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wise studied and emphasized. These subjects are particularly stressed because of the role played by the general practitioner in public health activities and in his capacity as a public health officer. Incidentally, osteopathic physicians are serving on State boards of health in the States of California, Colorado, and Kentucky, and there are a number of osteopathic physicians who are serving as county, city, and town health officers and physicians. Under the subject of preventive medicine are presented the following:

Here I should like to have inserted this list of subjects included in our treatment of preventive medicine.

Mr. BULWINKLE. All right, sir.

(The list of subjects above referred to is as follows:)

1. Communicable diseases:

(a) Specific and general measures of prevention.

2. Insect transmitted diseases.

3. Lower animal transmission diseases.

4. Immunity-heredity-eugenics.

5. Public health measures:

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Dr. DRESSLER. Further with respect to our hospital, I should like to say that since 1919 a school of nursing has been maintained. That school of nursing is accredited by the Board of Registration of Nurses in Pennsylvania and it is listed in the list of schools of nursing by the National League of Nursing Education. Its graduates are serving in the Nurses' Corps of the Army and Navy. Our school of nursing is approved by the Public Health Service for nurses' training and a nurses cadet corps is now in operation there.

Our hospital is an official casualty receiving station under the civilian defense set-up of Philadelphia. It is an authorized Emergency Medical Service depot. It has organized two medical field units which are manned, of course, by osteopathic surgeons. happen to be a member of the Emergency Medical Service.

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Mr. Chairman, I hope this information will be found helpful to the members of the committee. We are grateful to you for this privilege of being heard.

Mr. REECE. If I may revert to the first insert, in the first column is captioned "Recommendations of American Osteopathic Associa

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tion, and American Medical Association." I understand from that that the recommendations for courses of study in the medical colleges is the same by the Osteopathic and the American Medical Association.

Dr. DRESSLER. I would interpret, that the same way; yes, sir.

Mr. PRIEST. Their number of hours of instruction in the various subjects are parallel?

Dr. DRESSLER. That is how I would interpret that tabulation; yes. Each association has its professional bureau and its bureau of colleges that acts upon those things, I believe.

Mr. BULWINKLE. Doctor, I would like to ask you a question: Admitting, for the sake of argument, that the standards required in your college at Philadelphia are very high, how do these standards compare with the other osteopathic schools in the United States?

Dr. DRESSLER. The other colleges?

Mr. BULWINKLE. The other colleges.

Dr. DRESSLER. The bureau of colleges in the American Osteopathic Association has certain set standards for osteopathic education and all of the recognized colleges of osteopathy in this Nation meet those standards.

Mr. BULWINKLE. Now, the question was asked here, a few minutes ago by Mr. Priest what was that question, Mr. Priest?

Mr. PRIEST. Yes, I asked a question there in an attempt to get information on the licensing of osteopathic physicians in the various States. The question was approximately, In how many States are the requirements for license similar or the same as the requirements, for license for physicians, before a licensing board?

Dr. DRESSLER. I am very, very much embarrassed, because I did not anticipate a question of that variety, and I am not prepared in the subject of legal medicine. However, I do hold a chair and know something about the education of the doctor.

That information can be put in your hands without any difficulty, I am sure.

(See information inserted in Dr. Swope's testimony.)

Mr. PRIEST. If I may ask one other question there, to pursue a question I asked a few minutes ago, with reference to major surgery: Do graduates of all of these six institutions which you have listed here meet the qualifications insofar as training is concerned to practice major surgery; in your opinion, do they meet those requirements? Dr. DRESSLER. Legal requirements?

Mr. PRIEST. Yes.

Dr. DRESSLER. Yes; now, there are some States-for instance, the State of Pennsylvania-where we have a special surgical examining board which requires certification of postgraduate study. Of course, that would be an exception. The State of Florida-I am licensed to practice in Florida, operative surgery; evidently qualified by law, despite the fact that my specialty is pathology-I rarely work on the living body.

Mr. REECE. I was trying to elicit some information a while ago which would enable me to distinguish between homeopathic and osteopathic physicians. Could you give any further enlightment on it?

Dr. DRESSLER. I think this, that the information that you have elicited from Dr. Swope (which discussion was off the record) is very much to the point.

I am totally unqualified to testify to the precepts of the Homeopathic School of Medicine. I can testify somewhat to the precepts of the Osteopathic School of Medicine. However, it is my impression that, as in the various schools of theology, all of us have the same objective. We may perhaps pursue a different course to attain that objective.

Mr. REECE. I rather drew the conclusion from what Dr. Thompson said that probably the homeopathic was coming to be an extinct species as an independent type of practitioner. Anyway, I will not pursue that any further.

Mr. BULWINKLE. Any further questions?

Mr. PRIEST. There was one question I made a little note on. Oh, yes; I believe it was on page 4 of your prepared statement. You made reference to instructions in tropical diseases and hygiene, and sanitation, and other subjects, and emphasized that these subjects were stressed in connection with the role they would play in public health and in the public-health courses.

Are there special courses in public health given in your college; for example, do, you have a course in public heath or special instruction relating to public health?

Dr. DRESSLER. Yes.

Mr. PRIEST. Is that true also of the other five recognized institutions or institutions certified by the American Osteopathic Association? I fail to find that.

Dr. DRESSLER. They do not necessarily title it as such, but it usually is comprehended under the subject of hygiene and sanitation. Mr. PRIEST. That is all, Mr. Chairman.

Mr. BULWINKLE. We thank you, sir.

Dr. DRESSLER. Thank you.

Mr. BULWINKLE. That exhausts our list of witnesses for today and the committee will stand adjourned until Tuesday morning at 10 o'clock.

(Thereupon, at 11 a. m., the subcommittee adjourned to meet Tuesday, March 14, 1944, at 10 a. m.)

PUBLIC HEALTH SERVICE CODE

TUESDAY, MARCH 14, 1944

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE OF THE COMMITTEE ON
INTERSTATE AND FOREIGN COMMERCE,

Washington, D. C.

The subcommittee met at 10 a. m., pursuant to adjournment, in room 1536, New House Office Building, Hon. Alfred L. Bulwinkle presiding.

Mr. BULWINKLE. The committee will come to order. We will hear Rear Admiral Luther Sheldon, Assistant Chief of Bureau of Medicine and Surgery, of the Navy.

STATEMENT OF REAR ADMIRAL LUTHER SHELDON, ASSISTANT CHIEF OF BUREAU OF MEDICINE AND SURGERY, UNITED STATES NAVY

Admiral SHELDON. Mr. Chairman, I have not had the opportunity of studying this bill and was informed that the part that would be of interest to the Navy was in connection with the hospitalization of dependents and that is all I have come up prepared to talk about. Mr. BULWINKLE. What section is that, doctor?

Dr. PARRAN. Page 35, section 326 (b).

Mr. BULWINKLE. Very well, sir.

Admiral SHELDON. In 1935 the Navy began to care for dependents of its service personnel, both officers and enlisted men, based upon authority given by the Secretary of the Navy to establish beds in certain naval hospitals, wards, or buildings for that purpose. No action of Congress was required to put that into operation, because the Army, since 1880, had had the same rights and our laws were so worded that the Navy personnel should have the same rights and privileges, of course, as the Army.

On the strength of that, we established this in seven or eight naval hospitals.

We found that it was such a booster for the morale of the service people to know that they had such facilities available for their families when they were away, that we wanted to extend it. In order to do that, we had to ask for legislation and appropriation to get funds to add to some of our existing hospitals. That was granted and in May of 1943, a bill was passed authorizing the care of dependents in naval hospitals and stating who composed dependents. They are the dependent children of service personnel, mother or father, if that mother or father is actually dependent; and widows of service personnel.

Then, that was extended to include the Coast Guard during time of war, since the Coast Guard becomes an integral part of the Navy at that time, so that now we are caring for our own personnel and the Coast Guard in our dependents' hospitals and we have at the present time 23 hospitals in the continental limits of the Unied States where this work is being carried on.

The question of cost for the care of these dependents was gone into very carefully and in the beginning we charged $3.75 a day, which was the reciprocal rate of hospitalization set by the Federal Board for Hospitalization. That worked a real hardship on most of the service personnel. With the comparatively low rates of pay of the men in the lower pay grades, to send a wife to the hospital, to a naval hospital, to have a baby, for instance, would cost around $40 or $50 before she got out, and that is a pretty good lump to come out of a man's pay check.

So, when the legislation was passed expanding these facilities, we asked that a lower rate be set and we made a study and found that the cost of care of dependents averaged around $2. That included, of course, food, laundry, the salaries of civilian employees, and medication, and special appliances which were necessary for these particular types of cases. It did not, and does not, include, of course, the salaries of medical personel, of the nursing staff, or hospital corps

men.

We thought that even $2 was more than these men should be required to pay, so we recommended a rate of $1.75, which just about almost covers the actual cost of that care, and that is the rate under which we are now operating, set by the President. And in the law it states that that will be the rate until such time as the Director of the Budget has an opportunity to make a thorough study of the whole subject and make further recommendations, when there may be some change.

So far as we are concerned; so far as the Navy is concerned-the Medical Department of the Navy-I better limit it to that-we feel that it was the intent of Congress in passing this law to give men hospitalization at a rate which they could pay, without crippling them, and, therefore, we hope that the rate will be always that prescribed by the President and that it will be kept lower than that of the rate for reciprocal hospitalization set by the Federal Board, which is now $4.25 and the 1st of July becomes $5.

Mr. PRIEST. Mr. Chairman, may I ask the Admiral a question at this point?

Mr. BULWINKLE. Mr. Priest.

Mr. PRIEST. I want to ask if the last sentence of paragraph (b) on page 35 as it is incorporated in this legislation would be sufficient to guarantee, insofar as legislation may guarantee, that the provisions you have in mind would remain in effect and permanent. That issuch cost shall be equivalent to the uniform per diem reimbursement rate, approved by the President for Government hospitals for the fiscal year in which such hospitalization is furnished.

Admiral SHELDON. No, sir. That refers to the reciprocal rate for treatment of personnel between Government hospitals; the Navy, the Army hospitals, Public Health Service hospitals, and that is the higher

rate.

This rate has no relation to that at all.

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