STATEMENT OF DR. JESS E. GOROSHOW, REGISTRAR, ILLINOIS COLLEGE OF OPTOMETRY; ACCOMPANIED BY WILLIAM P. MacCRACKEN, JR., WASHINGTON COUNSEL; AND H. E. MAHLMAN, DEPUTY DIRECTOR, WASHINGTON OFFICE OF AMERICAN OPTOMETRIC ASSOCIATION

Mr. GOROSHOw. Mr. Chairman, I would like to offer a short oral summary in order to save time. I request permission to have my full written statement included for the record.

Chairman RUSSELL. That will be followed. The entire statement will be included in the record as if delivered, and you may make such comments as you wish.

Dr. GOROSHOW. Thank you.

With me today is our Washington counsel, Mr. William P. MacCracken, Jr., and the deputy director of our Washington office, Mr. H. E. Mahlman.

Chairman RUSSELL. All right, sir.

Dr. GOROSHOw. Mr. Chairman and members of the committee: I appreciate the opportunity to appear before you on behalf of the American Optometric Association. I am Dr. J. E. Goroshow. I am an optometrist, a member of the faculty, and registrar of the Illinois College of Optometry in Chicago.

My interest in the Universal Military Training and Service Act is one of rather long standing. I have been a Reserve officer since 1937, which includes a period of active duty during World War II.

At the college I work with students who have problems relating to the Selective Service Act, Reserve components of the armed services, and I counsel those who seek commissions in the Army, the Navy, the Air Force and the U.S. Public Health Service. I have a bachelor of science degree of electrical engineering in addition to my doctor of optometry degree.

Familiarity with both military needs and the problems of optometry students dictated by appearance here today. The American Optometric Association takes the position that optometrists should fulfill their military obligation at the highest level of their capabilities. Members of the optometric profession, by virtue of their education and experience, have a moral and ethical responsibility to utilize their specialized professional skills for the Nation's welfare, never losing sight of their primary mission-the provision of essential vision care for the military and civilian population.

I am pretty proud to state that the vast majority of optometrists have had military service. Today we have over 600 men that are serving in the Armed Forces. Far more are needed.

The preprofessional and professional requirements for the doctor of optometry degree and licensure are fully covered in the prepared statement that you have.

Throughout the country, optometrists provide approximately 70 percent of all vision services, while in the military services, optometry officers conduct from 80 to 90 percent. The relative importance of vision care to our armed forces was recently emphasized by the Army Surgeon-General, Leonard D. Heaton, who stated:

Since 1947 optometry officers have been rendering outstanding services as a part of the Army Medical Service team and we now have an authorization of over three hundred officers to fill world-wide assignments in the clinical practice of optometry, vision research, optical laboratory activities, occupational vision, and other areas vital to the mission of today's Army.

General Harold K. Johnson, Army Chief of Staff, has indicated his awareness of the importance of vision in accomplishing our mission by directing the Army staff to add seeing to those elements previously concerned basic to successful combat operations-to shoot, to move, and to communicate. The Army Medical Service Corps optometry officer has a vital role, therefore, in the correction and protection of vision for the Army's most priceless commodity-the individual soldier.

The military services need optometry officers to help our fighting forces obtain the best vision possible, but military optometry officers have been in short supply. In March of 1966 DOD asked the Selective Service System to draft 100 optometry officers. This call under the doctor's draft was filled, and these 100 optometry officers are now on duty in the Army.

The American Optometric Association cooperated in every way possible to help the Selective Service System obtain these officers. On the State level, subcommittees of optometrists were appointed to work with State Selective Service advisory committees. In my official capacity at the college, I work with the Illinois committee, with the State director and of course with local boards.

Even though the Army has increased its number of military optometry officers by some 100, shortages still exist. The latest information on military population is in the table we submitted. You will see at the bottom of that table that the ratio of optometry officers to eligible recipients of vision care in the Army is about 1 to 10,000, in the Navy it is about 1 to 40,000, and in the Air Force it is 1 to 15,000.

Similar shortages of optometrists, although not as pronounced, also exist in the civilian population. Congress has recognized these shortages by remedial action.

If present optometry school enrollments can be maintained, the next 4 years should produce approximately 2,000 new optometrists. This is form all of the colleges of optometry.

However, if optometry students cannot receive deferments, this total would be cut drastically, probably in half, or maybe even more. At the same time, lack of deferments for preoptometry students would severely curtail the number of students eligible to enter optometry schools.

To provide adequate vision care, the American Optometric Association feels that the minimum ratio of 1 optometrist to each 7,000 people of our population should be maintained. As indicated above, the ratio of military optometry officers to those eligible to receive vision care currently exceeds this ratio.

The American Optometric Association is offering some amendments to the act, and rather than take the time to read those, they have been included in the material presented to the committee. The first amends Section 2.

We believe that drafting students enrolled in schools of optometry, medicine, dentistry, osteopathy, and veterinary medicine for 4 months'

duty would seriously interfere with their college education. It would cause them to lose 1 full year, and this would contribute even further to the national shortage problem that exists. So we suggest that on page 2 of the bill, between lines 12 and 13, the following short amendment be included:

(3) are not enrolled as student in a school of medicine, dentistry, osteopathy, optometry, or veterinary medicine;

Manpower in all five professions, optometry, medicine, dentistry, osteopathy, and veterinary medicine, is in short supply.

To assure that the licensed optometrist is available to serve in his professional capacity, we propose he be handled in the same manner as the physician and dentist that was suggested yesterday in the American Medical Association's statement submitted to this committee. If you handle it that way rather than in the catchall allied category of specialists, the shortage problem would be lessened. We recommend that you consider the attached amendment to care for this particular problem.

The fourth amendment is probably the most important. Section 5 of the bill extends special pay for physicians, dentists, and veterinarians. Optometrists are not included in this special pay.

We offer the enclosed amendment to the bill for your consideration. We feel the Army showed good judgment when it added "seeing" as the fourth element of successful combat operations. To assure the availability of optometrists to the armed services in the future, we urge your favorable consideration of the amendments we have submitted.

We appreciate this opportunity to appear before you. If you have any questions I will be glad to try to answer them.

Chairman RUSSELL. Senator McIntyre.

Senator MCINTYRE. Thank you, Mr. Chairman.

Doctor, will there be any appreciable increase in the number of optometric graduates during the next 4 years?

Dr. GOROSHOW. No, sir. I think the situation will get worse.

Senator MCINTYRE. Are you taking steps to increase the numbers coming out?

Dr. GOROSHOW. Yes. We have a certain amount of expansion of our optometric colleges taking place. This will take some time. We hope to add some new schools. One in New York perhaps can be in operation in approximately 2 years. We have a strong concerted effort by southern optometrists to open a school in Atlanta, Ga. We are helping in every way we can, but even if we open one tomorrow, or this fall, it will take 4 years to turn out a finished, educated optometrist. He needs 2 years of preprofessional study at some accredited school or college to cover his preprofessional work, followed by 4 years of professional study at one of the accredited colleges of optometry, so the next 4 years are certainly not going to get any better.

Senator MCINTYRE. I have one other question.

How many of the health professions to correct human deficiencies receive the entering rank of captain and who do not?

Dr. GOROSHOW. Well, sir, this is rather a sore point. All of the health professions that are qualified to examine, prescribe, and provide remedial care enter in the grade of captain except optometrists. Senator MCINTYRE. What is their grade, first lieutenant?

Dr. GOROSHOW. First lieutenant now. This we consider not to be equitable, and I know that you gentlemen consider this system of fairplay part of your basic consideration of any bill. We are hoping that that will be corrected.

Senator MCINTYRE. And in your statement you say that somewhere between 80 and 90 percent of the men who are in the service today who are having vision problems are treated by these optometry officers?

Dr. GOROSHOW. Yes, sir; although I must confess I am not too proud or happy with the type of care they receive. An optometrist in private practice who is pretty busy can handle perhaps 10 or 15 patients a day, but our optometrists on duty in the Army, for example, have to handle perhaps 30 to 35 or 40 a day, or whatever they can crowd through. There just aren't enough optometrists on duty. They are doing the best job they can, and we are proud of them. Senator MCINTYRE. Thank you very much, Doctor. We will certainly pay attention to these amendments you have suggested. Dr. GOROSHOW. Thank you, sir.

Chairman RUSSELL. Doctor, were these 100 men you referred to drafted as optometrists? I did not know they were named in the law.

Dr. GOROSHOW. They were drafted as optometrists, sir.

Chairman RUSSELL. They were?

Dr. GOROSHOW. Yes, sir.

Chairman RUSSELL. Thank you very much. We will give careful consideration to this.

Dr. GOROSHOw. Thank you, sir.

(The prepared statement of Dr. Goroshow follows:)

Mr. Chairman and Members of the Committee: I appreciate the opportunity to appear before you today on behalf of the American Optometric Association to discuss the proposed Selective Service Act of 1967.

For the purposes of the Record, I am submitting as an attachment a statement of personal background. Permit me at this point to state simply that I am Dr. J. E. Goroshow, a member of the faculty and Registrar for the Illinois College of Optometry in Chicago; and Chairman of its Committee on Admissions. This February I completed 30 years of continuous service as an active and reserve officer in the Army, and I am a Colonel in the USAR. Because I am famaliar with both military needs and the problems of optometry students, my national association, which represents 17,000 full-time practicing optometrists, asked me to speak for them today.

It is the position of the American Optometric Association that each of its members has a responsibility to actively participate on behalf of our country in times of national emergency. These members of the optometric profession, by virtue of their education and experience, recognize this moral and ethical responsibility to utilize their specialized professional skills for the welfare of both the civilian and military populations of our nation, never losing sight of their primary mission-the provision of essential vision care.

Thanks to the assistance your Committee and the House Armed Services Committee have given our profession in years past, we can now report to you our pride in the fact that approximately 600 military optometry officers are presently

serving the vision needs of the Army, Navy, and Air Force. This number is not adequate, as I will describe to you later, but we are grateful that these men can serve their country as commissioned officers, providing an essential part of the health care required by our men and women in uniform.

One of our primary objectives as an Association is to assist the military in recruiting the best of our young men to enter the service as a career. While there may be some differences of opinion as to the best means of providing personnel for our Armed Services, as patriotic Americans we recognize the necessity for the extension of the induction provisions of the law you are now considering. We hope that before another four years elapse world conditions will have improved to the point where a further extension will be unnecessary. We have four amendments which we are submitting to the Committee and which we earnestly believe are in the public interest. A separate document containing these amendments is attached to this statement for your convenience.

Before going further, perhaps there are some members of the Committee who may desire more information about our Association and the educational background and service rendered by the optometrist. With this statement you also have a brochure titled "Facts About AOA," describing the Association and its purposes. Although you will find that the definitions of an optometrist by the U.S. Army and U.S. Navy Medical Service Corps, the U.S. Air Force, Biomedical Services Corps, and the Civil Service Commission are included as attachments, permit me a moment to briefly describe the nature of my profession for your better understanding.

OPTOMETRY AND ITS FUNCTIONS

Optometry is a profession based on a sound scientific body of knowledge. It is one of only four health professions whose training is recognized by the U.S. Office of Education and whose members are licensed, in every state and the District of Columbia, to clinically examine, prescribe, and correct human deficiencies.

As a science, optometry studies the dynamics of functional vision and the physical structure of the eye. Reliance on this functional base influences every facet of the optometric practice of vision care and serves to distinguish optometry from other health professions, such as those that specialize in disease and surgery of the eye.

In the hands of optometrists and scientific researchers with advanced degrees. vision has acquired a new meaning. Considered as the behavioral pattern which is established when the faculty of sight is applied to a specific task, vision is evaluated in terms of efficiency. Since the factors involved in vision lend themselves to objective as well as subjective evaluation by optometric techniques, visual performance under varying requirements may be predicted with a high degree of assurance.

To predict visual performance, modern optometry ascertains man's visual requirements in relation to each seeing task he must perform. This approach calls for a systematic survey of man's environment, classification of the visual tasks he must carry out, definition of average standards for each such task, and integration of these standards into a general formula of vision management suited to the occupational and vision needs of each individual. Then, in his professional practice, the optometrist strives to accommodate the seeing abilities of the eye and the perceptual abilities of the brain to the demands which man's ever-changing environment make upon him.

Together with increased utilization of optometrists by the three military branches of our national defense system, there has grown an increasing awareness among our upper echelons of the importance of vision to our military missions.

IMPORTANCE OF VISION

The need for good vision was emphasized in remarks made recently by Lt. Gen. William W. Dick, Jr., Chief of Research and Development of the Army when he said:

"In recent years the Army has been teaching that there are three basic elements to successful combat operations: A unit of any size-from a squad to a field army-must be able to shoot, to move, and to communicate.