve n ad eq uat e su pp or t, w ill co nt in ue to be an ess ential co mpo ne nt of an y co m m un icat ion system in th e hea lth scien ces. Hom e ci rc ula ti on of vo lum es fr om th e med ical li bra ry of th e U niv er si ty of Michiga n has in cr ea se d 43 pe rc en t in th e p ast 3 ye ars. Loa ns w it h in th e li bra ry it se lf hav e in cr ea se d by ap pro xi ­ m at el y 75 pe rc en t in th a t sa m e pe rio d. I ci te th es e figu res to em ph as ize th a t we a re by no mea ns su gges ting th a t we ab an do n th e exis ti ng system sin ce it is cl ea rly* a ve ry a tt ra cti v e re so urc e to it s us er s. R ath er, we look fo rw ar d to se cu ri ng th e ad va nta ges of th e pre se nt sy stem w hi le addin g new an d im prov ed 

ca pa ci ties .

SE CTI ON 3 9 8 . GR AN TS FOR E S T A B L IS H M E N T OF RE GI ON AL M ED IC AL LI BRARIE S

M or e and mo re in th e U nited S ta te s we are reco gn izing th a t healt h serv ices of all kin ds m us t be pla nn ed on a region al ba sis. The unne ce ss ar y du pl ic at io n an d se lf- se ek ing co m pe tit io n th a t ca n dev elo p whe n is ola te d in st it uti ons purs ue
86 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

th e ir own de ve lopm en t w it h o u t re fe re nc e to re gi on al ne ed s is a lu xu ry th a t we 

can not aff ord . Som e earl y be ginn in gs ha ve been m ad e in th is kind of re gi on al 

deve lopm en t. Th e New Y or k Acade my of Me dic ine , a s an exam ple , ha s fo r 

y ears co llab or at ed w ith th e ho sp ital s, th e m ed ical so ci ety, an d th e univ er si ties 

in th e gre ate r m et ro polita n are a in pr ov id in g a cen tr al re po sito ry li bra ry an d 

re fe re nc e sou rce . Mo re re ce ntly, H ar vard , Ya le, an d Colum bia ha ve an no un ce d 

th e ir intent io n of de ve lo pi ng co mm un ications th a t wou ld all ow th eir med ical 

scienc e libra ri es to coll abora te m or e eff ectiv ely . Ther e a re a few mo re in st an ce s 

th a t could be c ite d.

In ge ne ral, howe ver, th e su pport ne ce ss ar y to fu nct io n as a region al reso ur ce 

whi ch ca n prov ide fr ee lo an se rv ices to qu ali fie d use rs a n d m ak e av ai la bl e ph otodu pl ic at ed or fa cs im ile co pies w he re ve r qu ali fie d re quest ers wish to re ta in 

th em is un av aila ble. T his se ction, th er ef or e, ad dre ss es it se lf to thos e medica l 

li b ra ri es wh ich mig ht w ish to pr ov id e re gi on al se rv ice and fr ee loa n serv ice in 

ad dit io n to th eir tr ad it io n al ob lig ations . W he re th e budg et of a med ical libra ry 

is sh ar pl y lim ite d— as all of them ar e— it is ve ry difficult to ad d th e pe rson ne l 

an d eq uipm en t th a t is nec es sa ry to m ee t th e re gi on al re sp on sibi lity de scrib ed 

in th is sec tion. The de ve lopm en t of a ph ys ic al pla nt w hi ch wo uld prov ide th is 

re gio na l service w ithout dim in is hin g serv ice to th e exis ti ng us er s of th e li bra ry 

m ak es ne ce ssary th e pr ov is io n fo r co ns truc tion th a t is w ithin th is section.

As we look fo rw ar d to th e de ve lopm en t of re gio nal iz at io n of hea lth se rv ices 

of all kind s, it is es se nt ia l th a t we ha ve th e mea ns fo r de ve loping region al med ­

ic al li bra ri es to serv e as h ealt h sci ence in fo rm at io n ce nte rs .

SE CT IO N 3 9 9 . FIN A N C IA L SU PP ORT OF BI OM ED IC AL S C IE N T IF IC PU BLIC ATI ONS

An es se nt ia l co mp on ent of our pr es en t met ho d of dis tr ib u ti n g new re se ar ch 

in fo rm at io n re la te d to h ealt h is th e pu bl ishi ng capac ity of no np rofit so cieties 

and or ga ni za tio ns . The cost s of pu bl ic atio n ha ve ri se n to th e po int th a t even 

w her e ad ve rtisin g is so lici ted by th e jo urn al , th e co st s of pu blicatio n are an 

im port ant lim iti ng fa cto r in th e jo urn al’s dis se m in at io n. Ma ny jo urn als are 

sh arp ly lim ite d in th e ex te n t to whic h th ey will ac ce pt ch art s an d il lu st ra ti ons 

or bibl iogr ap hic refe re nc es .

Of part ic ula r im por ta nce is th e need to su pp ly bi om ed ical .scientific pu bl ic ati ons w ith th e reso ur ce s w hi ch wi ll all ow th em to a d a p t th e ir pre se nt inde xi ng 

and abst ra ct in g to th e ne ed s of ex is ting an d pr oj ec te d co mpu teriz ed fo rm s of 

bi bl io gr ap hi c st or ag e an d re tr ie val. As we loo k fo rw ard to th e de ve lopm en t 

of a co mpu ter-ba sed nati onal ne tw or k of libra ri es , th e fo rm of th e in fo rm at io n 

p u t in to th is system m ust be ad ap te d to th e ne ed s of th e elec tro nic m ea ns of 

re tr ie vin g it. The se ch an ges in abst ra ct in g an d in dex in g jo urn als is an es se nti a l elem en t of the de ve lo pm en t of a nat io nal sy stem of li bra ri es whe re fr ee 

in te rc han ge of in fo rm at io n is av aila ble. Th e g ra n ts au th ori ze d in th is se ction 

w ill allow fo r a more co mpl ete an d ex pe nd itio us tr a n sm it ta l of in fo rm at io n to 

th os e in ve stig at or s an d p ra cti ti o n ers wh o ha ve a ne ed fo r it.

REGION AL B R A N C H ES OF T H E NATIO NAL LIBR ARY OF M ED IC IN E

Ther e are in th e U nite d S ta te s ge og raph ic are as w hi ch do no t now co nt ai n 

a med ical libra ry or gr ou p of med ical libra ri es which a re ab le to undert ake th e 

ro le of a region al re so ur ce . W he re such a ci rc um st an ce ex ists, th e need of th e 

pe op le, in my opini on , sh ou ld be met by th e es ta bli sh m ent of region al br an ch es 

of the N atio na l Lib ra ry o f Me dicin e.

Mr. Cha irm an , it is ob viou s th a t we are not ta lk in g ab out su pp or t of th e 

li b ra ry fu nc tion wh ich is confined to giving re ad er s ac ce ss to print ed m at er ia ls . 

We a re ta lk in g in st ea d ab o u t th e need fo r se cu ring an es se ntial region al hea lth 

so ur ce whic h is ca pa bl e of pr ov id ing to st uden ts , te ac her s, re se ar ch er s, an d 

pra cti ti oners th e up- to -d at e in fo rm at io n whi ch th ey m ust ha ve in ord er to 

se rv e th ei r rol e in pro vid in g fo r th e hea lth of th e N at io n. I ur ge pa ss ag e of 

th is Me dic al L ib ra ry A ss is ta nce Ac t of 1965 as an ess enti al co mpo nent of th e 

pr og ra m s ne ce ss ar y to m ee t th e he al th ne ed s of th e N at io n.

Sept ember 14, 1965.

Mr. Macdonald. With that the hearing is concluded.

(The following material was submitted for the record:)
MEDICAL LIB RA RY ASSISTAN CE ACT OF 1965 87

Sta temen t of Dr. F rederic II. B arth , Pres ident of th e P hil adel ph ia College

of Osteopa thy

Mr. C ha irm an , an d m em be rs of th e co mm ittee, my na m e is D r. Fre der ic II. B art h . I ha ve lon g been in te re st ed in th e he ld of ed uca tion as a mem be r of th e B oard of Edu ca tion of th e C ity of Phi la del ph ia an d as pre si den t of the 

P hil adelp hia College of O steo pa th y. I am im m ed ia te p ast pre si dent of th e American Ass oc ia tio n of Osteo pa th ic Co lleges, which co ns ists of th e fiv e sch ools of os te op athi c m ed ic in e an d su rg er y, all of w hi ch are no np ro fit an d ac cr ed ited by th e Amer ican O steo pa th ic Asso cia­ tio n, on wh ose be ha lf I am pri vi le ge d to ex pr es s en th u si ast ic su pp or t fo r all p art s of th e pe nd ing Med ica l L ib ra ri es Assistanc e Ac t of 1965, H.R . 3142. The pri nci pal ob jective of th e American O steo pa th ic A ss oc ia tio n is th e m ai n­ te nan ce an d im prov em en t of s ta n d a rd s of ed uc at io n in ost eo pat hic c ollege s. Th e ass ocia ti on’s st andard s fo r accre dit ati on re qu ire th a t a scho ol m us t m ai nta in a m ed ic al li bra ry wh ich sh al l in cl ud e curr ent te xts , re fe re nc e boo ks, an d th e pe riod ic al s needed in th e te achin g an d re se ar ch pr og ra m , an d th a t a quali fie d li b ra ri an sh al l be em ploy ed to su per vis e an d develop th e li bra ry . Ass oc ia tio n st andard s fo r appro val of teac hi ng hosp ital s re quir e th at the hosp it al sh al l prov ide a pro fe ss io na l libra ry which m us t co n ta in mod ern te xts and c u rr e n t pe riod ical s on anat om y, an esthesiology , ba cter io lo gy , ch em istry , d er­ matolog y, diag no sis , in te rn al med icine, la bor at ory di ag no si s and tec hn ic, ne u­ rol ogy, obst et ri cs an d gy ne colog y, op htha lm olog y, or th op ed ic s, ot or hin ola ry n­ gol ogy, pa thol og y, pe dia tric s, ph ys ic s, physiolo gy, pra ct ic e of os teop athy , pr oc ­ tol og y. ps yc hi at ry , radiolog y, su rg ery , syp hilolo gy, an d urolog y, an d ad ditio nal c u rr e n t te xts an d oth er pro fe ss io nal pe rio dica ls of a gen era l an d sp ec ialty n atu re . N on teac hi ng hosp ital s ac cr ed ited by th e as so ci at io n are also requ ired to pr ov id e an d m ai nt ai n a pro fe ss io na l libra ry to m ee t th e pr of es sion al nee ds 

of th e in st itution. T here is a wide vari ati on in th e fa ci lities an d eq ui pm en t prov ided in th e scho ols and ho sp ita ls. L it tl e or no fa ci lities are pr ov id ed by mos t S ta te osteo ­ pat hi c so ci etie s notw ithst an din g th e ur ge nt needs of pra cti ti o n ers fo r mo re re ad y ac ce ss to th e grow ing bo dy of new me dical in fo rm at io n, an d th e nu mbe r of S ta te s w hi ch re quir e annual re gis tr ati on of ph ys ic ia ns fo llo w in g re fr es her 

co urse s. As sta te d in th e spec ial re p o rt of th e Su bc om mittee on F acil it ie s co nt ai ne d in vo lum e II of t he re po rt of th e P re sid e n t’s Co mm ission on H e a rt Dise ase, Ca ncer, an d Strok e, th e dis re pair of th e med ical li bra ry sy stem , so es se nt ia l to th e tr ansm is si on of med ical kn ow ledg e ac ro ss tim e an d space* const it ute s a m aj or w ea kn es s in bo th Fed er al and p ri v ate he al th an d m ed ical pr og ra m s. The sp ec ia l re port em ph as ized th a t th e need fo r sp ac e in whi ch to m ai nta in th eir co lle ctio ns an d to carr y out ne ce ss ar y da y- to -d ay oper at io ns is per ha ps one of th e m os t cr itic al ne ed s of th e m ed ic al libr ar ie s, an d ci te d th e follo wing ta bl e 

of m ed ic al lib ra ry sp ace re quir em en ts :

Medical librar y space req uirem ents

Prese nt 

average sire 

(squ are 

feet)

Average

ad ditio na l

square

footage

neede d

Es tim at ed co st

Av era ge 

pe r school

To tal cost

Medical scho ols: 87est ablish ed.. .. ____ .. . . . . . . . . 18,115 32,921 

37,736

9,797

9,000

11.S03

$1.316.840 

1,509,440

391,880 

360,000 

472,120

« $106,664.040 

18,113,280

8,228,480 

1,800,000 

2,360,600

12 ne w .. _ ___ _

Den tal schools : 21 se pa ra te ___ ______________ _ _ _ _ _ _ 1,430

5 ne w - _ __________________ Oste on athie colleges, 5 colleges __ __ _ ___ 2,637

Tot al ____________ 137,167,400

i 6 of th e e sta blish ed m edical schools st at e th ey do not nee d ad ditio na l space. There for e, th e est im ate d 

to ta l c ost is for 81 schools.

T hi s ta ble refle cts th e sq ua re fo ota ge em plo yed , an d ne ed ed , by th e 113 est ab­ lish ed sc ho ols of me dicin e, d en ti st ry , an d os te op athy , an d th e 12 develop ing new m ed ic al sch ool s an d 5 ne w d en ta l schools. F or th e purp ose s of th is tabl e, in fo rm ati on was so ug ht also fr om pu blic he al th sch oo ls but w as no t av ailable.
88 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

Th e med ical scho ol libra ry dat a ha ve be en de rive d in p a rt from a su rv ey 

cond uc ted earl y in 1964 by th e Assoc iatio n of American Medica l Co lle ge s to ­

ge th er w ith est im ate s by th e N at io na l L ib ra ry of Me dic ine. The D iv isio n of 

Den tal Pub lic H e a lt h an d Re sources, BS S, PH S, prov ided th e in fo rm ati on on 

th e de nt al sch oo l libra ri es . D at a on th e li b ra ri es of th e os te op at hi c sc ho ol s 

was obtaine d dir ectl y fro m t ho se li bra ri es or sch oo ls.

Est im at ed co st s w er e ob tained by st udyi ng sp ac e re qu irem en ts an d apply in g 

th e fig ure o f $40 p er sq ua re foo t ba sed on d ata deve lope d by th e G en er al Se rv ices 

A dm in is trat io n fr om it s ex pe rie nc e in const ru ct in g pu blic bu ild ings .

Se cti on 393 of II .I i. 3142 au th or iz es a 5- ye ar pr og ra m of as si st ance fo r th e 

co ns truc tion of m ed ic al libra ry fa ci lities . T he am ount of an y g ra n t w ould no t 

excee d 75 perc ent of th e ne ce ss ary co nst ru ct io n cost. P ri ori ty wou ld be give n 

to app lica tion s ev id en ci ng th e g re ate st ne ed.

Se cti on 394 auth ori zes a 5-year pr og ra m of g ra n ts fo r tr ain in g in m ed ic al 

libra ry scien ces. G ra n ts wo uld be mad e to in div id ual s to su pport tr ain eesh ip s 

an d fello wsh ips in th e field of med ical li bra ry scienc e, in re la te d fie lds p ert ain in g 

to sci ences re la te d to h ea lt h an d in th e field o f th e c om mun ication of in fo rm at io n. 

G ra nt s wou ld al so be mad e to in di vid ual s wh o a re li bra ri ans or sp ecia li st s in 

in fo rm at io n on sc ie nc es re la ti ng to hea lt h to en ab le them to a tt a in in te nsi ve 

tr ain in g an d re tr ain in g . Th is sh ou ld he lp re duce th e defic it of pro fe ss io nal 

libra ri ans an d per so ns ad eq ua te ly tr ain ed a t th e s ub pr of es sion al le vel.

Secti on 395 auth ori zes a 5-year pr og ra m of g ra n ts fo r spec ial fe llow sh ip s to be 

aw ar de d to phys ic ia ns an d sc ie ntist s fo r th e co m pi la tion of ex isting , or w ri ti ng 

of original, contr ib uti ons re la ting to scientifi c ad va nc em en ts in scienc es re la te d 

to he alth .

Secti on 396 auth ori zes a 5-ye ar pro gr am o f g ra n ts fo r pr oje ct s of re se arc h 

an d in ve st ig at io ns in medica l li bra ry scienc e an d th e de ve lopm en t of new 

tech niqu es, sy st em s an d eq uipm en t fo r pr oc es sing , stor ing, an d re tr ie v in g an d 

dis trib uting info rm ati on on sci ences re la te d to healt h.

Secti on 397 auth ori zes a 5- ye ar p ro gr am of g ra n ts fo r im prov ing an d expan din g 

th e ba sic re so ur ce s of med ical libra ri es . A cc or ding to th e Su bc om m ittee on 

Fac ilitie s ab ov e re fe rr ed to, one of th e m os t sign ific an t in ad eq ua ci es of th e 

N at io n’s med ica l li b ra ri es “is th a t th ey ha ve onl y ab ou t half th e boo ks, jo urn als , 

an d ot her re so ur ce s th ey ne ed .” In fo rm ati on pr ov id ed by th e ost eo pat hic co lleges show s th a t th e ir ho lding of vo lumes ra nges fr om 6,000 to 23,225, an d th eir 

an nu al bu dg ets ra n g e fr om $10,500 to $23,500. Ob vio usl y, none of th e co lle ge s 

ha s a de si ra bl e num ber of volum es or adequate bu dg et. Se cti on 397 pr ovid es 

fu nd s fo r acquis itio n of books, jo urn al s, ph ot ogr ap hs, mo tio n pic tu re and oth er 

films, an d fo r ca ta lo gin g an d bind ing, and fo r ac quis itio n of du pl ic at io n de vice s, 

an d new te ch no lo gi ca l eq uipm en t to fa cil it ate th e us e of th e libra ry . As po in te d 

ou t in th e M ed ical E du ca tion Fac ilitie s, Pub lic H ealth Se rvice P ubli cati on No. 

11 80 -A -lb , bu dg et ed ex pe nses fo r boo ks, su bsc riptions, an d oth er su ppl ie s are 

as h igh fo r 64 st u d en ts p er c las s as f or 96. A sm all er clas s an d a sm al le r fa cult y 

do no t redu ce th e ne ed fo r libra ry re fe re nc e m ate ri als . Ho we ver, th e in cr ea se 

in clas s siz e will call fo r mo re serv ices or la rg e r li bra ry st af f an d th e li b ra ry 

fa ci lities w ill be m or e fu lly uti liz ed .

An est im at e of w h at th e pr og ram en visa ge d in th is bill ca n m ea n as ap pl ie d 

to th e Philadelp hia College of O steo pa th y is pro vi de d in th e follo wing co m m en t 

by D ea n Sh erwoo d R. M erc er:

“ (a ) A lon g- term p ro gr am o f c on stru ctio n, be gi nni ng w ith a $7 m ill ion hosp it al 

pr oj ec t now under co ns truc tion , in clud es a ne w colleg e bu ild ing in w hic h will 

be a gr ea tly enla rg ed li bra ry fo r a st udent bo dy to be ex pa nd ed from ab o u t 359 

to 575 (b as ed on in cr ea si ng th e firs t-ye ar cla ss fr om 100 to 15 0). T h e new 

li bra ry ca n be m ad e an eve n mo re eff ectiv e in str u m en t in su pp or t of le arn in g 

th an is now po ss ib le under pre se nt pl an s, if we could en joy th e ad d it io n al 

su pp or t a s pr oj ec te d in 11.R. 3142.

“ (ft) Th e li b ra ry sy st em of th e c ollege will b e b u il t ar ou nd th e m ai n co llec tion 

a t th e ne w cit y li n e ca m pu s whe re th e bui ld in g ci te d abov e will be lo ca te d. A 

sa te llite co lle cti on w ill be ho used in th e pre se ntly us ed (a nd to be enti re ly re no ­

va ted ) college a nd hosp it al b uilding a t 48tli an d Spr uc e St re ets. A no th er sate ll it e 

co lle cti on will be lo ca te d a t ou r 20 th and Sus qu eh an na Av enue ho sp ital . As is 

pr es en tly ou r pra cti ce, dep ar tm en ta l li b ra ri es w ill be develop ed in a ll th re e 

locatio ns.

“ (c ) Bec au se th e co lle ge is loca te d in P hil adelp hia an d in close pro xim it y to 

som e of the w orld’s fin es t c oll ectio ns i n med ical li bra ri es, o ur p la ns c al l fo r a mor e 

efficient in te rc om m un ic at io n system w ith are a libra ri es an d we hope, th ro ugh 

region al li bra ry fa cil it ie s, w ith th e enti re co un ty . Clea rly , th e in te n t of H.R. 

3142 s eems to support th ese projec tio ns .
MEDICAL LIBRARY ASSISTANCE ACT OF 196 5 89

“ (d ) W e hav e begun th e se ar ch fo r pr of es sion al le ad ers hip fo r th e libra ry 

comp lex . O ur d isc ussio ns a lw ay s in cl ud ed a n ex pl or at io n of o ur in te re st in tr a in ­ ing fo r care ers in me dical libra ri es . H ere ag ai n we a re fo rt u n ate in be ing close 

to the G ra d u ate School of L ib ra ry Sc ienc e a t Drexe l In sti tu te of T echn olog y. “ (c ) W e are aw ar e of th e ro le of el ec tron ic eq ui pm en t in th e m an ag em en t of libra ri es m or e eff ectiv ely to mak e th em vital teac hing ce nt er s. B ec au se of costs we ca n do li tt le ot he r th an to pla n sp ac e in to th e new li bra ry w her e th is eq uip­ m en t co uld be ho used an d use d. H.R . 3142 wo uld m ak e po ssible applica tion fo r su pport fo r th is an d ot he r eq ui pm en t, pe rson ne l, an d fa ci li ti es to m ak e ou r new 

li bra ry a b e tt e r on e t han we can now aff ord to p lan . “ (/) In o u r discus sion s w ith candid ate s fo r th e po st of li b ra ri an we ha ve out­ lin ed id ea s fo r th e ed uc at io n of fa cu lt y an d st ude nts ali ke in th e co mm un ication of id ea s, ne w k no wl edge, an d new te ch ni qu es , so th a t th e wh ole bo dy of ph ys ic ians 

w ill kno w ho w b ett er to be i nf or m ed a n d t o in fo rm .” We appre cia te th is op po rt un ity of pre se nting our view s on H.R . 3142, an d we 

hope f or e arl y e na ct m en t of t his m os t im p o rt an t legislation.

Sta teme nt of E dward C. R osenow , J r., M.D., E xecutive Director, American

College of P hysi ci an s

Con gr es sm an H arr is , ch ai rm an of th e Com mittee on In te rs ta te an d Fo reig n Co mm erc e, I am Dr. Edw ar d C. Ros en ow , Jr. of P hilad el phia —a n in te rn is t who sp en t 20 y ears in the pra ct ic e of m ed ic in e be fore becomi ng ex ec utive dir ec to r 

of th e A m er ic an Colle ge of P hy sici an s. The pre si dent of th e American Co lle ge of Phy sician s, Dr. A. C arl to n Ern st en e, of Cl ev elan d, h as as ke d me to p re p are a st at em en t in su pport of H.R . 3142 an d H.R. 6001, M ed ical Lib ra ry A ss is ta nc e Act, wh ich was in tr oduce d in th e Ho use 

of t he A m er ic an C olle ge of P hy si ci an s. F or thos e wh o do no t know of the A m er ic an C olle ge of Phys ic ia ns, I wo uld lik e to de sc ribe o u r socie ty. Th e college, w hic h is 50 yea rs old th is year, re pre se nts 

12.400 spe ci al is ts in in te rn al m ed icine a n d re la te d field s. O ur pri nci pal in te re st is th e conti nuin g ed uc at io n of phy si ci an s. To work to w ar d th is go al, th e college sp on so rs 2 nat io nal an d 25 re gi on al m ee ting s each y e a r ; it co nd uc ts 18 post gra dua te cours es an d pu blishe s th e m on th ly Ann ua ls of 

In te rn al Med icine. To ai d in m ai nta in in g high sta n d a rd s of med ical pra ct ic e, th e co lle ge part ic i­ pate s in th e adm in is tr ati on of th e cert if y in g ag ency fo r in te rn is ts — th e Ameri­ ca n B oa rd o f In te rn al Medicine— an d, w it h oth er med ical org an iz at io ns, op er at es th e Jo in t Co mmiss ion on A cc re ditat io n of H os pi ta ls an d th e Co mmiss ion on 

Pro fe ss io nal and H os pi ta l Activiti es . In cl ud ed am on g ou r le ad er sh ip are th e ph ys ic ia ns re sp on sibl e fo r th e tr ain in g of a la rg e pe rc en ta ge of our N ation’s underg ra duate an d g ra d u ate ph ys icians . Bec au se of it s in te ns e in te re st in th e tr ain in g of phy sici an s an d in th e con­ tinuin g ed uca tion of in te rn is ts , th e A m er ic an College of Physi ci an s look s fa vorab ly on an y F ed era l ac t t h a t wo uld i m pr ov e med ical lib ra ry fa ci lities . We f ee l th a t th es e bil ls an d th eir c om pa ni on b ill in th e Se na te, pro vid e re al is tic so lu tion s to a gr ow ing pro ble m of co llec ting an d re ta in in g in fo rm ati on vital ly 

im port ant to th e p re se nt a nd f utu re p ra cti ce of me dic ine . Th e act w ou ld ass ure th e ex is te nc e of ad eq uat e med ical li b ra ry fa ci lities to se rv e phys ic ia ns an d ot he r m ed ical scie n ti st s in al l re gi on s of th e U nited Sta te s. The Am er ic an Colleg e of Phy si ci an s su pport s th e pr ov isions of H .R . 3142 an d H.R. 6001 an d comm ends C on gr es sm an H a rr is an d Con gr es sm an Fogart y fo r 

sixm so rs hi p o f t h e le gisla tio n.

T han k you v er y much.

Reso lut ion on th e Medical Library Ass ista nc e Act of 1965, Adopted by th e

Young Demo cra tic National Com m it te e, and th e Nation al E xecutiv e Committee of th e C ollege Young Democratic Clubs

W he re as (1 ) th e un pr ec ed en ted ex pan si on of kn ow led ge in th e h ealt h sci ences w ithin th e p a st tw o decades ha s bro ught about a mas sive gr ow th in th e quan tity , an d m aj or ch an ge s in th e n atu re of, biom ed ical in fo rm at io n, m ate ri als , an d pu bl ic atio ns , and (2 ) th ere h as not be en a co rres po nd ing gr ow th in th e fa ci lities and t ec hn iq ue s ne ce ss ar y ad eq ua te ly to co ord in at e an d di ss em in at e am on g he al th sc ie ntist s an d pra cti ti oners th e ev er -i ncr ea si ng volum e of kn ow ledg e an d in fo rmatio n and in fo rm at io n which h as be en develop ed in th e healt h sc ienc e field,
90 MEDICAL LIBRARY ASSISTANC E ACT QF 19 65

an d (3) mu ch of th e va lu e of th e ev er -inc re as in g volum e of kn ow led ge an d 

in fo rm at io n which h a s bee n, an d c on tinu es to be, de ve lope d in th e healt h sc ienc e 

field will be lo st unle ss pr op er m ea su re s are ta k en in th e im m ed ia te fu tu re to 

develop fa ci li ti es a n d tech niqu es ne ce ss ar y to co lle ct, preserve , stor e, pr oc es s, 

retrieve , an d fa c il it a te th e di ss em in atio n an d utili zati on of. such kn ow ledg e an d 

m fo n n ati o n ; an d

W he reas th e “M ed ic al Lib ra ry A ss istanc e A ct of 1965” (S. 597 in th e Senate 

an d H.R. 3142 in th e H ou se of R ep re se nt at iv es of th e U ni ted Sta te s) is pr op os ed 

an d wo uld pr ov id e th e mea ns to (1 ) ass is t in th e co ns truc tion of new, an d th e 

reno va tio n, ex pa ns io n, or re hab ilitat io n of ex is ti ng medica l li bra ry fa c il it ie s; 

(2) ass is t in th e tr a in in g of medica l li b ra ri an s and oth er in fo rm at io n sp ecali st s 

in th e he al th sc ie n ces; (3 ) as sist, th ro ug h th e aw ard in g of spec ial fe llow sh ip s to 

ph ys icians an d sc ie ntist s, in th e co mpilatio n of ex istin g, an d th e cre ati o n of 

ad di tion al w ri tt en m a tt e r wh ich w ill fa cil it ate th e th e d is trib ution an d uti li zati on 

of kn ow led ge an d in fo rm at io n re la ting to sc ientifi c, soc ial, an d cu lt u ra l ad van ce ­

men ts in scien ces re la te d to healt h; (4 ) ass is t in th e co nd uc t of re se arc h an d 

inve stig atio ns in th e field of me dical li bra ry sc ienc e an d re la te d ac ti vit ie s, an d 

in th e de ve lopm en t of ne w tec hn ique s, system s, and eq uipm en t fo r pr oc es sing , 

stor ing, r et riev in g, a n d dis trib uting inf orm at io n in th e scie nces re la te d to h e a lth ; 

(5 ) as si st in im pr ov in g an d ex pa nd ing th e ba sic re so ur ce s of m ed ical li b ra ri es 

an d re la te d fa cil it ie s; (6) as si st in th e de ve lo pm en t of a nat io nal sy st em of 

region al med ical li b ra ri es each of which wo uld hav e fa ci lities of suffi cie nt de pth 

an d scope to su pp le m en t th e service s of o th er m ed ic al libr ar ie s w ithin th e regi on 

serv ed by i t ; an d (7 ) pr ov ide fina nc ial su pport to biom ed ica l sc ientifi c publica ­

tion s : B e i t th ere fo re

Re solve d, T h at th e Yo ung Dem oc ratic Cl ub s of Am eri ca he reby en dors e th e 

Medical Lib ra ry A ss is ta nc e Act of 1965, an d co mmen d it to our elec ted re pre ­

se nt at iv es in th e C on gr es s fo r ea rly pa ss ag e.

Una nimou sly adopte d by the Young D em oc ra tic N at io na l Co mm ittee, an d by 

th e N at io na l E xec utive Co mmittee of th e Co lle ge Yo ung Dem oc ratic C lu bs of 

Am eri ca, in si m ultan eo us bu t se par at e m ee ting s a t K an sa s City, Mo.. A pril 10, 

1965.

Res ol ut io n on Med ic a l Ass is ta nce Act, Ado pted by t h e Stu den t Am er ic a n

Med ical Ass ocia ti on

W he re as th e un pre ce de nte d ex pa ns io n of kn ow ledg e in the hea lt h scienc es 

w ithi n th e p ast tw o de ca de s ha s br oug ht ab ou t a m as sive gr ow th in th e q u an ti ty 

an d m aj or ch an ge s in th e natu re of biom ed ical in fo rm at io n, m ate ri als , an d 

pu blicati on s, an d (2 ) th ere has no t been a co rr es po nd in g gr ow th in th e fa cil it ie s 

an d tech ni qu es nec es sa ry to ad eq ua te ly co or di na te an d di ss em in ate am on g h ealt h 

sc ie nt ists and p ra cti ti o n ers t he ev er -inc re as in g vo lu m e of kno wledge a nd i n fo rm atio n which ha s be en de velop ed in the hea lth sc ienc e field, an d (3) muc h of th e 

va lue of th e ev er -i ncr ea si ng volum e of kn ow ledg e an d in fo rm at io n w hi ch has 

been, an d co nt in ue s to be developed in th e hea lth scienc e field wi ll be lo st unle ss 

pr op er m ea su re s a re ta ken in th e im m ed ia te fu tu re to develop fa cil it ie s an d 

tech niqu es nec es sa ry t o coll ect, pres erve , stor e, pr oc es s, re trieve , an d fa c il it a te t he 

di ss em in atio n an d utili zati on of such kn ow led ge an d in fo rm ati o n : T here fo re be 

it

Resol ved. T hat th e st udent Am erican Me dic al Assoc iatio n en do rses le gi sl at io n 

th a t wo uld (1) a ssis t in th e co ns truc tion of new. and the reno va tio n, ex pan si on 

or re hab il it ati on of ex is ting me dical li bra ry fa cil it ie s: (2) ass is t in th e tr a in in g 

of med ical li b ra ri an s and ot he r in fo rm at io n han dli ng sp ec ia lists in th e healt h 

sc ienc es; (3) to ass is t, th ro ug h spec ial fe llow sh ip s, ph ys icians , an d sc ie nti st s 

en gaged in r es ea rc h in vo lv ing hea lth scien ce info rm ati on sto rage , dis tr ib u ti o n a nd 

uti li zati on; (4 ) a ssis t in th e co nd uc t of re se arc h an d in ve stig at io n in th e field 

of medica l li bra ry sc ienc e an d re la te d ac tivi ties , an d. in th e de ve lopm en t of new 

tec hn ique s, sy stem s, and eq uipm en t fo r proc es sing , stor in g, re trie vi ng , an d dis ­

tr ib uti ng in fo rm at io n in th e sci ences re la te d to healt h : an d (5 ) a ssis t in 

im prov ing an d expan din g th e basic re so ur ce s of med ical li bra ri es an d re la te d 

fa ci lities .

Th e reso lu tio n w as ad op ted by th e nat io na l co nv en tion of the Stu den t A m er ica n Me dic al A ss oc ia tio n, mee tin g a t Chica go, Ill .. M ay 3 -6.19 65 .
MEDICAL LIB RA RY ASSISTAN CE ACT OF 196 5 91

[ Te legram ]

Santa Mon ica , Cal if., Sep te m ber IS, 1965.

Ho n. Oren Harris,

Cha irm an , Com mitt ee o n I n te rsta te a nd F oreig n Co mm erc e,

R ayburn H ou se Office Bui ld in g, W as hi ng to n, D .C.:

On b eh alf of th e so ut he rn C ali fo rn ia c ha pt er , of t he sp ec ial li b ra ri es as so ciatio n 

I re port o u r un an im ou s su pport fo r H.R . 3142, to am en d P H S Act to prov ide a 

pr og ra m of gra nts to ass is t in m ee ting the ne ed fo r adequate med ical li bra ry 

se rv ices a nd f ac ili tie s.

J. E. T al lm an , C hapte r P re side nt.

H ouse of R ep re sent at ives, 

W as hing ton, D.C., Sep te m ber 16,1965.

Ho n. Oren H arris.

C om m itte e on In te rs ta te a nd Fo re ign Comm erc e,

U.S . Hou se o f R ep re se nt at iv es ,

W as hin gto n, D.C.

Dear M r. Cha irma n : Dea n F. M. W al te r, of th e K irksv ille C oll ege of O ste op athy 

& Sur ge ry , which is loca ted in my dis tric t, wro te in som e deta il in su pp or t of 

H.R. 3142. I believe Dea n W a lt e r’s commen ts m eri t th e att en ti o n an d consi dera ti on of th e mem bers of your co mmitt ee an d re sp ec tfully re ques t th a t his 

st ate m ent, as follow s, be m ad e a p a rt of th e official co m m ittee tr ansc ri pt.

“I t is my under st an din g th a t th is prop osed ac t wou ld pro vid e Fed er al ass is tan ce in th e co ns truc tion of m ed ic al li bra ry fa ci lities , m ed ical li b ra ry re se ar ch , 

th e tr ain in g of me dic al li b ra ri an s, an d th e es ta blish in g of re gi on al me dical 

li b ra ri es as br an ch es of th e N ational L ib ra ry of Med ici ne in th ose ca ses whe re 

pri vate res ou rc es a re not ava ilab le .

Th e co nt in ue d ra pi d ex pa ns io n of med ical re se ar ch an d re su lt in g li te ra tu re 

m ak es th e ta sk of ke ep ing cu rr en t li te ra tu re av ai la bl e fo r st u d en ts ex trem el y 

ex pe ns iv e an d th er ef or e quite di fficul t espe ciall y fo r th e no np ro fit pri vat e 

in sti tu ti o n al libr ar ie s. The enactm ent of th is prop osed le gis la tion cou ld be of 

gre at ass is ta nce with th is end ea vo r.

T hankin g yo u in adv an ce fo r y our c on side ra tion . I re m ai n,

C or di al ly you rs.

W il li am L. IIungate.

American H ospit al A ssoc iatio n. 

W as hing ton. D .C., Sep te m ber 16, 1965.

Hon . Oren H arr is.

Cha irman , Com mitt ee on In te rsta te a nd Foreig n Co mm erc e,

R ayburn H ou se Office B uild ing, W as hin gto n, D.C.

Dear Congre ssm an H arris : In th is st at em en t to yo u we w ish to ex pr es s the 

view s of th e Am erican H os pi ta l A ssoc iatio n in re sp ec t to H.R . 3142, “M edica l 

L ib ra ry A ss ista nc e Act of 1965 .” The bil l am en ds th e Publ ic H ealth Service 

Act so as to prov ide fo r a pro gra m of gra nts to as si st in m ee ting th e nee d fo r 

adeq uat e med ical l ib ra ry se rv ices a nd f ac ilitie s.

Th e A m er ic an H os pi ta l Ass oc ia tio n ap pr ov es th e gen er al purp os es of th e bill. 

The re e xis ts a v ast unm et n eed fo r th e diss em in atio n of i nfo rm ati on in th e hea lth 

scien ces. The ve ry ra pid ad van ce m en ts now be ing m ad e in h ealt h re se ar ch an d 

in th e tr eatm en t of ill ne ss ha ve ou tp ac ed ex is ting m ea ns of co mmun ica tio n. 

Ther e is al so a fa il ure to su ppo rt th e gr ow th of li bra ry fa cil it ie s an d m at er ia ls 

co m m en su ra te w ith th e de ve lopm en t of m aj or he al th re se ar ch . A de qu at e li bra ry 

an d co m m un icat io n fa ci lities an d se rv ic es are a lso ne ce ss ar y in al l of th e sch ools 

an d ed ucati onal pr og ra m s direc te d to th e tr ain in g of healt h pe rs on ne l.

The Con gr es s ha s alr ea dy en ac te d le gi slat io n look ing to w ar d a ra pid ac ce le ra ­

tion in th e tr ain in g of ph ys ic ians , den ti st s, pu blic hea lth w ork er s, nu rses , an d 

ot he rs . I t is im pe ra tive to th e su cc es s of th es e effo rts t h a t we d ir ect at te nti on n ow 

to th e so ur ce s of fu nd am en ta l kn ow ledg e an d to w ar d th e dis se m in at io n of su ch 

kn ow led ge . You r co mmittee re centl y vo ted ou t H.R . 3140. a bill w ith fa r- re ac hing im pl ic at io ns fo r the hea lt h care of th e Am erican people. T he ki nds of pr opo sa ls w hi ch are embodie d in H.R . 3142 are of vit al co nc ern to th e succ essfu l 

im ple m en ta tion of th e H eart D isea se . Ca nc er, an d Strok e Am en dm en ts of 1965.

F o r m any year s th e he al th field h a s been aw ar e of th e pr ob le m s de velop ing 

be ca us e of th e un m et ne ed s fo r ad eq u ate he al th scienc e libra ri es. W e be lie ve
92 MEDICAL LIB RARY ASSISTAN CE ACT OF 196 5

perh aps the mo st urg en t ne ed is th a t of tr ain in g more pe op le in libra ry scienc e. 

A t pr es en t, li bra ri es a re o ft en s ta ff ed l ar ge ly by eit her u n tr ain ed or in ad eq ua te ly 

tr a in e d p ersonn el. The o ver al l ob jectives o f t he b ill w ill be s er io us ly ha nd icap pe d 

w it h o u t m aj or em ph as is on tr ain in g . We sinc er ely hope th a t th e Co ng res s will 

mov e ahead ra pi dl y in m ak in g av ai la bl e th e as si st an ce prop os ed in H.R. 3142. 

O ur ge ne ra l ap pr ov al of th e bil l is lim ite d only by w hat we be lie ve ar e li m it ati ons in the l an gu ag e of th e bill.

RE COM M EN DATI ONS ON SPE C IF IC PR OVIS IO NS

W e stro ng ly ur ge th a t th e ti tl e of th e ac t which cite s over al l in te nt be bro ad ­

en ed beyo nd its pr es en t lim it ed lang ua ge an d th a t th e act may be ci te d as th e 

‘•H ea lth Scienc e L ib ra ry A ss is ta nce Ac t of 1965.” The te rm “m ed ical” is fa r 

too lim ited in ligh t of th e es se ntiall y br oa d pu rp os es of th e act . We ur ge th a t 

th e appro pri ate la ng ua ge c ha nge s be ma de th ro ughout th e bi ll to accomp lish th is 

pu rp os e.

Se ctio n 39 0(b) (3 ) pr ov id es fo r spec ial fe llo wsh ips fo r th e cr ea tion of w ri tt en 

m att er. Th e pu rpos e of th e pr ov ision is no t a t all cl ear. Ho we ver, w ri tt en 

m ate ri al in an y way e ss en tial t o re se ar ch is p a rt o f re se ar ch pr oj ec ts. We, th ere ­

fo re . do not su pp or t th e in cl us io n of this pr ov ision in t he bill.

Se ctio n 39 1(1) sh ou ld be br oa de ne d so as to incl ud e th e te rm “h os pi ta l adm in is tr ati o n ” follo wing th e te rm “p ub lic healt h” on line 22. The re are a t th e 

pre sen t tim e 16 univ er si ty pro gra m s pr ov id in g m aste r’s de gree s in hos pi ta l 

ad m in is tr at io n. We be lie ve th e bil l shou ld pr ov id e ass is ta nce in it s var io us 

pu rp os es to such l ib ra ri es and p ro gr am s.

P ara g ra p h (3) of th is se ct io n, line 4, sh ou ld be am en de d by de letin g th e wor d 

“m ed ic al ” a nd in se rtin g th e p h ra se to an y “hea lth s cien ce ” libra ry .

We rec om me nd th a t Se ctio n 39 3: A ssistanc e fo r C ons truc tion of F a c il it ie s: 

Se ctio n 39 7: G ra nts fo r Im pr ov in g an d Expa ndin g th e Bas ic Re so urce s of 

M ed ical Lib ra ri es an d R ela te d In st ru m enta li ti es sh ou ld cl ea rl y pr ov id e fo r 

ass is ta nce to all te ac hin g hosp it als an d oth er ho sp ital s m ai nta in in g such es se nti a l he al th scienc e in fo rm at io n on be ha lf of th eir st af fs an d st ud en ts.

In se ction 399 (a ) we ques tion bo th th e ne ce ss ity an d des ir ab ility of th e 

se ct io n. We believe it will te nd to prom ote th e unne ce ss ar y pu bl ic atio n of 

m ate ri al. It ca n fu rt h er burd en li bra ri es w ith m ate ri als in an ar ea which 

ap p ears to be ad eq ua te ly se rv ed . The re is th e de finite lik elih oo d of pu blishi ng 

m ate ri al th at rec og nized sc ie nt ific ch an ne ls an d pub lica tions will no t carr y 

be ca us e they de em i t to be in ad eq uat e.

Se ctio n 3, p a rt (h ) of ti tl e II of the Pu bl ic H ealth Se rv ic e Act wh ich de als 

w it h th e N at io na l L ib ra ry o f Medicine is am en de d so a s to prov ide re gi on al 

bra nch es of th e na tion al li bra ry .

We wo uld urge th a t th is se ct ion no t be lim ite d, as it ap p ears to be at pr es en t, 

so as to mak e it ess en tial th a t such ex tend ed fa cil it ie s 'be se par at e an d in de ­

pe nd en t faci lities . Th e bill sh ou ld prov ide th at in so fa r as po ssible, suc h regi on al 

br an ch es be loca ted in exis ti ng ho sp ital s an d med ical cente rs wh ich ma y se rv e 

a la rg e ge og raph ic ar ea .

We ap pr ec ia te th is opport unit y of s ub m itting to you th e view s of th e American 

H osp ital As sociati on on H .R . 3142. We wo uld appre cia te yo ur mak in g th is 

st ate m ent a p a rt o f th e re co rd of th e he ar in gs o n th is bill.

Sinc erely y ou rs,

K en n eth W il l ia m s o n , A s s o c ia t e D ir e c to r .

H arvard M ed ical Sch oo l.

Boston. Mass., September 10, 1965.

H o n . O ren H arr is.

House of Representatives, Washington. D.C.

D ear Mr. H arris : Tho se o f us wh o are close t o med icine and me dical ed uc at io n 

on a da y-to-day ba sis ho pe ve ry mu ch th a t yo u co nt in ue to giv e high pri ori ty 

to th e pa ssag e, duri ng th e pre se nt ses sion, of th e M ed ical L ib ra ri es Assistanc e 

Ac t.

T his legi slatio n m us t not la ng ui sh . Our med ical scho ols an d medica l ce nt er s 

a re m ak in g ho pe fu l pro gre ss w ith th e comp lex ta sk of im pr ov in g th e qual it y of 

m ed ic al edu ca tio n, w ith th e tr ain in g of addi tiona l do ct or s a nd w ith re se ar ch in t he 

m ed ic al scienc es. In m os t of our med ica l sch ools we a re h am pe re d in ou r ef fo rts 

be ca us e of in ad eq ua te libra ri es.
MEDICAL LIB RA RY ASSISTAN CE ACT OF 1965 93

Yo u a re on e who is kn ow n to ap pre ci at e th a t m ed ic al pro gr es s is de pe nd en t 

on quali ty me dic al li bra ry se rv ic e an d th at it is of te n im po ssib le fo r a med ical 

sch oo l to mobilize th e fu nds th a t ar e ne ce ss ar y to cre ate a fir st-c lass libra ry . 

H er e a t H arv ar d we wer e fo rtu n a te in being ab le to fin d pri vate do no rs fo r our 

ne w li bra ry bu ild ing . B u t th is is fa r fro m ty pi ca l. A t mos t medica l schools 

th e li bra ry receives less th a n pri ori ty at te nti on be ca us e p ri v ate fu nds are ju st 

not av ai la bl e.

T he Medica l L ib ra ri es A ss is ta nce Ac t pr om ises a nat io nw id e al le vi at io n of 

th is si tu at io n. Its se ve ra l pr ov isio ns wo uld gre at ly st re ngth en th e med ical 

li b ra ri es of th e co un try. T his , in tu rn , wou ld ex te nd cri ti call y needed libra ry 

se rv ic e to th e no nu rb an a re a s of th e Nati on so th a t— am on g oth er th in gs —th e 

pra cti cin g ph ys ician in su ch a re a s wo uld ha ve a ch an ce of keeping up w ith 

cu rr en t med ica l ad va nc es an d of br in ging ne wly disc ov er ed med ical kn ow led ge 

to b ear on his ab ility to he al th e sick.

I sh ou ld like to hoi>e th a t your co mmittee will ta ke ac tion on th e Me dic al 

L ib ra ri es A ssistanc e Act ju st as soo n as po ssible and th a t it wi ll re port it fa vorab ly. If th is ca n be do ne no w. is th er e no t an excellent, ch an ce th a t th e Hou se 

will ac t pr om ptly a nd f avora bly ? Sin ce t his leg isla tion , is f av ore d by so ma ny , it 

wou ld b e a pi ty i f its en ac tm en t w er e pu t off a noth er y ea r.

P le ase co un t on me to lend a hand w ith th is ef fo rt if th is see ms to you to be 

appro pri at e.

Ve ry tr uly yo urs,

R obert H. E bert, M.D., Dean.

T he A me ric an P ublic H ea lth Assoc iation , I nc.,

Washington, D.C., Septe mber 1 1965.

Ho n. Oren Harris,

Chairman. House Committee on Int ersta te and Foreign Commerce,

Washington, D.C.

Dear Mr. Cha irma n : I am ple as ed to info rm yo u of th e su pport of th e Am erican Pub lic H ea lth Assoc iatio n of th e prin cipl es and obje ct iv es of II. R. 3142, th e 

bil l w hi ch you ha ve in trod uce d re la ti n g to med ical libra ri es . The st at em en t of 

dec la ra ti on of policy in II.R . 314 2 whe rein th e ne ed s of m ed ic al li bra ri es ar e 

enum er at ed is fu lly su bs cr ib ed to by the APH A. Th e pr op os ed co urse o f re ­

m ed ia l ac tion s ap pe ar s to us to be bo th logica l an d ne ce ss ar y.

We a re de lig hted to no te th a t un d er th e de fin iti on s th e te rm “scie nces re la te d 

to h e a lt h ” includ es pu blic h ealt h and fu nd am en ta l an d ap pl ie d scienc es re la ted 

th er et o. We beli eve, you will ag re e, th a t pu blic hea lth scho ols an d de pa rtm en ts 

sh ou ld be clea rly eli gible to p a rt ic ip a te un de r al l ap pl ic ab le se ct io ns of the bill. 

The la ngu ag e of section 394 is expli cit in th is re sp ec t, but we be lie ve it would 

be ve ry he lp fu l to cl ar if y th e la nguage of th e re m ai ni ng port io ns of th e bill in 

th is re sp ec t.

May I re it era te ou r su ppo rt of H.R . 3142 an d ur ge pa ss ag e a ft e r th e minor 

am en dm en ts refe rr ed to above.

Since re ly yo urs,

Ber wyn F. Mat tis on, M.D ., Executive Director.

Ame ric an Association of Colleges of P ha rm ac y,

Washington, D.C., Septem ber 15, 1965.

Ho n. Oren H arris,

Chairman, Committee on Inte rstate and Foreign Commerce,

House o f Repre sentatives,

Wash ington, D.C.

Dear Mr. H arri s: Th e ex ec ut iv e co mmittee of th e Am er ic an Assoc iatio n of 

Co lle ges of Pha rm ac y is pl ea se d to ha ve th is op po rtunity to su bm it fo r th e 

re co rd th is st at em en t in su pport o f H.R. 3142, th e Medica l L ib ra ry Assistanc e 

Act. W hi le th is ac tio n is ta ken in th e na me of th e ex ec ut iv e co mmitt ee . I am 

co nfiden t th a t th e ad m in is tr ato rs of our 73 mem be r colleges wo uld give full 

en do rs em en t to the legi slat io n if ti m e pe rm itte d a so lici ta tion of th eir views.

It. is anti cip ate d th at sch oo ls of ph ar m ac y will be eligible fo r be ne fits un de r 

H.R . 3142 ju st as they are under th e he al th re se ar ch fa cil it ie s co ns truc tion 

pro gra m in as m uc h as th e te rm “sci en ce s re la te d to h ealt h ” is de fin ed id en tica lly 

in ea ch in st an ce . How ev er, it is re sp ec tfully requ es ted th a t th e de fin ition as 

give n in s ec tion 391 (1 ) be am en de d to specif ica lly so st ate .
94 MEDICAL LIBRARY ASSISTANCE ACT OF 19 65

Th e se ve ra l pro gra m s em bodie d in H.R. 3142 pr ov ide a br oa d- ba se d ap pro ac h 

to an of te n ne gl ec te d but an ex trem el y im p o rt an t and es se nt ia l p a rt of th e to ta l 

ed uc at io na l pro gra m of th e he al th sci ences. F o r th e pas t se ve ra l ye ar s, F edera l 

legi slatio n ha s pr ovi ded mu ch ne ed ed su pport fo r th e de ve lopm en t of new 

know led ge th ro ugh su ppo rt p ro gr am s fo r fa cil it ie s an d rese ar ch . The pro gra m s 

prov ided fo r th ro u g h H.R. 3142 will give im pet us to th e dis tr ib uti on of th is 

kn ow led ge to th e re se ar ch er s, to th e ed uc at or s, an d to th e p ra cti ti o n ers of th e 

hea lth pr of es sion s. Th e ul tim at e ob jective of all h ealt h re se ar ch is th e im pr ov emen t of t he h ealt h of th e public, an d un less th e re su lt s of th e re se ar ch a re tr a n sla te d in to p ra cti cal pr oc ed ur e fo r tr eatm en t and dis tr ib ute d to th e p ra cti ti o n ers 

th e ob jective c annot be ac hie ved.

Fed er al ass is ta n ce in th e form of hea lth re se arc h fa ci lity g ra nts and re se arc h 

gra nts from th e N ati onal In st it ute s of H ealth h as se rv ed as a pr on ou nc ed st im ulu s to th e g ra d u ate p ro gra m s of sch ools of p har m ac y. In fiscal 1964 g ra n ts to ta ling $820,000 w er e aw ar ded to 5 sch oo ls of ph ar m ac y, an d a re ce nt su rv ey , 

w ith 59 of our sc ho ol s re po rting, show ed th a t duri ng th e de ca de en din g Ju ne 

1974, fu nd s in ex ce ss of $20 mi llio n, ba sed on th e to ta l co st of co nst ru ct io n, will 

be r eq ui re d fo r ne w r es ea rc h fac ilitie s.

D ur in g fiscal 1964, Pub lic H ea lth Se rv ic e- su pp or ted re se ar ch p ro je ct s in scho ols 

of ph ar m ac y to ta le d 182 w ith a do llar va lu e of $2,834,000. Sin ce 1961 th e an ­

nual grow th ra te o f th e am ou nt of su pport h as be en 44 p erc en t; duri ng th e p ast 

10 ye ars, th e d o ll ar val ue ha s in cr ea se d a hu nd re dfo ld . In as m uc h as about 56 

pe rc en t of all fu n d s ex pe nd ed fo r re se ar ch in fis cal 1964 came from th e Nation al In sti tu te s of H ea lth, th e gr ow th ra te figu re exem plifies th e gro w th of th e 

rese ar ch p ro gr am s in s choo ls of p ha rm ac y.

In ad di tion to th e gre atl y in cr ea se d am ou nt of in fo rm at io n comi ng fr om ou r 

ed uc ation in st it uti ons, all of us are well aw are of th e vas t am ou nt of in fo rm atio n on new dr ugs co min g from th e re se ar ch la bora to ri es of th e pharm aceuti cal 

house s, all of w hi ch is es se ntial to th e re se ar ch pro gra m s an d to th e ed ucati onal 

pr og ra ms of ou r sc ho ol s of ph arm ac y. It is q u it e sa fe to st ate th a t th e av ail ­

ab ility of fu nd s fo r th e ex pa ns io n of fa ci lities and of reso urce s in th e li b ra ri es 

of ou r schools h as n o t kep t pa ce with th e avail abil it y of new kn ow led ge ess enti al 

fo r th e to ta l educa ti onal pr og ra m fo r ph ar m ac y st uden ts . It can al so be sa id 

th a t to as k st udents to pr ov id e fo r th is es se ntial pr og ra m th ro ug h in cre ase s in 

st uden t fees wou ld pl ac e an im po ssible bur de n up on such st ud en ts , both now 

an d in th e fu tu re .

It shou ld be poi nte d ou t th at phar m ac eu tica l ed uc at io n is co nc erne d w it h th e 

ph ysical sci ences an d w ith th e bio logic al scien ces, fr om bo th th e ba sic and applied view po ints, an d th u s th e li b ra ry re so ur ce s w hi ch m us t be av ai la ble to our 

un der gra duat e an d g ra d u ate pro gr am s are qu ite ex tens iv e.

Th e in ad eq ua cy of m an y of ou r libra ri es w as em ph as ized in a re ce nt su rv ey 

in w hic h in fo rm at io n w as re qu es ted on th e avail abil it y, on a pe rc en ta ge bas is , of 

1,000 boo ks an d re fe re nce wor ks re la ting to th e pro fe ss io na l cu rricul um . W he n 

th e ph ar m ac y li b ra ry and uni ve rs ity li bra ry w ere th e ba sis fo r th e per centa ge 

estim atio n, 71 scho ols re po rted a rang e of 3 to 100 pe rcen t, th e av era ge w as 

60 pe rc en t of th e li st ed books an d re fe re nc e w or ks , an d th e m ed ian w as 62 

pe rce nt.

In a second te st des ig ne d to d et er m in e th e effectiven es s of th e libra ri es re ad il y 

av ailable to sch oo ls of ph ar m ac y, li bra ri ans w er e as ke d to cho ose on e o r tw o 

review ar ticl es from th e Jo u rn al of P harm aceuti cal Sciences an d to det er m in e 

fro m th e bi bl io gr ap hi es w het her or no t th e art ic le s could ha ve be en w ri tt en 

by th e us e of th e co mbi ne d ho ldings of th e pharm acy lib ra ry , th e univ ers it y 

lib ra ry , an d ne ar by li bra ri es. Tw en ty -thr ee sa id th ey could no t ha ve pre pare d 

th e ar ticl es from th e ph ar m ac y an d th e univ ers it y libr ar ie s. How ev er, 12 of 

th e 23 sa id th a t n earb y li bra ri es wo uld ha ve pr ov id ed th e ho ldings ess ential 

to th e pre par at io n of th e ar ticl es .

Ph ar m ac y, lik e th e o th er he al th pr of es sion s, is becomi ng in cr ea sing ly aw are 

of the ne ed fo r conti nuin g ed uc ation pro gra m s fo r it s p ra cti ti o n ers ; a few 

pe rson s ha ve ad voc at ed at te nd an ce a t su ch pro gra m s as re qu is ite to re new al of 

th e pr of es sion al lice ns e. As th es e co nt in ui ng ed uc at io n pr og ra m s ta k e on 

in cr ea se d sig nific an ce , th e re ad y avai la bility of c u rr e n t in fo rm at io n to all co mm un ity pra cti ti oners will be es se ntial. Thu s, m et ho ds of dis tr ib uti on of 

in fo rm at io n an d of th e co mm un ication of in fo rm ati on wi ll need in cr ea se d a ttention. In sh ort , th e re so ur ce s of its li bra ry a re th e h eart of an y in sti tu ti o n 

of high er le ar ni ng . W hile th e prob lem of m ain ta in in g ad eq ua te fa cil it ie s is 

cr itic al in al l in st it uti ons, it is part ic ula rl y sign ific an t in ar eas re la te d to h ealt h 

be ca us e of th e trem en dous volum e of re se ar ch ac hi ev em en t an d th e p ri m ary
MEDICAL LIB RARY ASSISTANCE ACT OF 1 9 6 5 95

im port an ce whi ch m us t be a tt a c h e d to th e w id es t dis se m in at io n of kn ow led ge 

a t th e earl ie st mom en t po ssible. Ext en si ve re habil it ati on of fa ci lities an d 

in cr ea se d ca pa bi lit y fo r handli ng ac qu is itio ns ca n m ak e th is possible .

The di sc us sion in th is sta te m en t of indi vi du al se ct io ns of th e legi slatio n is 

de em ed un ne ce ss ar y in as m uc h as th ey were co vered by se ver al of th e witn es se s 

duri ng th e he ar in gs . How ev er, it is our op ini on th a t ea ch of th e pro po sed 

pro gra m s su pp lemen ts th e oth er an d th a t all a re ess en tial in st re ngth en in g th is 

im port ant are a o f t he h ea lth sci en ce s pr og ra ms.

R es pec tf ul ly s ub mitted .

J os eph B. Sprowi.s,

Chairman. Executive Committee.

Univ ersit y of Min nes ota,

Colleg e of P h arm a cy, 

Mi nn eapo lis , Minn., S ep te m ber 15,1965.

Ho n. Oren H ar ris,

Cha irman , Com m ittee on In te rsta te an d Fo reign Co mm erce, H ou se of Rep re ­

se nta tive s, W as hing ton, D.C.

Hear Mr. H arris : I am w ri ti n g in re sp ec t to H.R. 3142, th e M ed ical L ib ra ry 

A ss is ta nce Act of 1965. I re sp ec tfully re qu es t th a t th is le tt e r be in cl ud ed in th e 

re co rd of th e he arin g. The U niv ers ity of Minnesota Co llege of Phar m ac y an d. 

I am su re , oth er colleges of pharm acy in th is co un try urg entl y ne ed as si st an ce 

of th e ty pe prov ided by H.R. 3142 , es pe cially as re gar ds new li b ra ry fa cil it ie s; 

re no va tion an d ex pa ns ion of exis ti ng fa cil it ie s; su bs id y of post bac ca la ure at e 

de gr ee pro gra m s in libra ry scienc e, d a ta pro cessing , an d com m unic ati on; spec ial 

fe llow sh ip s to a id de ve lopm en t of ne w in fo rm at io n to o ls ; an d fu nds fo r pu rc ha se 

of boo ks, jo urn als , films an d eq uip m en t to ex pe di te do cu m en ta tion an d com ­

m un ic at io n.

I ass ure yo u of th e g ra ti tu d e of phar m ac eu tica l ed uca to rs fo r th e im plication of co lle ge s of pha rm ac y in th e ph ra se , “sc ien ces re la te d to healt h.” On 

th eir behalf I ap pe al, ho wev er, fo r th e ex pl ic it id en tifi ca tion of colleges of 

ph ar m ac y as in st itutions eligible fo r as si st an ce under th e te rm s of H.R. 3142.

The k no wledg e of dru gs w ith w hic h ph ar m ac is ts , in th e i n te re st o f med ical c ar e 

an d pu blic hea lth, m us t be fa m il ia r and to which pharm acis ts m ust ha ve re ad y 

acce ss i s very lar ge an d ve ry dy na m ic . The f re quen t ch an ge s are m os t sign ifi ca nt 

as re gard s th e efficacy an d sa fe ty of dr ugs. The i nf orm at io n ban k is do ub lin g a t 

an ala rm in g ra te an d th e ra te is ac ce le ra ting . Sin ce 1960, pharm acy st uden ts 

ha ve be en re quir ed to spen d 5 y ears (i nst ead of 4) in m as te ri ng th e ph ar m ac al 

scienc es an d, even more im port antl y, in le ar ni ng ho w to us e th e v ast st or e of 

re co rd ed in fo rm at io n effecti ve ly in th e in te re st of m ed ic al care an d publi c 

hea lth and fo r re se ar ch on dru gs . D uri ng th e pe rio d, 195 8-64, 18.8 pe rc en t of 

th e st u d en ts rece iving th e B. S. deg re e in ph ar m ac y a t th is co lle ge ha ve und er ­

ta ken po st bac ca la ure at e de gr ee pro gra m s mo st of which invo lv e re se ar ch . Th e 

ro le of co lle ge s of ph ar m ac y as cl ea ring ho us es fo r dru g in fo rm ati on an d the 

ro le of co m m un ity an d hosp ital p h arm acis ts in healt h co m m un icat io ns shou ld 

be reco gn ized an d shou ld be fu rth e r en ha nc ed by th e ass is ta nce prov ided in 

H.R. 3142. I ha ve enclo sed a re cent art ic le on “T he P h arm acis t’s Re spon ­

si bi lity in D ru g In fo rm at io n Ser vi ce s.” C er ta in of th e arg um ents fo r na min g 

ph ar m ac y specifically in H.R. 3142 a re el ab or at ed in th a t ar ti cl e.

The Ja n u a ry 1963. re port of th e P re si dent’s Sc ien ce Adv isor y Co mm ittee. 

“Science, Gov ernm en t, an d In fo rm ati on", em ph as izes th e ne ed fo r “cen tr al 

deposi to ri es ” an d “spe cialized in fo rm ati on ce nte rs ”. Co lle ges of ph ar m ac y 

shou ld be en ab led to serv e as c en tr al de po sitories an d as sp ec ializ ed ce nt er s 

in han dling in fo rm at io n on dr ug s. So me of our st udents sh ou ld be en co urag ed 

to ta ke th e ad di tional tr ain in g re quir ed fo r th e role of in fo rm at io n sp ec ia lists 

in do cu m en ta tion , re trie va l, and co m m un icat io n of dru g in fo rm at io n. Nam ing 

ph ar m ac y in II.R . 3142 wou ld co n st it u te a st ro ng po sitive th ru st in th es e 

di re ct io ns . Co lleges of ph ar m ac y urg en tly ne ed th e as si st an ce pr ov id ed in H.R . 3142 to 

fulfill re sp on sibi lities th a t fu lly ju sti fy suc h as sistan ce .

Ag ain , I th an k you fo r you r ef fo rts in be ha lf o f th e Med ica l L ib ra ry Assistan ce 

Ac t an d fo r yo ur intent io n as re g ard s ph ar m ac y. I am mo st si nc er e in my hope 

th a t you will rec ogniz e th e m eri t of th e po ints I ha ve mad e and th a t you wi ll 

includ ed ph ar m ac y specifically under th e prov isions of H.R. 3142.

Ve ry s in ce re ly yo urs,

Geo. P. H ager. Dean.
96 MEDICAL LIBRARY ASSISTANCE ACT OF 1965

A mer ic an Nu r se s’ Ass ocia ti on, I nc.,

New York, N.Y., September 13,1965.

H o n . Oren H arris,

Chairman, Committee on In terstate ami Foreign Commerce,

U.S. House of Repre sentatives, Washington, D.C.

D ea r Mr. H ar ris : The A m er ic an N ur se s’ A ssoc iatio n w ishe s to rec ord its su pp o rt of II.R. 3142, tlie M ed ical Lib ra ry A ss ista nc e Ac t of 1965. We be lie ve th e 

pr ov isio ns in th is bill wi ll do mu ch to me et th e curr ent an d ev er-inc reas ing need 

fo r tr ain ed med ica l li b ra ri an s, ad eq ua te spa ce, eq uipm en t, books, an d jo urn al s. 

T he gr ow th in scientifi c re searc h an d w ritings re quir es a sy st em at ic ac cu m ul ation of the va lu ab le in fo rm ati on an d an or de rly, spee dy metho d of re tr ie val if 

th e hea lth o f the N at io n is to be ad va nc ed .

The re por t o f th e P re sid en t’s Comm ission on H ea lth Disea se . Ca ncer, a nd St ro ke 

em ph as ized w ha t was gen er al ly know n, th a t med ical li b ra ri es are in ad eq ua te in 

te rm s of space, tr ain ed st af f, and es se nt ia l volum es, and th e Comm ission reco mm en de d im med iate a tt en ti o n to th is by th e Congre ss.

It is ou r be lie f th a t nurs in g ed uc at io n wi ll benefit gre atl y by th e pr og ra m pro ­

po sed in th e Me dic al L ib ra ry Fac ilitie s Ac t of 1965, es pe ci al ly sin ce a co mpr ehe ns iv e ind ex to nu rs in g pe ri od ic al li te ra tu re is to be pu bl ishe d in co op eration 

w ith th e Natio na l L ib ra ry of Me dic ine , us in g th e fa cil it ie s of med lars. We ca ll 

your at te ntion to th e im p o rt an t p art w ell-trai ne d med ical li bra ri ans will pl ay in 

th e di ss em in atio n an d in te ll ig ent use of th is m at er ia l w hi ch will he re trie ve d fro m 

m ed la rs . The refo re , we gi ve st ro ng su pp or t to th e tr ain in g gra nt pr og ram pro ­

po sed in th is le gislati on .

In or de r to in su re th e co nt in ue d inclus ion of nurs in g sch ool libr ar ie s in all 

pr ov isio ns o f th e bill we w is h to rec om me nd th a t section 393 (1) of H.R . 3142, be 

am en de d to includ e th e w or d “n urs in g" aft e r “pub lic h ealt h " (l in e 22, p. 3).

Alth ou gh we be lie ve it desi ra ble th a t sch ools of nu rs in g sh ar e libr ar y fa ci lities 

w ith ot her discipl ines in th e h ealt h field, it is a fa ct th a t tw o-thirds of th e schoo ls 

m ain ta in inde pe nd en t fa cil it ie s an d de sp er at el y need th e qu al ity an d nu m be rs 

of vo lum es increa sed, as w ell as ad eq ua te ph ys ic al pla nts . It is es tim ated th a t 

th e nu mbe r of volu me s in li b ra ri es of schools of nu rs in g is less th an hal f of w hat 

is co ns idered th e es se ntial minim um . I f nurs in g is to ke ep ab re ast of th e ad ­

va nc es in science, ed uca tional m at er ia ls m us t he re ad ily av ai la bl e.

We welcome th is opport unit y to len d ou r su pp ort to th is ve ry sign ifi ca nt legi sla ti on a nd u rg e y ou to act fa vora bly on our rec om men de d am en dm en t.

Very sin ce rely,

J u d it h G. W h it a ker

(M rs.) Ju d it h G. W hitak er , R.N.,

Exe cutive Director.

G eo rg etow n U niv er si ty Sch oo l of Med ic in e,

O ffic e of t h e Dea n. 

W as hing ton, D.C ., Feb ru ar y 25,19 65 .

Hon . Oren H arr is,

H ou se of Rep re se nt at iv es ,

Washington, D.C.

D ear Cong re ss man H a r r is : I w an t to ex pr es s my su pport an d th e who leh eart ed su pp ort of th e fa cu lt y an d st uden t body of th e Ge org eto wn U ni ver si ty 

Sc hool of Me dic ine fo r th e bil l H.R . 3142. In th e F ed era l pr og ra m to up gra de 

m ed ic al ed uc ation, in w hic h you r effo rts ha ve been so im jior ta nt , no item is 

mor e im port ant th an su p p o rt fo r the li bra ri es of th e m ed ic al school s. The se 

li bra ri es a re p art ic u la rl y im port ant wh en th ey also se rv e un iv er si ty hos pi ta ls , 

scho ols of d en tist ry , an d o th er tr ain in g a re as fo r th e h ealt h professio ns.

I kn ow th a t you are w el l aw ar e of th e prob lem cre ate d by th e in cr ea si ng 

vo lum e of im port an t sc ie nt ific med ical li te ra tu re . T he m ed ical ce nt er libra ri es 

a re face d w ith ra pi dly de ve lopi ng obsoles cence un le ss fa ci lities ca n be co nst ru cte d, peo ple tr ai ned, an d new tech ni qu es de ve lope d fo r processin g, st or in g, 

and dis trib uting in fo rm ati on in th e hea lth sci ences.

H er e a t Ge orge town U niv ers ity Me dic al Cen ter, w e a re keenly aw ar e of 

th is pro blem . In de ed , we ca n pr ov ide a gra phic dem onst ra tion of th e ur ge nc y 

fo r ac tio n in th e med ical li b ra ry field. Th e in ad eq ua cy of ou r libra ry fa ci li ti es 

th re ate n s to redu ce th e e ffec tive ne ss of our ed uca tional pr og ra m s. In co nsu ltation w ith ex pe rts, we hav e no w develop ed pl an s fo r a ne w li bra ry to se rv e th e 

ex tr ao rd in ari ly la rg e popula ti on of a gr ow ing m ed ical c e n te r: med ical st uden ts , 

denta l st ud en ts, nu rs in g st uden ts , in te rn s, re si dent ph ys icians , fu ll-tim e
MEDICAL LIB RARY ASSISTANCE ACT OF 1965 97

fa cu lt y of th e th re e healt h-r ela te d schools of th e univ er si ty , th e st af fs of ou r 

af filiated ho sp ita ls, an d th e co m m un ity of ph ys ic ians an d den ti st s. W e a re gra te fu l fo r your ef fo rt s in th is vital field, and I w ant to as su re you th a t we st and re ad y to he lp yo u in an y wa y th a t we ca n to w ard th e pa ss ag e of 

th is prop os ed leg islatio n.

Sinc erely , J oh n C. R ose, M.D., Dean.

P en nsyl va nia College of P odia try,

Off ic e of th e Dea n, 

Phila de lp hi a, Pa., F eb ru ary 19,19 65.

Re M ed ical Lib ra ry A ss ista nc e A ct of 1965.

Mr. Oren H arris,

In te rsta te and Fo reign Com mer ce Co mm ittee , Roo m 1336 , Lo ng wor th Ho use

Office Bu ild ing, W as hi ng to n, D.C.

D ear Si r : Sen ator L is te r H ill has in trod uc ed S. 597 in th e Se na te. Mr. Oren 

H a rr is h as in trod uc ed H.R. 3142 in th e Ho use of R ep re se nta tives . As a pr iv at e, no np rofit in sti tu ti o n th e Pen nsy lv an ia Co lle ge of P odia tr y in Philadelp hia , I’a., is gre at ly in te re st ed in su pp or tin g th e pas sa ge of th es e hills. T his co lle ge is de siro us of obta in in g fu nd s of mo ney , m ate ri als , or both, fo r th e pu rp os e of ex pa nd ing and im pr ov in g our ba sic m ed ic al li b ra ry an d re la te d 

re so ur ce s. I t is o u r pl an to mak e our re so urc es co mp let ely avai la ble to th e co mmun ity . In ad dit io n, we ha ve need fo r m ate ri als which ca nnot be st ore d in ou r li bra ry an d, fo r th is reason , are in te re st ed in the de ve lopm en t of li b ra ri es oth er th an 

ou r ow n. I t is o u r under st an din g th a t h eari ngs on th es e bi lls m ay be he ld duri ng th e la st wee k of Feb ru ar y. We ar e, th er ef ore , re qu es ting th a t th is le tt er be filed from th e Pe nn sy lv an ia Colleg e of Podia tr y as an in sti tu ti o n per fo rm in g a 

re gi on al service .

Very tr u ly y ours, R obert J. W agnon, Dean.

(Whereupon, at 12:10 p.m., the hearing was concluded.)