History of Medicine
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 1969
From interviews with Dr. Cheryl Dee, 2009
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 1969
U.S. SENATE . . . Subcommittee of the Committee on Appropriations
BIOMEDICAL COMMUNICATIONS AND NETWORK DESIGN
Pursuant to the recommendations of the House Appropriations Committee Report, 1967, and the Rogers Special Subcommittee on Investigation of HEW (80th Congress, second session, House report 2266), the library has established and successfully staffed a program of developmental and engineering work relating to a biomedical communication network.
The staff of this program has prepared a preliminary design for such a network, which encompasses medical libraries, specialized information centers, audiovisual communications, and related components.
Dr. Cummings. Planning for the Toxicological Information Program, mandated by the President's Science Advisory Committee, has accelerated with professional staffing made available this year.
Most recently we have acquired the assistance of the National Research Council -- National Academy of Sciences in the choice of substantive information within the system.
Senator Hill.That will be helpful, won't it?
Dr. Cummings. That will be most helpful, Mr. chairman.
REGIONAL MEDICAL LIBRARIES
Funds available from the 1968 appropriation were used to fund the grant for establishing a regional medical library-the first of the systems envisioned by the Medical Library Assistance Act of 1965-at Harvard University.
Two more have been approved for Philadelphia and Seattle. Applications for several others are in the negotiation stage. These regional libraries will become operating units in the library component of the network.
Interview with Martin Cummings, MD, Director Emeritus, National Library of Medicine, 1964-84; interviewed by Cheryl Dee, PhD, 2009.
Biomedical Communications and Network
Dr. Dee. This period of time was pivotal for the Biomedical Communications Program.
Dr. Cummings. We were pleased with the recommendations of the House Appropriations Committee Report in 1967, and the Rogers Special Subcommittee on Investigation of HEW that established and staffed a program of developmental and engineering work related to a biomedical communication network. Our excellent staff had prepared a preliminary design for the network, specialized information centers, and audiovisual communications. We recognized we had work ahead of us.
Regional Medical Library Program Funded
Dr. Dee. Dr. Cummings, this year's testimony stated that 1968 appropriations were used to fund the first regional medical library at Harvard University.
Dr. Cummings. The Medical Library Assistance Act gave the National Library of Medicine the ability to give grants. One of the most significant grant programs was for the establishment of the regional medical libraries. NLM was authorized to award grants to institutions in return for their assistance in serving library users within their regions. The Medical Library Assistance Act provided library sources and services to the small community libraries and strengthened the larger medical libraries in order for the larger libraries to share their collection with the libraries with smaller collections.
The Regional Medical Library program developed an important focus on the provision of interlibrary loans. The number of requests for interlibrary loans had become so extensive that we determined that regional libraries could share the responsibility of the interlibrary loans if they were given the funds to do so. The funding that the National Library of Medicine provided was largely to reimburse the regional libraries for their interlibrary loan services to many small libraries with small collections.
The Regional Medical Library system developed into a four- tiered system of libraries. The first-tier was composed of thousands of community hospital libraries and other local libraries that would provide primary service. The second-tier was composed of about 125 resource libraries which were generally medical school libraries that could assist local libraries with interlibrary loans and other services. The third-tier was composed of eleven regional medical libraries with large collections and facilities capable of being the lead library in their region. The eleven libraries managed and coordinated the services within their region and collaborated with other regional libraries and with the National Library of Medicine. The fourth-tier was the National Library of Medicine, the end point of the Regional Medical Library system.
Future budget constraints became a factor for the Regional Medical Library program when the funding was not enlarged over a significant period of time. At that point the National Library of Medicine was faced with a major decision of whether to abandon the program or to reduce the program. This led us to the later decision to reduce the number of regions from eleven to seven. I might also point out that the National Library of Medicine's funding of the interlibrary loan program later changed to a fee-for-service concept. It became evident that the National Library of Medicine could not continue to provide free services through the Regional Medical Library program.
The Regional Medical Library program changed over time in different ways in different regions. Some regions developed strong outreach programs while other regions provided specialized training and assistance to smaller libraries. Each region was quite unique because they used their staffs' skills and expertise to develop their library programs.
Institutions and Programs
- Regional Medical Programs. National Library of Medicine. Profiles in Science. The Regional Medical Programs Collection. https://profiles.nlm.nih.gov/ps/retrieve/Narrative/RM/p-nid/94.
Articles and Oral Histories
- Bunting, A. "The Nation's Health Information Network: History of the Regional Medical Library Program, 1965-1985. Bull Med Libr Assoc. 1987 July; 75(3 Suppl):1-62. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC280609/.