Workshop on Allied Health Manpower:
A Cooperative Approach to Data
Collection and Analysis
B. L. CRAWFORD, MS
LUCY M. KRAMER, MA
B. JERALD McCLENDON, MS
ALTHOUGH ALLIED HEALTH MANPOWER includes more Allied Health Education and Accreditation, the
than 1 million persons now active in the overall health American Hospital Association, the Bureau of Health
work force, there is a serious lack of comprehensive Manpower, the National Center for Health Statistics,
and reliable data that policy makers and interested and the Bureau of Labor Statistics.
organizations can use to describe and project the
The specific objectives of the workshop follow:
supply and requirements for personnel. Among Fed-
eral agencies as well as professional associations of * to provide an exchange of information and ideas
allied health workers there is growing concern that on the current availability of data and analysis;
the lack of a cooperative, systematic, and inclusive * to familiarize participants with available data proc-
system to collect and analyze information hinders the esses, resources, and mechanisms capable of providing
accurate assessment of manpower trends and the de- analysis;
velopment of policy for the coming years. * to identify and prioritize problems, issues, and gaps
and develop a conceptual framework for constructing
Need for Cooperative Efforts a more efficient and effective means of obtaining and
To address the current insufficiency of data, the Bureau
analyzing data on allied health manpower; and
* to identify and select appropriate, cooperative
of Health Manpower (BHM), Health Resources Ad-
ministration, sponsored a workshop on September strategies for producing information useful to all parties.
11-13, 1979, in Bethesda, Md. The Workshop on The workshop was opened by its moderator, Mary
Allied Health Manpower was a unique effort, bring- Schneider, Research Associate in the Division of Allied
ing together for the first time representatives from Health, University of South Dakota, who indicated
Federal agencies and professional associations to dis- that the workshop grew out of a series of discussions
cuss common data problems and needs. Participants between the Bureau of Health Manpower and several
represented 14 allied health professional associations, professional associations. It soon became apparent,
the American Medical Association's Committee on Schneider said, that a forum for discussion and coopera-
tive efforts among many interested parties would be
essential to development of a common information base.
Mr. Crawford is a writer-editor for the Division of Associated The current workshop was an attempt to stimulate these
Health Professions and Mr. McClendon is a health statistician efforts, she said, with one day of presentations on exist-
in the Division. Miss Kramer is a technical writer-editor in ing activities to be followed by a day and a half of
the Division of Manpower Analysis. All three are in the
Bureau of Health Manpower, Health Resources Administra- small group meetings to identify critical issues and pro-
tion. pose tentative solutions or strategies.
Tearsheet requests to B. L. Crawford, Division of Associ- Thomas D. Hatch, Acting Deputy Director of the
ated Health Professions, Rm. 5-41, Center Bldg., 3700 East-
West Highway, Hyattsville, Md. 20782. Bureau of Health Manpower, welcomed participants on
80 Public Health Reports
behalf of the Bureau. Hatch noted that concern about ing information can not only provide more inclusive
the adequacy of supply and distribution of allied health data, but can help minimize expenditures and alleviate
personnel was even more important today than in the financial limitations.
mid-1960s and early 1970s, when the principal concern Howard V. Stambler, Director of the Division of
was the total number of personnel in the work force. Manpower Analysis, BHM, noted that several problems
Questions about "where these personnel are, what now constrain improved data efforts, including the
they're doing, and how they're doing it" will become large number of occupations in a large number of set-
increasingly vital, he said. tings, the limitation on funds that both Federal and
David A. Hoover, Acting Deputy Director of the professional organizations have available for such en-
Division of Associated Health Professions, BHM, noted deavors, and the lack of consensus on what con-
that widespread conceptions about allied health man- stitutes "allied health." An extended lag between col-
power have seldom been drawn from a systematic body lection and presentation of data often results from
of quantifiable data. As a result, "fairly gross miscon- funding, contractual, and methodological problems. In
ceptions" appear prevalent, he said. "I don't think particular, he said, the lack of consensus on the defini-
anyone has evidence to really show in any meaningful tion of allied health occupations, tasks, and work set-
national sense what the cost-benefit situation and the tings complicates collection of data and utilization of
supply-requirements situation are for allied health findings. In addition, local and State regulations or
personnel." laws governing the employment of allied health per-
Hoover said that many believe no national shortages sonnel need to be taken into account as data efforts
of allied health manpower exist, yet there is enough are mounted.
information to suggest strongly that there are short- Stambler said that many current perceptions of allied
ages in some occupations and critical manpower pro- health manpower are based on "apocryphal stories not
blems in rural and inner-city areas that may affect backed by hard data and analysis." While some data
service delivery. Hoover also stated that information collection in allied health is being conducted, there has
about the impact of manpower regulation is needed, but been "very little attempt at analysis," he noted. Addi-
that currently, "no one is in any position to say what tional attention must be paid to work force mobility,
the probable impact of any proposed or actual regula- to where the students go to work after graduation, and
tion will be, because we simply do not know enough." to forecasting supply and requirements for allied health
Federal policymakers and program managers and pro- occupations.
fessional associations concerned with future trends all
have similar data and analytical needs, he said, so that Finally, Stambler said that "although the manpower
cooperation among all parties in collecting and analyz- policies that emerge can be argued over, current
January-February 1980, Vol. 95, No. I 81
policy on the allied health professions is being argued Bernstein also reported on a forecasting effort em-
over in a complete vacuum of information. Reliable ploying a variant of the existing Supply Output and
information, therefore, is urgently needed to establish Requirements Model now used to forecast manpower
a consensus on the current status of allied health man- figures for medicine and other health professions. A
power, upon which policy makers and legislators can new effort, this model will incorporate components
base their deliberations. A reliable data base is one relating to permanent and interim attrition in the work
from which all stand to benefit." force and its racial and ethnic composition. Initially,
Following these introductory remarks, a series of this model will be used to project the future supply
panels presented detailed descriptions of allied health of physical therapists and occupational therapists. The
data activities conducted by Federal and non-Federal Division will also investigate the feasibility of applying
organizations. The first such panel was composed of this model to other allied health occupations.
Federal participants. B. Jerald McClendon of the Division of Associated
Health Professions, BHM, briefly discussed the Bureau's
Federal Data Collection Efforts use of manpower data in budgetary decision-making,
Charles Croner of the Division of Health Manpower program evaluation, and reporting to Congress. He then
and Facilities, National Center for Health Statistics stated that several major changes in emphasis would
(NCHS) discussed the Center's publication, "Health greatly improve the Bureau's ability to supply informa-
Resources Statistics" (1). The data are drawn from tion for policy and program development. More em-
professional societies, which provide annual data on phasis is needed, he said, on obtaining and analyzing
87 categories of manpower; public agencies, which work force data and, particularly, the geographic dis-
provide information on population, education, and tribution patterns by occupation. Analyses of the work
various types of outpatient and nonpatient facilities; force have not focused on regional and local varia-
and the NCHS Master Facility Inventory and the Co- tions or shortages. He recommended that such efforts
operative Health Statistics System, which yield counts pay greater attention to demand and need considera-
of inpatient health facilities. Croner discussed the tions, rather than simply considering the supply.
methodology and preparation of the document, and the Methodological and definitional problems are endemic
necessity to keep abreast of factors that affect such to allied health, he noted, and should be carefully
data. Research, he noted, must take into account considered before beginning extensive collection of
factors such as the influence of national legislation, data. Finally, more emphasis needs to be placed on
licensure status of personnel and accreditation of in- forecasting and projections, which have received too
stitutions, signs of stability or growth in facilities and little attention in the past.
occupations, and trends affecting current and future
status of personnel or facilities. The fourth panelist, Mike Pilot of the U.S. Bureau
Stuart Bernstein of the Division of Manpower Anal- of Labor Statistics, described the BLS Occupational
ysis (DMA) reported on two Bureau efforts in the Outlook Handbook Project, and the relation of its
collection and analysis of information on the allied occupational projections to the Bureau's economic
health work force. From existing State studies, DMA model of the national economy (2). This project
has developed two systems to compile manpower data utilizes secondary data from other agencies and mem-
on allied health personnel. The Allied Health Em- bership associations, and Pilot indicated that BLS
ployment Matrix presents employment and vacancy has faced problems in collecting accurate information
information for approximately 50 occupations. It has on allied health professions (only 25 of which are
generated national supply estimates for 15 allied health represented in the current Handbook) and in assem-
occupations as of 1976. Bernstein noted that the sys- bling accurate information on the flow of workers from
tem is hampered significantly by the low technical the educational pipeline to the work force.
quality of the primary data sources; only about one-
third of the documents reviewed have been of suffi- Efforts of Professional Associations
cient technical rigor to merit inclusion. Only with im- Three succeeding panels brought together speakers
provement in primary sources and elimination of many from allied health professional associations, who re-
gaps in the data can the utility of the national es- ported on the activities undertaken by their associations
timates be improved significantly. The Bibliographic to collect information on their memberships and occu-
System supplies basic bibliographic information on exist- pational fields. The first panel included Fran Acqua-
ing studies and detailed descriptions of studies used viva, Director of Operations Research for the American
to supply data for the Employment Matrix. Occupational Therapy Association; Beverly Bailey,
82 Public Health Reports
Legislative Coordinator, American Dental Hygienists He pointed out that the association was particularly
Association; Donald Balasa, Legal Director, American interested in presenting a case for the expansion of
Dental Assistants Association; and Elizabeth Price, dental assistant functions, which now vary considerably
Director of Professional Services, American Medical from State to State, but there are no hard data to assess
Records Association. the productivity and effectiveness of dental practices
Several comments of these panel members were employing dental assistants with expanded functions.
echoed throughout the conference. Although a few Balasa indicated that the organization would be ex-
associations maintain capability and resources to con- tremely interested in information that could demon-
duct manpower research to some degree and are ap- strate the cost savings or potential of dental assistants.
parently building a research constituency among their Elizabeth Price described surveys conducted by the
membership, others are constrained by limited resources American Medical Records Association over the past
and an inability to convince their members that collec- 15 years. These produced salary data on all levels of
tion and analysis of such information are consonant imedical record* personnel according to experience,
with the objectives of the organization. education, location, and type of work facility; on con-
Fran Acquaviva noted that data collection and anal- tinuing education; on academic programs providing
ysis efforts conducted by professional associations can medical records training with various types of degrees;
assist associations in planning and conducting activities and on independent or correspondence study programs.
for their members. Such studies are used by the The association is also interested in the impact of
American Occupational Therapy Association in es- credentialing on personnel, and on career mobility
tablishing career mobility programs, assessing appro- patterns from medical record technician to administra-
priate entry-level qualifications and requirements, help- tor.
ing State associations in developing placement pro- The second panel brought together representatives
grams, and refining and redirecting continuing educa- of the American Society for Radiologic Technologists
tion programs for members. The association conducts and three groups representing segments of the clinical
full membership surveys every 2 or 3 years, securing laboratory field: American Medical Technologists, the
data on age, sex, race, education, employment experi- International Society for Clinical Laboratory Tech-
ence, and work settings. It also maintains data on newly nologists, and the American Society for Medical Tech-
certified therapists and assistants. The association an- nology.
nually surveys some 95 educational programs for in- The American Medical Technologists, with a cur-
formation on enrollments, graduates, faculty, and out- rent membership of about 14,000, is both a member-
side funding support, and biennially surveys fieldwork ship organization and a credentialing body. Chester
experience centers. The organization serves as a clear- Dziekonski, its Executive Director, described three
inghouse for State association surveys to prevent dupli- surveys: a biennial membership survey of occupational
cation and maintains full data files from its own levels, education, employment setting, and position; a
survey results and other pertinent surveys and sources. survey of enrollees and graduates of accredited institu-
Beverly Bailey noted that the American Dental tions; and a tabulation of continuing education credits
Hygienists Association represents about two-thirds of earned by members.
all active hygienists but only about one-third of all Mark Birenbaum, Coordinator of Educational Pro-
licensed hygienists. Membership surveys, therefore, will grams for the International Society for Clinical Labor-
not provide critical information on the reasons for tory Technologists, described the organization's mem-
inactive membership and on turnover among practic- bership and proficiency examination surveys, and
ing hygienists. Constrained by limited resources, the discussed computerization of data on membership and
association relies on national data compiled by the continuing education. Birenbaum stated that major
Bureau of Health Manpower or the American Dental concerns of the society are the time lag between data
Association; not all of these data, up to this point, have collection and publication and the burden placed on
been particularly relevant to hygienists. The associa- respondents by extensive and duplicative survey re-
tion does not conduct regular surveys of its members quests.
but did produce a membership profile in 1978. The American Society for Medical Technology
Donald Balasa stated similar concerns, indicating represents 30,000 laboratory personnel. Nick Kaufman,
that the American Dental Assistants Association repre- Director of the society's Washington office, described
sents as little as 10 percent of this work force and laboratory manpower studies the organization has
could not, as a result, provide information that was conducted over the past 10 years. These have focused
necessarily representative of the occupation as a whole. on salaries nationwide, the attitudes of medical tech-
January-February 1980, Vol. 95, No. 1 83
nologists toward work-related problems, State licensure Katherine Evans of the American Association for
requirements, and distribution and shortages of medical Respiratory Therapy noted that comprehensive data
technology personnel. The society is particularly con- on respiratory therapy manpower are of major concern
cerned with development of data bases relating to to a field in which large numbers of practitioners are
competency assessment, health planning, cost contain- trained on the job. The association approached the
ment, job placement, continuing education, career question through a 1977-78 survey of respiratory
mobility, and multiple registry and licensure issues. therapy manpower in hospitals (5). Evans echoed
Marilyn Fay, Director of Education for the Ameri- comments from other participants who noted that a
can Society for Radiologic Technologists, reviewed the variety of methodological and procedural problems are
society's data concerns involving 22,000 members, in- faced by associations with limited experience in and
cluding 3,000 students. The organization represents resources for data collection. Evans suggested that a
10 to 20 percent of the total work force in the field of useful approach might include simplification of ques-
radiologic technology. The society and the American tionnaires where possible and dividing data collection
College of Radiology are preparing a report on into smaller efforts at staggered intervals.
radiologic technologist manpower, examining factors Kenneth Perrin reported that the American Speech-
that will influence demand. These include education, Language-Hearing Association represents 5,000 audi-
workload, credentialing requirements, job descriptions, ologists and 28,000 speech-language pathologists, all
and the supply, distribution, and characteristics of of whom have graduate degrees. He noted that the as-
work force (3). sociation is interested in collecting data on approxi-
The third panel included William K. O'Connell, mately 12,000 persons with baccalaureate degrees who
Assistant Executive Director, American Dietetic As- work in the field but do not qualify for membership in
sociation; James Clinkingbeard, Director of Educa- the association.
tional Affairs, American Physical Therapy Association;
Katherine J. Evans, Director of Education, American Perrin discussed the organization's 1978 survey of
Association for Respiratory Therapy; and Kenneth educational programs and an extensive 1977 manpower
Perrin, Director of Education and Scientific Programs, study conducted in cooperation with the National In-
American Speech-Language-Hearing Association. stitutes of Health (6). The association also conducts
periodic salary surveys of its membership and at the
William O'Connell discussed supply and demand same time obtains information on employers, geo-
studies conducted by the American Dietetic Associa- graphic location, sex, age, and certification.
tion-an annual survey of membership, a study of the
roles and functions of entry-level practitioners, and a Perrin listed several issues that would shape future
dietetic staffing study from which the association plans data collection and analysis efforts: impact of unem-
to develop a model to compute staffing needs for in- ployed members returning to the work force, role of
stitutions. It is also conducting a 2-year dietetic manu- part-time workers, changing employment settings,
power demand study and a study to analyze the ef- future projections of supply and requirements, absence
ficiency and cost effectiveness of providing nutritional of Black and Hispanic educational programs, and an
counseling to ambulatory care patients. The organiza- assessment of the association's certification program.
tion would like to see a cost analysis of training at
various levels and studies on the productivity of dietetic Other Efforts in Data Collection and Analysis
professionals in different health care settings, on The final panel included Barbara Bloom, Director of
physician usage of dietitians, and on consumer prefer- the Council on Human Resources, American Hospital
ences and habits. Association (AHA); Charles McClinton, Assistant Di-
James Clinkingbeard reported that since 1973, the rector of the American Medical Association's Depart-
American Physical Therapy Association has conducted ment of Allied Health Evaluation; A. Bruce Cyr, Asso-
a series of salary surveys. A 1978 membership profile ciate Director for Research Projects, Foundation of the
has produced data on salaries, education, job mobility, American College of Nursing Home Administrators;
and employment (4). An annual education survey and Pamela Griffith, Project Coordinator, American
assesses the supply of manpower entering the field and Society for Allied Health Professions.
has assisted the organization in developing a minority Barbara Bloom reported that the American Hospital
recruitment and retention program. The association Association has convened a Task Force on Manpower
is also planning more complete studies on educational which recommended the coordination, by or through
programs, changing degree requirements, and supply the association, of data collection at Federal, State, and
and demand for physical therapists. local levels. The association collects annual statistics
34 Public Health Reports
on allied health manpower in hospitals including types which would describe in detail the relationships be-
of positions, vacancies, union membership, and num- tween education and practice.
bers of personnel. In the past, AHA has also collected Priority Issues
data on hospital-based educational programs. Following these opening presentations, the remaining
The American Hospital Association suggests the day and a half were devoted to developing a list of
development of a model format for data collection issues and problems requiring immediate concern and
that could be adapted for use by various organizations. attention and possible solutions. These exchanges were
Data elements of interest would include manpower reasoned, enthusiastic, and occasionally heated. The
supply and demand, wages and salaries, staffing pat- groups participating have rarely had the opportunity
terns, retention rates, educational programs, apprentice- to voice their specific concerns and data needs, and
ships, productivity, and entry level requirements. the extent of involvement and commitment to data
Charles McClinton described the AMA's Committee gathering and analytical efforts varied considerably
on Allied Health Education and Accreditation as a pos- among the groups present. As a result, unanimity
sible source of health manpower data. In accrediting among the participants could not have been a reason-
educational programs, the committee reviews and acts able goal for this initial effort.
on approximately 900 applications each year. In all, Yet, as David Hoover noted, the participants at the
nearly 3,000 programs in 26 allied health fields are workshop, "all have responsibilities as analysts of
accredited by this group, and each year, it surveys health manpower and have a common mission to
these programs to assess program changes, student provide organizational decision-makers with data for
capacity, available financial assistance, tuition costs, policy formulation." Thus, as Howard Stambler said,
and number of graduates. McClinton also presented "reaching a quick consensus on issues and activities
preliminary tabulations of the data that will appear is less important at this stage than broadening the
in the next annual report and the committee's "Allied relationship between allied health practitioners and the
Health Education Directory" (7). Educational data Bureau of Health Manpower and promoting a co-
are available from the Committee on Allied Health operative approach to analytical and data efforts."
Education and Accreditation on request. Nevertheless, a number of primary concerns were
A. Bruce Cyr reported that the Foundation of the delineated in the final workshop session. The workshop
American College of Nursing Home Administrators group agreed that clearly defined goals and objectives
is concerned with and uses secondary data sources such for data efforts was a basic lack and appeared particu-
as the NCHS Master Facility Inventory and the larly critical because of the multiplicity of organizations
National Nursing Home Survey. It is also concerned and interests represented within the broad category of
with the methodology of data collection and analysis, allied health. The sense of the group was that this
validity, coordination of data, and limited financial problem must be addressed immediately. Given the
resources. Cyr expressed concerns similar to those of serious constraints on funds available to any given
other organizations participating in the conference. organization, a national effort is needed to undertake
Pamela Griffith reported that the American Society issue identification and related matters.
of Allied Health Professions is an umbrella organiza- A series of methodological problems drew con-
tion for allied health fields, with a current member- siderable comment. The group indicated that there
ship of 145 schools and professional organizations and existed no consensus on definitions and measurements
some 1,250 persons from various allied health occupa- of need and demand for allied health occupations. It
tions. It is currently conducting the fourth inventory of was clear that little agreement exists on which occupa-
collegiate allied health programs. Results of the third tions are "allied health" and the limits of their re-
inventory were published in 1978 (8). The 1979-80 sponsibilities. Which occupations should be considered,
inventory will include data on enrollments, applicants, or which levels of personnel within a set of related
faculty, graduates, and student characteristics such as occupations should be studied, also remains unclear.
sex and racial or ethnic composition. The society is The associations indicated that, as membership or-
also conducting a study of minority participation in ganizations, they have had considerable difficulty in
collegiate allied health education. Recommendations developing profiles of their fields because of an inability
will be made to alleviate identified problems of minority to collect data about nonmembers who, in some cases,
representation. The organization also has a Task Force are the majority within the profession.
on Research and is beginning to develop a clearing- Data on turnover and retention rates were considered
house of data on allied health education and prac- a major need, as was the need to develop methods for
tice. The society would like to see a model developed forecasting and projections. The participants agreed
January-February 1980, Vol. 95, No. 1 S5
that it is necessary to collect sufficient information on Next Steps
trends in licensure requirements, health insurance, The participants agreed to create an Ad Hoc Working
technological change, and a variety of other factors Group on Allied Health Manpower to plan an agenda
that will influence the development of the health care for a series of small and large group meetings on
system as a whole, and allied health manpower in specific issues and problems. The Ad Hoc Group might
particular. Several participants recommended the crea- consider, at some early date, the possibility of updating
tion of a minimum basic data set for allied health and refining basic resource documents or systems cur-
occupations. rently being developed by the Bureau of Health Man-
The group expressed concern about a number of power. These could include the Report on Allied
additional issues that should receive specific attention in Health Personnel, prepared for Congress and published
the future. Existing information on minority concerns by the Division of Associated Health Professions, and
and minority representation in the allied health work the national estimates and forecasting projects being
force is woefully inadequate, and a means should be developed by the Division of Manpower Analysis.
found to collect and analyze data on minorities in The Ad Hoc Group will consist of eight members.
these occupations. It was also noted that, although For its initial meetings the four non-Federal repre-
women compose a large majority of the practitioners sentatives are from Washington-based professional as-
in many of these occupations and are entering others sociations -James Clinkingbeard, Pamela Griffith,
in increasing numbers, they are not always adequately Kenneth Perrin, and Fran Acquaviva, who will chair
represented at supervisory and managerial levels. Better and host the first meeting of the Ad Hoc Group. The
documentation of representation, salary structures, and four Federal representatives are David B. Hoover, B.
career prospects for women is clearly needed. Jerald McClendon, Howard V. Stambler, and Stuart
Issues related to credentialing also received con- Bernstein.
siderable attention. The group felt that data on up- Information about the group and its plans can be
ward mobility within the work force, and on the im- requested from Fran Acquaviva, Director of Operations
pact of State licensure and voluntary credentialing, Research, American Occupational Therapy Associa-
needed additional work. tion, 6000 Executive Blvd., Rockville, Md. 20852, tele-
Some professional associations reported a serious lack phone: 301-770-2200, extension 54.
of knowledge about data collection processes and
procedures. There is also a need to compile information References
on funding sources for such data collection and analyti- 1. National Center for Health Statistics: Health resources
cal efforts. It was recommended by several persons statistics: health manpower and health facilities, 1976-77
that a clearinghouse for information on studies planned edition. DHEW Publication No. (PHS) 79-1509. U.S.
Government Printing Office, Washington, D.C., 1979.
by various organizations might help to reduce duplica- 2. Bureau of Labor Statistics: Occupational outlook hand-
tion of efforts. Noting that incomplete information and book, 1978-79 edition. Bull No. 1955. U.S. Government
inability to validate much of the available information Printing Office, Washington, D.C., 1978.
was the rule rather than the exception, participants 3. Technologist manpower, a report of the Conjoint Commit-
called for improved data collection and analysis in these tee on Technology Job Descriptions and Manpower Studies.
American College of Radiology and American Society of
specific areas-geographic distribution, the impact of Radiologic Technologists, Chicago, Ill., April 1979.
credentialing requirements, and existing or potential 4. Membership profile survey, a summary report. American
cost benefits of improved utilization of these occupa- Physical Therapy Association, Washington, D.C., January
5. Respiratory therapy uniform manpower survey, 1977.
The workshop group was not inclined to develop a American Association for Respiratory Therapy, Dallas,
final list of issues and recommendations for future ac- Tex., 1977.
tion, particularly as few felt that they could yet commit 6. Speech pathology and audiology: manpower resources and
their organizations to major efforts or allocations of needs. Report prepared by the American Speech and Hear-
resources. Nevertheless, the enthusiasm this workshop ing Association for the National Institute of Neurological
and Communicative Disorders and Stroke. NINCDS
generated seemed to augur well for cooperative na- Monogr No. 17. DHEW Publication No. (NIH) 77-1297.
tional efforts in data collection and analysis. Concerns U.S. Government Printing Office, Washington, D.C., 1977.
were seldom raised throughout the conference about 7. Allied health education directory/7th edition. American
possible submersion of organizational identity as a Medical Association, Chicago, Ill., 1978.
8. Bureau of Health Manpower: Allied health education
factor limiting cooperation, and the professional associa- programs in junior and senior colleges, health planners
tion representatives expressed a strong desire to take edition. DHEW Publication No. (HRA) 78-31. U.S. Gov-
a leading role in future meetings and projects. ernment Printing Office, Washington, D.C., 1978.
86 Public Health Reports