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 1980
From interviews with Dr. Cheryl Dee, 2011
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 1980
Thursday, March 1, 1979
U.S. SENATE . . . Subcommittee of the Committee on Appropriations
Senator Eagleton, presiding.
STATEMENT OF DR. MARTIN M. CUMMINGS, DIRECTOR
Dr. Cummings. I should say coming at the end of these hearings that good research often begins and ends in a library. A good library should be able to provide my scientific colleagues with a record of what took place before they engaged in their investigations, and it should also preserve the record of their accomplishments, at least as reflected in the publication.
We have been doing this for our Nation for 100 years. This is the centennial of the publication of Index Medicus, the world's most comprehensive medical bibliography. When my predecessor, a young surgeon, Dr. John Shaw Billings, started this monumental publication, he and one colleague had to examine the world's output, which then consisted of 570 journals, and some 20,000 articles. Today we are acquiring more than 20,000 journal titles each year. From this number, we carefully examine 2,500, and index and catalog the material contained in some 250,000 articles.
Senator Eagleton. I visit academic institutions from time to time, make speeches, things like that. And I know this question is sort of a generic one that goes beyond your particular statement. The thing I hear most often about, or I guess one of the things, is the library costs are eating the institutions alive. I spoke 2 months ago at the Washington University School of Law.
They have a brand new facility. I don't recall the exact figure, but the Dean was telling me just what library costs at that one law school were. It was a horrendous figure. Many, many thousands of dollars.
How are librarians, medical librarians, going to get some kind of a cost control handle on this?
Dr. Cummings. The information you have been provided from law libraries is correct. Inflation is a real phenomenon. The inflation rate in the library business is more than 20 percent per year, and for the first time in my 15 years at the National Library of Medicine, we are faced with a dilemma of perhaps not having an adequate budget to acquire all of the world's medical literature. Acquisitions costs increase at double the normal inflation rate.
We are attempting to deal with this problem, Mr. Eagleton, by suggesting that libraries organize themselves in consortia, and that they in fact address the problem through cooperative acquisition and through the sharing of their resources. For example, in a community such as St. Louis, several universities might conceivably decide on sharing their acquisitions, one stressing specialization in one field, and another in another field.
Senator Eagleton. In Amherst College, Mount Holyoke, and University of Massachusetts, I have been told they are beginning to do some sharing, which seems to be a very prudent thing to do.
The students can take courses outside of their school of residence, and they can put books on the vans and shuttle them back and forth.
Dr. Cummings. In the medical library field, we have been supporting a network of regional medical libraries. In a sense we have had a favored situation, where the large universities that have the greatest medical libraries, through our subsidy, agree to share their resources with smaller community hospital libraries and other institutions within a fairly large geographic area.
FOREIGN MEDICAL LITERATURE TRANSLATION
Senator Eagleton. Do you have medical translators on your staff out there doing nothing but translate?
Dr. Cummings. I should say that we have the capability in 40 to 45 foreign languages, and the translation that we do is for our cataloging and indexing. But we do not announce our capabilities because we would be besieged with requests for translations of full articles and textbooks and we do not have the staff for that.
Senator Eagleton. What does what? What if there is a beautiful article out there, say, in Russian or any other foreign language, Japanese, how does that brilliant article get out to our doctors?
Dr. Cummings. With our own staff and with collaboration with institutions abroad, we try to match linguistics and scientific capabilities to read the article, summarize, and enter the correct citation into Index Medicus and in the computer system. We have people who know Russian and other languages but for some languages like Chinese and Japanese, we have an extremely difficult task. Here we have resorted to acquiring indexing overseas from our foreign partners, who in turn for using our library resources, index the literature in their own language. This is a quid pro quo arrangement that is carefully monitored, and we actually set a unit price for each article that they index.
LIBRARY SERVICE USERS
Senator Eagleton. The greatest demand for your service, I trust would come from teaching hospitals around the country?
Dr. Cummings. Roughly speaking, the services we give are divided into four almost equal parts. The academic community is probably the largest user of our services.
The practitioner community, industry, and the Federal Government, each represent about a quarter of our services.
Question: Dr. Cummings, what do you consider to be the most important program within the National Library in 1980?
Answer: During periods of severe budget constraints and with library costs inflating at a rate of 20 percent per year, the National Library of Medicine must protect its basic library and information services. These unique mandated services we perform for the entire biomedical community must be considered our highest priority activity. We are hopeful, nevertheless, to adequately support our research and development effort in computer and communication technologies particularly now that the specialized facilities of the new Lister Hill Center Building will soon be available. We must be able to exploit existing and newly emerging technologies if we are to effectively improve information services to the health community.
Interview with Martin Cummings, MD, Director Emeritus, National Library of Medicine, 1964-84; interviewed by Cheryl Dee, PhD, 2011.
Dr. Dee. Dr. Cummings, you made an insightful comment that good research begins in the library. In the age of electronics some years later, do you still believe this to be true? If so, do you have any additional comment on it?
Dr. Cummings. The library will continue to be the source of good research. The format of information will change, and the access points to the information will change, but the librarians who will develop the information into accessible resources, they will not change. The librarians are the expertise behind the access to the information no matter what the format. Books and journals and electronic resources will become increasingly complex but the librarians in charge of these resources will give the value to the information by making the information accessible to the community at large.
Dr. Dee. Dr. Cummings, can you recall any of your impressions or thoughts on the 100th Anniversary celebrations of the publication of Index Medicus?
Dr. Cummings. I congratulate and give credit to the excellent work on Index Medicus by the NLM staff over the last 100 years. Index Medicus, published since 1879, was brilliantly and laboriously initiated by my NLM predecessor and a man I greatly admire, Dr. John Shaw Billings, head of the Library of the Surgeon General's Office, United States Army which later became our National Library of Medicine. The comparative statistics of the number of journals and articles in Index Medicus from its beginning to this date tell the story of the success.
Foreign Medical Literature Translation
Dr. Dee. In the testimony you provide an excellent description of the quid pro quo agreement with foreign countries for the exchange of their indexing with the use of the National Library of Medicine's computer system.
Dr. Cummings. The exchange of foreign journal article indexing for the use of our computer system that is described in the Testimony was beneficial to many foreign countries and to the cataloging needs of the National Library of Medicine. We were able to extend our resources to countries that needed access to our system and we were able to meet our needs for translations that were not within the expertise of our own staff. The exchange worked very well.
Regional Medical Libraries
Dr. Dee. Dr. Cummings, from your discussion of the collaborative agreement of the medical libraries for cost savings, it sounds like NLM was again setting a precedent for an important library model that has continued to have broad applications for library networks and collaboration. Do you have any comment?
Dr. Cummings. The collaboration among the medical libraries particularly the regional medical library network has turned out to be one of the finer accomplishments initiated by the National Library of Medicine. The Senate Testimony you sent points out other collaborations.
Dr. Dee. Senator Eagleton gave you a flattering compliment with the statement: "Well, as always, this is one of the more interesting hearings. I have looked forward to it. I'm always glad to see you, Doctor, and your associates."
Dr. Cummings. Senator Eagleton was very kind. The Senators and the NLM staff had many enlightening and productive discussions.
- Eagleton, Thomas Francis, (1929 - 2007). Biographical Directory of the United States Congress. https://bioguide.congress.gov/scripts/biodisplay.pl?index=e000004.
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/.