part of a large university medical school and clinic. There is ample precedent for such an arrangement. For there already exist in various university centers special departments devoted to the study of particular groups of diseases and caring for patients suffering from these diseases. Such departments occupy floors within a building which includes other units or are housed separately. The list of specialties partially though not adequately provided for is a long one and includes cancer, tuberculosis, psychiatry, neurology, obstetrics, and gynecology, urology, ophthalmology, pediatrics, and orthopedics. You will note that cardiology, that is the field devoted to cardiovascular diseases, is conspicuously absent. In a university atmosphere there can be correlation of the various specialties and workers in particular fields can avail themselves of facilities and contacts which do not exist in an institution which lacks these affiliations. It is in the universities that the best medical and scientific talent is concentrated and it may prove difficult to persuade those best qualified to leave their academic surroundings for an atmosphere in which such advantages are lacking. Furthermore, for one interested in academic medicine in its broadest sense, a university affiliation is highly desirable. These bills place great power in the hands of the Surgeon General of the Public Health Service and the Federal Security Administrator, for the Surgeon General, with the approval of the Federal Security Administrator, may appoint 12 members to the proposed National Heart Disease Council. In view of the fact that this council will be responsible not only for the expenditure of the funds provided but for determining the policies to be followed, it would seem wise to specify that such appointments should be made only after consultation with, and the approval of, such representative national organizations as the National Research Council, the Association of American Physicians, the American Medical Association, and the American College of Physicians. The officers and directors of these groups are in the best possible position to know the outstanding authorities in the field concerned. In the national science bill, introduced in the House by the chairman, Mr. Wolverton, on March 25, 1948, and I understand passed by the Senate yesterday, it is specifically stated that nominations of persons for appointment to the National Science Foundation should be submitted to the President by various recognized and qualified national scientific or educational organizations. In passing, it may be said, also, that the science bill, H. R. 6007, provides for the establishment of a special commission on heart and vascular diseases. I understand that the science bill was passed by the Senate without provision for any such commission. The CHAIRMAN. I was informed that the Senate thought that it would be a cleaner bill without those measures in it. I am unable to understand the application of the word "clean." Mr. LEVY. It is my opinion that the integration of various scientific research programs can best be accomplished by having special commissions of this type appointed under the auspices of a single foundation, as provided for in the national science bill. There is one other point with regard to policy which I would like to mention. In initiating any new project, it is always wise to start modestly. We must learn to walk before we can run. So in setting up funds for special studies, it is well not to appropriate more money 76054-48-8 than can be spent profitably, not to plan more projects than can be staffed by qualified workers, and not to build institutes until it is clear that they are needed. I venture to suggest the following as basic concepts in the consideration of a Federal heart plan: First, that the National Heart Council be appointed according to the principles previously outlined. Second, that funds made available by the National Heart Disease Act as passed be expended, at the start, in facilities already existing in the universities, their medical schools and hospitals. Third, that provisions be made for grants-in-aid for projects sponsored by such institutions. Grants-in-aid could be made also to individuals working independently if the council should deem this proper. Fourth, that fellowships be established in order to train groups of promising young research workers who would, by their growing numbers, make possible the expansion of this program. Fifth, that a campaign of public education be conducted with respect to diseases of the heart and circulation. Sixth, that the establishment of a National Heart Institute be deif desired, such an Institute or institutes might be organized; if so, if desired, such an Institute or institutes might be organized; if so. it should be located in an established university medical center. The CHAIRMAN. Doctor, we see from the statement that you have made, that you have given this a great deal of study and consideration and we value your opinion very highly because of your experience and the contact that you have had with the subject. It would seem as if you believed that the expansion of heart research should be in the medical schools and universities rather than in a distinctive building located in Washington or elsewhere. Is that a true understanding of your views? Dr. LEVY. That is correct, sir. The CHAIRMAN. Any questions, gentlemen? Mr. HESELTON. Just one question the answer to which I think might be helpful to anyone who has an opportunity to read your statement. Could you furnish the committee a list of the medical schools and universities where there are medical schools such as you have mentioned, as well as their location? Dr. LEVY. Possibly, Dr. Teeter has that. I am not sure. I can go further than that. There is being prepared at the present, under the direction of Dr. E. C. Andrus, of Johns Hopkins, for the Public Health Service, a complete list of all of the researchers in cardiovascular diseases being carried on in all of the medical schools and universities in this country and that should be available before long. There is a questionnaire that has been sent out. Dr. Rappelye, I know will bear me out on this. Mr. HESELTON. I wonder, Mr. Chairman, in view of that if the clerk can be requested to obtain it or some arrangement may be made so that that list may be obtained for our use in considering these bills. That is all. (The list referred to is as follows:) |