GOVERNMEN"

Storage

,11111111.1rr16/31acm.

LOANS TO STUDENTS 0 RY

Addendum to hearings held May 26 and June 22, 1964, on H.R. 8546

(NoTE.—The following statements were inadvertently omitted when

the above hearings were printed.)

STATEMENT SUBMITTED BY HON. JAMES C. CLEVELAND, MEMBER OF

THE HOUSE OF REPRESENTATIVES OF THE UNITED STATES FROM THE

STATE OF NEW HAMPSHIRE, SECOND DISTRICT, IN SUPPORT OF THE

PASSAGE OF H.R. 8546.

Mr. Chairman and members of the committee, it has come to my

attention that Paul Q. Peterson, M.D., representing the Department

of Health, Education, and Welfare, appeared before this committee

on May 26 and opposed the passage of H.R. 8546, the reason given

being that there was no need for additional loan funds for optometry

students.

As a member of the House Select Committee on Government Research, it has come to my attention that a Neurological and Sensory

Disease Service of HEW approved a project grant No. 99 for the

purpose of training ophthalmic assistants in order that ophthalmologists could "spend more time with the treatment of the individual

patient, can see more patients, and can fill up more of his time for

dealing with individual problems as prevention of blindness in order

to improve our standards of public health."

The same grant shows that only 1 percent of the medical students

at the time of graduation rated ophthalmology as the most liked

specialty while four times that number rated it as the least liked.

Since 1935 only 2.6 percent of all graduates have chosen ophthalmology

for postgraduate training. The grant also shows that of the time

given to the 16 clinical subjects in which American medical students

are trained, only 14 percent of the time was allotted to ophthalmology.

This shows clearly that the average physician has very little training

in vision care.

In my opinion there is no question but that the country is faced

with a shortage of both optometrists and ophthalmologists but the

way to correct this situation is not to turn out a group of so-called

ophthalmic assistants, but rather, first to increase the number of welltrained optometrists who are fully capable of detecting pathological

conditions discovered in the course of a visual examination and

referring the patient to a medical _practitioner, and second, to train

more ophthalmologists.

There is no prbvision in the laws of New Hampshire, or of any of the

other 49 States, for the licensing of ophthalmic assistants. Whenever

one would examine the vision of a patient and make findings, he must

do so under the direct personal supervision of a licensed physician who

is exempt from the optometry licensing laws, or he would be in violation of the law. Under these circumstances, the physician might

36-202-04
y •

•

2 LOANS TO STUDENTS OF OPTQL1VETIErZ1 .

411,"

better perform the examination himself, as far as Saving his time is

concerned.

In my opinion, the Department of Health, Education, and Welfare

is at fault for its failure to employ in its own organization the full-time

services of a single optometrist and also for failure to utilize more of

them in consulting capacities.

Certainly there can be no justification for the Department objecting

to making Federal funds available for loan to optometry schools and

colleges. The money will be repaid with interest and if it enables

only one student from each State to complete his or her optometric

education, it will be in the public interest.

It is my recommendation that this bill be reported promptly to the

House and passed.

STATEMENT OF HON. HARRISON A. WILLIAMS, JR., A U.S. SENATOR

FROM THE STATE OF NEW JERSEY

Thank you, Mr. Chairman, for this opportunity to speak on behalf

of legislation in which I am greatly interested. As you know, H.R.

8546 is identical with S. 2180 which I introduced to amend Public

Law 88-129. This amendment is designed to extend to qualified

schools of optometry and students of optometry those provisions in

the Health Professions Educational Assistance Act which relate to

student loan programs.

Our shortage of optometrists is something that must be corrected.

More than 100 million Americans are in need of vision care. Among

that number are a great many young people, as well as many of our

older citizens. They require the kind of vision care that only a

trained professional can provide. Of all Americans, in every age

group, who seek vision care, about 75 percent are patients of optometrists. The optometrist's role in our society is therefore a very

important one and carries with it a great responsibility. This is true

not only in the city, but also in the rural areas where there are practically no eye physicians.

The everyday visual tasks of 100 years ago were simple compared

to those which are required today of both young and old. Then,

there were books and newspapers, but movies, television, radar

screens, tolerances of infinitesimal dimensions, high-speed automobiles,

airplanes, space capsules, nuclear power, and its utilization both in

peace and war were never dreamed of a century ago. Each and

every one of these presents a challenge to man's eyesight.. To meet

this challenge, we need more optometrists, Even our national game

has its visual problems. Red Schoendienst, an outstanding baseball

player, improved his batting average as the result of visual training

given him by an optometrist.

. During the 1950's the ratio of our population wearing spectacles

increased more than 10 percent, and today two out of three adults

are receiving professional eye-care services. As our need for advanced

scientific and technical skills increases, and our civilization becomes

more mechanized, not only will the demand for professional vision

care rise, but vision requirements will also become more exacting.

A person's eyesight is one of his most precious possessions. The

optometrist safeguards that possession.

1 t.
LOANS TO STUDENTS OF OPTOMETRY 3

Because his function is so vital to the Nation's welfare, it is important that he live among us in numbers sufficient to take care of our

growing population's needs. This, unfortunately, is not the case.

The condition of the optometric profession in New Jersey is a good

example of the need for this legislation. According to 'The Blue

Book of Optometry," which lists all licensed optometrists in this

country, there were 856 optometrists in New Jersey in 1952. In 1962

the number had decreased to 739—representing a 14-percent decrease

during a period when New Jersey's population had increased by 25

percent.

It is apparent that we must take an urgent look at our problem—

the correlation between population and optometric manpower—and

provide some aid to those young men and women who wish to enter

this profession.

The testimony before the Senate Subcommittee on Frauds and

Misrepresentations Affecting the Elderly, of which I am chairman,

proved conclusively that the untrained and the unscrupulous move

in wherever there is a scarcity of professional people. The elderly as

well as youngsters are among tke groups most urgently in need of

vision care. Vision devices are being foisted on the uninformed and

gullible, which far from helping their vision problems often aggravate

them.

In recent months attention has been focused on the matter of

contact lenses. Several million Americans wear them. Fitting them

properly requires great professional skill. In New Jersey, only an

optometrist or a qualified physician is permitted to fit them. This

is not true everywhere in the United States.

The public is entitled to protection against frauds and misrepresentation, and against those who are not professionally trained to

provide vision care. To protect the public, however, we must have

a sufficient number of professionals to provide the needed service.

There are only some 17,000 optometrists in full-time practice in

this country. That is too small a number to handle the needs of 190

million Americans. There is also a shortage of certified eye physicians. So the combined shortage of professionals dealing with varying

types of eye care makes it easy and profitable for unlicensed, untrained

exploiters to enter the field of vision service. This alone is reason

enough to do everything in our power to help those who want to join

the ranks of trained professionals in the vision-care field. While

vision is an individual asset, it has a vital relation to our national

security and financial welfare.

From the Nation's point of view, vision's most dramatic use is in

space conquest. The men who work on machines which will carry

other men toward the stars, and the men who will be inside those

machines which will take them to the new frontiers of the sky, need

not merely 20/20 vision, but the best possible vision to perform their

tasks.

The late President Kennedy said in a health message to Congress

that "modern health care is extremely complex. It demands the

services of a skilled and diversified team of specialists and technical

personnel."

Optometrists certainly are an essential part of that team.
,

LOANS TO STUDENTS OF OPTOMETRY

Mr. Chairman and members of the committee, your gracious

attention to -this statement is appreciated. Make available loans to

the students who want to become optometrists, and who will become

members of that skilled and diversified team of specialists, and you

will have made a significant contribution to our Nation's future and

well-being at practically no cost to the taxpayer.

0