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to obtain a license by endorsement and without examination"; and

(2) by striking out the third and fourth sentences and inserting in lieu thereof "The Commission may issue a license by endorsement to an applicant under this section if it determines he has met the requirements

of this section. A license issued to an applicant under this section shall correspond in scope as nearly as practicable

to the license held by the applicant which is the basis for the issuance of a license under this section. No person 11 may be licensed under this section who has been ex

12

23

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amined under authority of the Commission and who has failed."

(b) Sections 6, 11, and 23 of such Act (D.C. Code, 15 secs. 2-104, 2-108, 2-119) are each amended by striking 16 out "reciprocity" each place it appears in those sections and 17 inserting in lieu thereof "endorsement".

18

SEC. 4. (a) (1) The first sentence of section 25A of 19 the Healing Arts Practice Act, District of Columbia, 1928 20 (D.C. Code, sec. 2-122a) (as so redesignated by section 2 21 of this Act), is amended by striking out ": Provided, That 22 the examination given by the national examining board" 23 and inserting in lieu thereof the following: "or to anyone 24 who has successfully completed the examination admin25 istered by the Federation of State Medical Boards of the

8

1. United States if the Commission determines that the ex

2 amination given by the national examining board or by 3 such federation, as the case may be,".

4 (2) The proviso in the last sentence of such section 5 25A is amended by inserting "or on the basis of successful

completion of the examination administered by the Federa7. tion of State Medical Boards of the United States" imme8 diately after "national examining board".

9 (b) (1) The second sentence of the first paragraph of 10 section 6 of such Act (D.C. Code, sec. 2-104) is amended 11 by inserting "or by virtue of successful completion of the 12 examination administered by the Federation of State Medi13 cal Boards of the United States as provided in such section," 14 after "section 25A of this Act,".

15

(2) The sixth sentence of section 11 of such Act (D.C. 16 Code, sec. 2-108) is amended by inserting "or by virtue of 17 successful completion of the examination administered by the 18 Federation of State Medical Boards of the United States," 19 after "national examining board,".

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21

(3) Clause (4) of the third sentence of section 23 of such Act (D.C. Code, sec. 2-119) is amended by inserting 22 "or by virtue of successful completion of the examination administered by the Federation of State Medical Boards of the

23

24 United States" after "national examining board".

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(4) The Fourth sentence of such section 23 is amended

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1 by inserting "or on the basis of successful completion of the 2 examination administered by the Federation of State Med

3 ical Boards of the United States" immediately after "national 4 examining board".

5 SEC. 5. (a) Section 50 of the Healing Arts Practice 6 Act, District of Columbia, 1928 (D.C. Code, sec. 2-141), 7 is repealed.

8 (b) The amendments made by this Act shall not be 9 construed as affecting any provision of Reorganization Plan 10 Numbered 3 of 1967, except that the Commissioner of the 11 District of Columbia and the District of Columbia Council 12 shall exercise their respective functions under the Healing 13 Arts Practice Act, District of Columbia, 1928, through 14 the Commission on Licensure To Practice the Healing Art 15 established by section 4 of such Act (as amended by this 16 Act).

17 (c) The members of the Commission on Licensure To 18 Practice the Healing Art in office on the date of the enact19 ment of this Act shall continue in office until at least four 20 members have been appointed to that Commission under 21 section 4 (a) (1) of the Healing Arts Practice Act, District 22 of Columbia, 1928 (as amended by this Act).

THE DISTRICT OF COLUMBIA,
Washington, D.C., June 23, 1971.

Hon. THOMAS F. EAGLETON,

Chairman, Committee on the District of Columbia,

U.S. Senate, Washington, D.C.

DEAR SENATOR EAGLETON: The Commissioner of the District of Columbia has for report H.R. 8589, a bill "To amend the Healing Arts Practice Act, District of Columbia, 1928, to revise the Composition of the Commission on Licensure to Practice the Healing Art, and for other purposes", as passed by the House of Representatives on June 14, 1971.

H.R. 8589 would substantially alter both the composition of the Commission on Licensure to Practice the Healing Art, and the method of appointing its members. The present five-member Commission, appointed by the Commissioner of the District of Columbia, would be replaced with an eleven-member body the membership of which is specified by the bill. Seven of the proposed eleven members would be private physicians, chosen by the medical schools and medical societies named in the bill. Two non-physician community representatives would be named by the Commissioner, and the Corporation Counsel and Director of Public Health (now the Director of the Health Services Administration) would serve as ex officio members of the Commission.

The Commissioner of the District of Columbia objects to those amendments of the Healing Arts Practice Act made by section one of the bill. The Commission on Licensure created by the Healing Arts Practice Act of 1928 was abolished by Reorganization Plan No. 5 of 1952 and a new Commission was established by the then Board of Commissioners. Pursuant to authority conferred by Reorganization Plan No. 3 of 1967, the Commissioner of the District of Columbia is empowered to alter and revise the composition of the Commission on Licensure and to increase or decrease its membership. Thus, the reestablishment by statute of a commission to regulate one particular profession is in derogation of the Reorganization Act of 1949, and Reorganization Plans No. 5 of 1952 and No. 3 of 1967, under which there have been vested in the Commissioner and the District of Columbia Council the functions which prior to Reorganization Plan No. 5 of 1952 had been vested in a number of statutory boards and commissions abolished by such Plan, and represents a partial return to the unsatisfactory administrative situation which existed prior to 1952 and which Reorganization Plan No. 5 of that year was intended to correct. Further, the establishment of such a commission by statute has the effect of fixing its membership at that specified in the statute, without regard to the changing needs of the community. The Commissioner is of the view that some degree of flexibility should be retained at least to the extent of vesting in him the authority which he presently has to determine the membership of the Commission, and permit him a freedom of choice in changing such membership from time to time as the need arises.

The Commissioner also questions the advisability of increasing the membership of the Commission from the present five to a total of eleven. The elevenmember size of the Commission can be expected to cause it to be cumbersome in its operation and create some difficulty in assembling a quorum for the purpose of conducting its affairs.

Moreover, the Commissioner questions the need for a Commission on Licensure to Practice the Healing Art with a membership such as that specified by section numbered two. Apparently the intent of the bill is to increase the number of persons on the Commission in the fields of medicine and osteopathy from one (the Director of the Health Services Administration), as at present, to a total of eight. The Commission on Licensure to Practice the Healing Art is required to deal not only with matters related to the public health and the practice of medicine or osteopathy, but it must also deal with questions of policy, law, and education. It is for this reason that the present Commission includes within its membership not only the Director of the Health Services Administration, but also a representative of the Commissioner of the District of Columbia, the Director of the Department of Economic Development, the Acting Superintendent of Schools, and the Corporation Counsel. With respect to participation in the administration of the Healing Arts Practice Act by physicians, the two examining boards on medicine and osteopathy are comprised entirely of members of those two disciplines.

Subsection (d) of section 4 of the Healing Arts Practice Act as amended by section 1 of H.R. 8589, provides that the Commission "shall make, and may alter, such rules as it deems necessary to conduct its business." Section 5(a) of the bill repeals section 50 of the Healing Arts Practice Act which defines the meaning of the term "commission". Section 5(b) of the bill provides "that the Commissioner of the District of Columbia and the District of Columbia Council shall exercise their respective functions under the Healing Arts Practice Act, District of Columbia, 1928, through the Commission on Licensure to Practice the Healing Art", as established under the authority of section 1 of such bill. These three provisions have the effect of removing from the District of Columbia Council its existing authority to make rules for the execution and enforcement of the Healing Arts Practice Act, and from the Commissioner his present authority to provide for the administration of that Act, pursuant to the powers conferred by Reorganization Plan No. 3 of 1967. The Commissioner believes that it is in the best interest of the public at large, as well as the medical profession, that activities of the Commission, including rule-making, be coordinated as closely as possible with District Government activities and policies in related areas. Rulemaking by the Commission would work against such coordination. For the foregoing reasons, the Commissioner recommends that section 1 and section 5 be deleted from H.R. 8589.

Section 2 of the bill provides for the issuance of temporary licenses without examination to persons holding the degree of doctor of medicine or doctor of osteopathy who wish to pursue or participate in residency or fellowship training programs in hospitals in the District. Such a license would allow them to sign birth and death certificates and prescriptions for narcotics and other drugs, and perform other duties for which medical licensure is now required. The Commissioner supports this provision as a means of involving residents and fellows more fully in the day-to-day administration of local hospitals.

Section 3 of the bill authorizes the Commission to issue licenses by endorsement and without examination to applicants who are licensed by examination in another jurisdiction. The District is presently authorized to license by endorsement physicians and osteopaths licensed in any other jurisdiction of the United States or its territories only if the other jurisdiction maintains a policy of reciprocity with the District. At present, only Florida, Hawaii, and the Virgin Islands do not grant reciprocity to the District. Section 3 of the bill would authorize the Commission to extend licensure by endorsement to physicians from other jurisdictions regardless of the jurisdiction's reciprocity policies.

The situation is somewhat different in the case of graduates of medical schools in foreign countries. The Commission has adopted a policy of granting licensure to graduates of foreign medical schools (with the exception of Canada) only after successful examination. The Commissioner suggests that, for the purposes of consistency with what has been regarded as a wise policy followed by the present Commission, graduates of Canadian medical schools who have been licensed to practice medicine in the Dominion of Canada be afforded the privilege of licensure by endorsement without examination as authorized by section 3. It is therefore recommended that section 3(a)(1) of the bill be amended to read as follows:

"(1) by striking out in the first sentence 'An applicant who desires to obtain a license without examination, by virtue of a license issued to him by a state, territory, or other jurisdiction forming a part of the United States, or by a foreign country,' and inserting in lieu thereof 'An applicant who desires to obtain a license by endorsement and without examination, by virtue of a license issued to him by a State or territory of the United States, or by the Dominion of Canada"."

This amendment would have the effect of extending license by endorsement to persons from all parts of the United States, its territories, and Canada, while maintaining what the Commission feels is a necessary requirement for examination for graduates of foreign medical schools.

Section 4 of the bill substitutes or inserts "Federation of State Medical Boards of the United States" either in place of or following "national examining board". The District has no objection to this alteration, although it would seem that the phrase "national examining board" includes the Federation of State Medical Boards.

In the belief the principal purpose of the bill-the establishment of a statutory Commission on Licensure to Practice the Healing Art-is in derogation of