There are six schools of osteopathy which are fully approved and recognized by the Bureau of Professional Education and Colleges of the American Osteopathic Association, after annual reports and inspections by qualified personnel. The student body in these six colleges is about 1,600, and the insti tutions graduate approximately 400 annually. All of these colleges require 2 years' preprofessional college work before matriculation in the professional college. The professional course is 4 years; however, these colleges are on an accelerated basis such as is the case in most colleges due to wartime needs. There has been no reduction in the number of hours of instruction required in any of these colleges. It is simply that the calendar time has been reduced due to the elimination of summer vacations. All colleges maintain teaching hospitals where all forms of medical and major surgical cases are hospitalized. In addition there are some 30-odd osteopathic hospitals which are approved for intern-training purposes. In these hospitals osteopathic graduates receive their additional year's professional training, making in normal times 7 years' professional training after high school. All States have enacted laws for examining, licensing, and registering physicians of the osteopathic school. Some States have osteopathic boards, others have composite boards, others have all medical boards. In a number of States, notably Colorado, Delaware, District of Columbia, Kentucky, Massachusetts, New Hampsihre, New Jersey, Ohio, and Texas, osteopathic applicants for State license are required to take the same examination as graduates of medical schools and before the same State board of examiners, after which they receive identical or equivalent licenses to practice. These State examinations run the entire gamut of the healing art. An example of how osteopathic candidates measure up in these examinations is provided in a report of the New Jersey medical board for 1940, carried on page 1402 of the April 6, 1940, issue of the American Medical Association Journal. An inspection of the report will indicate that the osteopathic applicants were among those making the highest grades. The successful applicants at that examination were granted a State license to practice medicine and surgery. Further, with respect to New Jersey, may I say that the State makes its own examinations of professional schools and has examined and approved osteopathic colleges as institutions possessing the training facilities and other requirements necessary to equip a qualified practitioner of the healing art in all its branches. The board of regents of New York University is the certifying agency for New York State, and that board also has inspected and certified osteopathic institutions as qualified training institutions. I hope I have given you information which will help you in assessing the merit of our contention that the provision for appointment of osteopathic graduates be incorporated in this bill. Dr. Dressler is connected with one of our training institutions and will, if you please, Mr. Chairman, at this time give you a brief account of the professional training provided there. We will remain available for any questions or requests for any additional data you may deem necessary. Thank you very much. 96248-44- 11 Mr. BULWINKLE. I think your statement should contain a definition of what osteopathy is, if you will leave that. Dr. SwOPE. Yes, sir. Mr. REECE. I think that is a good idea. (The matter referred to is as follows:) Osteopathy is the school of medicine or the art and science of prevention, diagnosis, and treatment of disease and injury which majors in manipulation and includes surgery and the other branches (specialties) of the healing arts. The osteopathic practitioner, according to the Dictionary of Occupational Titles (revised), diagnoses, prescribes for, and treats diseases, disorders, and conditions of the human body in accordance with the scope of regulatory laws in all the States; majors in manipulative procedures for the detection and correction of disorders and affections of the bones, muscles, nerves, blood vessels, and other tissues of the body structure; employs auxiliary medical appliances, devices, and other aids to diagnose and to support, immobilize, or otherwise adjust bodily impairments and, as legally qualified in varying degree in most States, practices obstetrics, surgery, internal medicine, or other branches (specialties) of medical science. Mr. PRIEST. Mr. Chairman, may I ask one question? Mr. BULWINKLE. Mr. Priest. Mr. PRIEST. Approximately how many States require a similar examination by a board for license to practice osteopathy as they require for other medical-profession applicants. Dr. SwOPE. Of course, all States have a law. That is, the practice is regulated in every State. I wonder if this would answer. In all but 5 States, for instance, they are licensed to practice obstetrics, and I think it is in excess of 30 that they are licensed to practice major surgery; minor surgery in most of the remaining States. Mr. PRIEST. Major surgery in how many States? Dr. SwOPE. I can give that to you specifically, and I would rather do that than make an off-hand statement. Mr. PRIEST. That is all right. Dr. SwOPE. But it is in a great majority of them. Mr. PRIEST. That is all. (The information requested is as follows:) Since most subjects of instruction in the healing art are common to both medical and osteopathic colleges, and there are licensing boards in all States whose duty it is to test the professional education of medical or osteopathic candidates, the practical effect is that all States contemplate a substantially “similar” examination for medical or osteopathic licensure. In eight States and the District of Columbia (Colorado, Delaware, District of Columbia, Kentucky, Massachusetts, New Hampshire, New Jersey, Ohio, and Texas), osteopathic and medical candidates take the same examination before the same examining board and receive identical or equivalent licenses to practice. In the remaining States the examining and licensing boards are osteopathic, medical, or mixed, and grant limited or unlimited licenses as the case may be. In 30 States, the District of Columbia, and Hawaii, osteopathic candidates are licensed to practice major surgery (Arizona, California, Colorado, Delaware, District of Columbia, Florida, Georgia, Hawaii, Indiana, Iowa, Kentucky, Maine, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, Wyoming). In most of the remaining jurisdictions, osteopathic candidates may resort to minor surgery on proper occasions. Minor surgery may be said to be the surgery usual to the office practice of a general practitioner. All States require graduation from a professional osteopathic college. Every State requires high-school graduation and college work as a prerequisite for entrance to the professional osteopathic college; while this requirement is not specifically mentioned in some States, it is implied by the fact that students must graduate from approved osteopathic colleges, and these colleges require highschool graduation and at least 2 years of college work for entrance. Mr. REECE. Mr. Chairman. Mr. BULWINKLE. Mr. Reece. Mr. REECE. What part of this did you have in mind should go into the record? [Indicating Guidance Leaflet on Osteopathy by the U. S. Office of Education.] Mr. BULWINKLE. That definition. Mr. REECE. The definition. Mr. BULWINKLE. Yes. Mr. REECE. Is this definition as prepared by someone in the Bureau of Education and is it quoted verbatim Dr. SwOPE. It is quoted verbatim. Its original source is a revised definition in the dictionary of Occupational Titles, Employment Service, Federal Security Agency. Mr. REECE. This seems to be a leaflet that is gotten out by the American Osteopathic Association; but down underneath, towards the bottom of the cover page, it says "As issued by Federal Security Agency, U. S. Office of Education," and so forth, "For sale by the Superintendent of Documents, Washington, D. C." Dr. SwOPE. That is right. The pamphlet is prepared by the United States Bureau of Education. We have been given the privilege of reproducing it. That is why this copy states that it is a reprint. Mr. REECE. Then in order to get it clear, this is all reproduced from some leaflet that is gotten out Dr. SwOPE. That is gotten out by the Federal Security Agency. Dr. SwOPE. Yes, sir; but as the text shows the definition of osteopathy is taken from a revision of the Dictionary of Occupational Titles. We have reprinted the Government document without change. Mr. REECE. That is what I wanted to get fixed in my mind, where it originated. Dr. SwOPE. That is right. Mr. BULWINKLE. We thank you very much, doctor. Dr. SWOPE. Thank you. STATEMENT OF LT. LEONARD J. CALHOUN, UNITED STATES NAVAL RESERVE Lieutenant CALHOUN. Mr. Chairman, my name is Leonard J. Calhoun, lieutenant, United States Naval Reserve. Mr. Chairman, I appreviate the opportunity Mr. BULWINKLE. I think that you should state what position you held before going into the Navy. Lieutenant CALHOUN. I was formerly, Mr. Chairman, assistant general counsel of the Federal Security Agency in charge of legislation and litigation. I appreciate the opportunity Mr. BULWINKLE. Just a minute. I want to ask you another question. What did you have to do with the drafting of this legislation, if anything? Lieutenant CALHOUN. I participated in the early stages of the legislation, Mr. Chairman, up until about October of last year, when I went with the Navy. Mr. BULWINKLE. Up to that time-the bill was introduced before that time? Lieutenant CALHOUN. Yes, sir; but some of the very last work that was done before the introduction of the bill, was done after I had transferred, as I remember. It was practically completed. Mr. BULWINKLE. All right. Lieutenant CALHOUN. I appreciate the opportunity of making a statement as to H. R. 3379, a bill to codify the laws relating to the Public Health Service, and for other purposes. As is the case with most worth-while proposals, H. R. 3379 represents the cooperative effort of many persons. As I remember, Mr. Chairman, you suggested the codification some months ago when a proposed public health bill was being reviewed by you. That bill, like a multitude of other public health bills before it-and a great many statutes which have been heretofore passed-proposed to change the law without amending or repealing any existing statutes, and indeed, without any one of us being able to say with precision exactly what existing laws were being changed. Enactment of H. R. 3379 would do two very important things in clearing up the existing uncertainty as to just what are the Public Health Service laws. First, it would set out in one act practically all of the statutes affecting the Public Health Service; and, second, it would repeal an enormous number of statutes, relating to the public health. Section 609 of the bill, which extends from page 75 through page 88 is one of the most important sections in the proposed legislation. This section repeals a vast number of provisions relating to the Public Health Service. Review of the section indicates that many of these provisions are merely sentences in appropriation acts or are found in statutes which only incidentally refer to the Public Health Service. The existence of many of these provisions has been of considerable embarrassment in interpreting the Public Health Service laws. Some have been obviously superseded by later enactments. The effect of, later enactments on others is extremely problematical. Many of these provisions were affected by the provisions of the reorganization plan, transferring the Public Health Service from the Treasury Department to the Federal Security Agency. The extent to which they were modi, fied or superseded frequently has presented a very perplexing problem. It might be said of the Public Health Service laws, in general, that there has been a very large number of overlapping statutes. Broad authority in one piece of legislation has been frequently followed by legislation in the same general field giving a narrower authority. There are instances where several acts cover the same subject matter under very different language. Unquestionably, enactment of the Public Health Service Code would minimize difficulties such as I have mentioned which have been increasingly evident in the last few years and consequently which have been increasingly in need of clarification, The Committee on Interstate and Foreign Commerce is performing a most valuable service in revising as a whole the body of Public Health Service laws and in spending the time necessary to clarify and improve this code of law. As the committee is aware, the existing provisions contain many gaps and there are many inconsistencies among these provisions. This is not to be wondered at, in view of the practice which has persisted through almost a century and a half of enacting Public Health Service legislation designed to cope with special situations and without review of the existing statutes bearing on the same subject matter. I feel that the committee is due a debt of gratitude for devoting its time and attention in considering his bill, which would rectify in some hundred pages the errors which have accumulated in the last century and a half. I understand that during the course of your hearings on this bill, many improvements have been suggested by witnesses who have appeared before your committee. I know that very great improvements have been made on the existing law during the several months since I have been no longer connected with the Federal Security Agency, as suggestions have come in from various sources. Before and since that time there have been very careful study made by Dr. Parran, Dr. Thompson, Dr. Draper, Dr. Stewart and others of the Public Health Service staff and of Miss Mary Switzer, and Mr. Willcox of the Federal Security Agency; Mr. Perley, of the House Legislative Counsel's office, as well as Lieutenant Drexler of the Coast Guard. No doubt that with the further review and improvements which your committee will make, there will be a resulting Public Health Service Code in which we may all take justifiable pride. I do not have any suggestions to your committee which I believe would be of value with respect to making changes in the proposed legislation; but before concluding, I should like to mention briefly something about the procedure which was followed in attempting the codification. From the indexes of the United States Code, Annotated, the Revised Statutes and the Statutes at Large, an effort was made to find all of the existing provisions of law relating to the Public Health Service. All of these provisions found in the Revised Statutes and in the Statutes at Large were photostated. As I remember, the result was some four or five hundred pages of photostats. The next step was to classify these various provisions by subject matter. A very tentative draft was made as to what we considered to be existing law in each of the divisions of subject matter. The Surgeon General then arranged for a series of conferences which extended over a period of weeks and the various subjects of the proposed bill were discussed by the members of his staff most familiar with the particular subject matter. The Surgeon General and Dr. Thompson, Dr. Draper, or Dr. Stewart were present at all of these conferences, and consequently, they were integrated and a consistent over-all approach was made as to the proposed codification. As you have no doubt been previously advised, by witnesses and by your own review of the proposed code, there are in some instances a conscious departure from existing statutory provisions, though in most cases the changes in statutory language which were made were made for purposes of clarification and of reaching the consistency with other provisions in the code. It was felt that, to the extent possible, Congress should specifically review and validate some of the more important regulations which had been issued by the Public Health Service pursuant to broad grants of statutory authority and where the Congress deemed it advisable that these should be modified. Accordingly you will find in the code a statutory provision of what has heretofore been only in regulations. In conclusion, since I am speaking in an entirely unofficial capacity, I should like to pay a special tribute to the patient work of the committee, and to Dr. Parran and to members of the staff of the Public |