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Commentary by Dr. Martin M. Cummings on his testimony before the U.S. Senate Appropriations Subcommittee concerning the National Library of Medicine, for fiscal year 1967

From interviews with Dr. Cheryl Dee, 2009

Excerpts from testimony
Interview and commentary
Further resources


Excerpts of U.S. Senate subcommittee testimony concerning the National Library of Medicine, followed by an interview with Dr. Martin M. Cummings, Director Emeritus, National Library of Medicine, reflecting upon the testimony

DEPARTMENTS OF LABOR AND HEALTH, EDUCATION, AND WELFARE AND RELATED AGENCIES APPROPRIATIONS FOR FISCAL YEAR 1967

March 14, 1966

U.S. SENATE . . . Subcommittee of the Committee on Appropriations

Opening Statement of Dr. Martin Cummings, Director, National Library of Medicine

New Computer System Design

New systems currently under development include (1) an on-line input system for MEDLARS to permit direct communication between indexer and computer; (2) an automated acquisition and cataloging system (the cataloging subsystem is now being tested and will be operational on January 1, 1966); (3) graphic image storage and retrieval system which will be closely linked to the MEDLARS computer search capability; (4) a drug literature program with chemical search capabilities being added to MEDLARS; and (5) development of an intramural research and development program in information retrieval and scientific documentation.

Rapid advances in computer technology along with important developments in the field of information retrieval will be useful in modernizing and expanding the MEDLARS system in the near future. For example, the recent development of very large capacity, random access storage devices could be applied to MEDLARS in improving the machine search process. By 1968 the library had utilized the Honeywell-800 computer for 4 1/2 years.

The MEDLARS decentralization program is also expanding.

Medical Library Assistance, Grants, and Contracts

The Medical Library Assistance Act of 1965 authorizes a. program of support and assistance to the libraries of the nation in seven major areas:

  1. Conduct research in medical library science, and the development of new systems and techniques for processing, storing and retrieving information.
  2. Compilation and dissemination of important biomedical information through the award of special scientific grants to scholars;
  3. Training of biomedical librarians and information specialists;
  4. Construction of new, and improvement of existing library facilities;
  5. Financial support of biomedical communications;
  6. Improvement and expansion of basic library resources, particularly literature collections;
  7. Development of regional medical libraries.

The largest part of the library's extramural program deals with the implementation of this act. However, programs of extramural grants in the history of medicine and drug literature, training in medical librarianship, and contract support of biomedical publications, in existence at the time of the act's passage, will be continued as well.

Research and development. -- Nearly all phases of current health science library practice need to be reassessed to develop more efficient skills and technologies. In addition, research is needed in the uses of published information by scientists, teachers and practitioners, whose requirements for this information are poorly understood and need to be examined critically. Studies are also needed to analyze the interrelationships between institutions which supply informational services to health scientists and provide data which may lead to more efficient distribution of documents and services. The program of research in the history of the life sciences will be continued.

Special scientific projects and fellowships. -- The very great increases in programs for the conduct of medical research has come with a concomitant increase in the rate of publication of scientific results. This makes it necessary that the results be compiled, reviewed, evaluated, and placed in historical perspective in order that they may be made available to busy practitioners and scientists in a form in which they are most useful. Opportunities for qualified scientists to devote a full-time period to such an effort with the resources of major research libraries such as NLM at their disposal are almost nonexistent. The Act authorizes awards for such purposes.

Training. -- There are only about 3,000 librarians with specialized training or experience in health science librarianship to serve the 6,000 health science libraries in the country. In order to help overcome the existing manpower deficits, additional training activities will be initiated and existing ones expanded. The requested $1 million will support about 20 to 24 training projects and provide more intensive training to update the skills of personnel now practicing in this field.

Construction of medical library facilities. -- The Association of American Medical Colleges' survey showed that its member institutions required more than $87 million for medical library construction and renovation. This sum represents about $65 million in federal funds when the 75 percent matching rate as allowed in the Medical Library Assistance Act of 1965 is applied. Provision of the library facilities needed by freestanding and other libraries will require an additional $10 million in Federal funds. The $7,500,000 requested will inaugurate the construction grant program in 1967 and support about 10 construction or renovation projects.

Publications support. -- The Medical Library Assistance Act of 1965 authorizes a program of grants and contracts for the support of biomedical publications. The program will be implemented by support of publications other than those that contain original journal articles. Examples of the types of activity supported under this authority include translations, bibliographies, critical reviews, indexes, and abstracting services.

Medical library resources. -- The program of grant support in this area authorized by the Act will provide for strengthening collections of health science libraries through the purchase of books, journals, and other informational resources; for improving access to the holdings of the libraries by providing assistance in cataloging, binding, and other services and procedures for processing library resource materials; for the introduction of new technologies in health science librarianship; and for the acquisition of photoduplication devices, facsimile equipment, film projectors, microfilm readers, and other needed equipment. Approximately 225 health science libraries will receive grants in 1967 from the $2,700,000 requested.

Contribution of the National Library of Medicine

Senator Hill. Now, Dr. Cummings. You may proceed.

Dr. Cummings. Chairman and members of the committee, this year the National Library of Medicine completes its first decade in the Public Health Service. Ten years have passed since the enactment of the Hill-Kennedy Bill (Public Law 84-94l), the basic enabling legislation for the National Library of Medicine, and in that time the Library has made great strides in contributing biomedical information support to institutions, scientists, practitioners, and students dedicated to improving the health of the Nation. During the past decade, four significant phenomena have occurred with profound effects on the National Library of Medicine. First, there is the explosive growth of scientific literature. Second, there is the tremendous expansion of health research accompanied by an increasing urgency to apply new knowledge to the improvement of health. Third, there is the resulting sophistication and specialization of health science, education, and practice which has carried the scope of medicine far beyond its earlier boundaries to include physical, mathematical, and behavioral sciences. Fourth, there is the so-called cybernetic revolution bringing forth complex, sophisticated computers and other automated equipment to be applied to library development.

In summary, our total request is for $19,231,000 representing a net increase of $9,547,000 over 1966. The principal item of increase is $8,900,000 for use in carrying out the provisions of the Medical Library Assistance Act of 1965.

Senator Hill. Doctor, you requested a total of $26,544,000 from the Department, didn't you?

Dr. Cummings. That is correct.

Department of the Budget Bureau Cuts

Senator Hill. The Department made a reduction of $56,000 and then the Budget Bureau cut your request by $7,257,000. Is that correct?

Dr. Cummings. I believe that is correct, sir.

Senator Hill. I believe the principal reductions were $2.5 million for construction grants, $2.5 million for regional libraries, and $725,700, and 30 positions, for direct operations. Is that right?

Dr. Cummings. That is about right, sir.

Senator Hill. What is going to be the result of this reduction of $7,257.000?

Dr. Cummings. I believe the net effect of this reduction will be to inhibit the development of the Nation's biomedical library system. But I think the funds in the President's budget permit us to make a good start in all areas with the exception of regional medical libraries for which no funds are available.

Senator Hill. No funds at all for the regional libraries?

Dr. Cummings. That is correct.

Senator Hill. How much did you ask for the regional libraries?

Dr. Cummings. The library requested $2.5 million for fiscal year 1967.

Senator Hill. Did the Department cut that?

Dr. Cummings. The Department supported the Library's request across the board. In fact, in one area the Department was more generous than the Library's own request. With respect to the second portion of your question, reduction in personnel, I think it is fair to say that I would have some concern about the prudent management of a budget of this size without concomitant increases in staff.

Senator Hill. You were reduced in your request for positions?

Dr. Cummings. We were reduced by 46 positions in the aggregate.

Senator Hill. Where would those positions have been?

Dr. Cummings. Sixteen of these positions would have been for management of the seven programs authorized by the Medical Library Assistance Act of 1965. The remaining 30 positions would be used to improve the services within the National Library of Medicine.

Senator Hill. The services within the Library itself?

Dr. Cummings. Yes, sir.

Senator Hill. Is there anything you would like to add?

Mr. ISBISTER. We could submit a statement on the positions for the record.

Senator Hill. You may submit that for the record, Doctor.


Interview with Martin Cummings, MD, Director Emeritus, National Library of Medicine, 1964-84; interviewed by Cheryl Dee, PhD, 2009-2011.

Medical Library Assistance Act of 1965

Dr. Dee. You were the right man at the right time for the Medical Library Assistance Act of 1965.1

Dr. Cummings. I brought some experience with research at a time that NLM needed to begin to do medical research. Nearly all of the health science library practices needed reassessment through research to develop more efficient skills and technologies.

The testimony that you sent outlines MLAA's program of support and assistance to libraries. For clarity it would be good to list the seven areas covered by the Medical Library Assistance Act.

  1. Conduct research in medical library science, and the development of new systems and techniques for processing, storing and retrieving information.
  2. Compilation and dissemination of important biomedical information through the award of special scientific grants to scholars;
  3. Training of biomedical librarians and information specialists;
  4. Construction of new, and improvement of existing library facilities;
  5. Financial support of biomedical communications;
  6. Improvement and expansion of basic library resources, particularly literature collections;
  7. Development of regional medical libraries.

Dr. Dee. Dr. Cummings, you brought political expertise and a vast number of political connections with people and organizations to the National Library of Medicine. Did these political relationships help get the Medical Library Assistance Act passed through the legislative process in a year. Did other factors assist in the passage?

Dr. Cummings. The Medical Library Assistance Act was introduced and approved in a short amount of time, a year, but a lot of work had been put in place to make it possible.

I was cautioned by my former chief and colleague, Dr. Shannon, Director of NIH that passage of the Medical Library Assistance Act would take 4 to 5 years. Fortunately we were able to prove him wrong.

Dr. Dee. Several of your colleagues at NLM tell me that the Medical Library Assistance Act of 1965 was one of the most important, if not the most important, of your accomplishment. How did you get it passed in a year? 2

Dr. Cummings. To explain how the Medical Library Assistance Act was passed so quickly I will explain a little of the story surrounding the National Library of Medicine related to the Medical Library Assistance Act. It is essential to know that the National Library of Medicine could not give grants. We could not at this time give away any money. A major part of the Medical Library Assistance Act allowed the National Library of Medicine to make grants, to give away money to do research, upgrade libraries, construct new libraries, provide training, and develop a system of regional medical libraries.

Before I accepted the job at the National Library of Medicine I wanted to find out if I had support from Senator Lister Hill for the position as Director of the National Library of Medicine. I had come to know and respect Senator Lister Hill in my work at NIH. I met with Lister Hill and I asked him for his advice about the opportunity that was offered to me at NLM. His responses convinced me that he was supportive of my ability to direct the National Library of Medicine. I discussed with him that they wanted me to organize an extramural program and I asked him whether he would be supportive. He gave me every reason to believe that he would be interested in supporting such legislation. Support from Senator Lister Hill would be essential to the passage of legislation of an extramural program because Senator Hill held two very key positions that would both have a strong influence on the legislation. Lister Hill was Chairman of the Subcommittee on Legislation, the Subcommittee that would approve an extramural program, and he was also the Chairman of the Subcommittee of the Committee on Appropriations that would approve the funding. Senator Hill was the chairman of the two essential Senate committees needed to implement an extramural program at NLM. Lister Hill is an important reason the Medical Library Assistance Act passed so quickly.

After I was hired and Dr. Marjorie Wilson came from NIH to join the NLM staff, I took Marjorie with me to Alabama to meet with Lister Hill. She was my witness. We met with Lister Hill at the University of Alabama to confirm his commitment and support for the extramural program for NLM. Dr. Wilson and I discussed every element of the extramural program. Lister Hill confirmed his support of all of the parts of the extramural program and he asked us to draft a Bill. I felt confident that NLM had the complete support of the most powerful person in Congress and he would be behind the extramural program. 3

I received full support and interest from the Surgeon General, Luther Terry. I also had strong support from the medical library community and from the American medical community. 4

Marjorie Wilson and Carl Douglass and their associates worked with people who had an interest in the Act in the medical schools, dental schools and other government health agencies to determine the needs of the medical libraries. Marjorie Wilson was the guiding professional describing what should be written in the Act. She and her team worked with a talented lady lawyer, I believe her name was Elizabeth Chase,56 who gets the credit for the precise legal language of the Medical Library Assistance Act. The whole staff worked very hard and contributed their ideas and expertise to the beautifully written Medical Library Assistance Act. I want to be sure that they get the credit.

The Act passed in the House and the Senate. The Senate carried the ball on it. The hardest part was to get President Lyndon Johnson to sign it. The White House didn't think that the Library had enough to get the appropriations. 7

NLM Funding Procedures

Dr. Dee. Please tell us some of the official procedures and the traditions surrounding how you and your staff obtained the budget for NLM.8

Dr. Cummings. When the budget request is in the U.S. President's budget you are expected to support it no matter what level is called for. When the Bureau of the Budget makes big cuts in your original submission, the Program Director has to figure out how to modify its program to fit the budget or seek methods of appeal. I choose to make my budget needs known informally to members of the House and Senate Committees dealing with our budget. The informal meetings provide the background information so that when the actual hearings begin, the Committee has some idea as to whether your budget request fully meets the needs of the program. Depending on the relationship between the Committee Chairman and the Program Director you may or may not be given an opportunity to answer questions, which allow you to tell the true facts of your original proposals. The Congressional Testimony often reveals that most of the cuts are provided by action of the Bureau of the Budget and not by the Department in which the program resides as is clearly the case of the 1966 Hearings as evidenced from the dialogue between Senator Hill, Chairman of the Committee and myself as Program Director.

Medical Library Assistance Act and Regional Medical Libraries

Dr. Dee. Dr. Cummings, is there more information regarding why the President's Office, the Bureau of the Budget turned down the regional medical libraries? 9

Dr. Cummings. In 1966 the Library was faced with introducing new programs and requesting money for the new line items which never appeared in the NLM budget before. New programs are more likely to be cut and are always more difficult to get funded than a project that's already established. For this reason the Bureau of the Budget refused to approve any funds for the requested regional medical libraries because it was a new program and the costs would be ongoing. This is a general experience whether it's in the medical library field or in other fields.

The passage of the Medical Library Assistance Act of 1965 [MLAA] provided new budgetary line items which allowed the National Library of Medicine to make requests for specific programs such as research, training, construction, publications etc. These activities being new, required new staffing and organizational arrangements so that they appear as new budget items and the monies are protected for those activities only. One cannot, without congressional approval, take funds appropriated for extramural grants and use them for intramural operations and services. In the same way without appropriate congressional authority one cannot take funds appropriated for library operations and services and divert them to funding of library grants such as those in the Medical Library Assistance Act of 1965. This is an orderly way of running a big operation and would be no different from the way state and other governments operate as well.

Colleagues in the U.S Senate

Dr. Dee. Senator Hill appeared to ask you all the questions you needed to defend your position on the Medical Library Assistance Act of 1965. 10

Dr. Cummings. Senator Hill was a good friend of the National Library of Medicine. He allowed me to explain on the record what was needed for the Medical Library Assistance Act of 1965. This is why the Senate Testimony is so important to the history of the National Library of Medicine. The story is told in the Senate through the testimonies.

Automation of MEDLARS

Dr. Dee. Will you please tell us about the automation of MEDLARS?

Dr. Cummings. At the Senate hearing we announced our intention to automate cataloging in a way that would provide centralized cataloging for the nation's medical libraries. We estimated that it would save millions of dollars in avoiding duplicate cataloging currently done at the individual biomedical libraries while at the same time increasing the efficiency of the MEDLARS services. Studies of this activity made years later revealed that in fact this was one of the most important new library operations and services provided during the next several decades. Similar experience was found when the Library of Congress reduced its centralized cataloging mechanism through the creation of a program called MARC, Bibliographic: Machine-Readable Cataloging.

[1] Interview with Dr. Cummings, 2009.

[2] Discussion between Dr. Dee and Dr. Cummings at lunch at Dry Dock Waterfront Grill, Longboat Key, Florida, June 30, 2011.

[3] Discussion between Dr. Dee and Dr. Cummings at lunch at Dry Dock Waterfront Grill, Longboat Key, Florida, June 30, 2011.

[4] Personal communication. Email reply from Dr. Cummings to a question emailed to Dr. Cummings. July 2, 2011.

[5] Elizabeth Chase confirmed. Wyndham D. Miles, A history of the National Library of Medicine, G.P.O., 1982. p. 399.

[6] Email from Dr. Dee to Dr. Cummings to confirm that he was correct about the name Elizabeth Chase.

[7] Discussion between Dr. Dee and Dr. Cummings at lunch at Dry Dock Waterfront Grill, Longboat Key, Florida, June 30, 2011.

[8] Interview with Dr. Cummings, 2009.

[9] Interview with Dr. Cummings, 2010.

[10] Interview with Dr. Cummings, 2009.


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