Optometric Visionary Completes an Historic Era

As a profession, optometry is quite young—basically being both invented and transformed in the twentieth century. So much of its impressive growth and emergence as the primary eye care profession in the U.S. and Canada is marked with the clear imprint of individuals whom it is fair to say are “optometry heroes.” In some cases, the name of a single individual is almost synonymous with the transition from a very immature and struggling aspect of optometry to a proud national and international first-rate resource to optometry and health care in general. In these cases, the single individual will correctly point to the tremendous and critical efforts of others, but nevertheless, his/her name deserves to stand out. With optometry's first-rate competence assessment and measurement agency, the National Board of Examiners in Optometry (NBEO), that name is Norman Wallis. For over a quarter of a century, Norman Wallis provided the continuity and executive leadership needed to bring the NBEO to its current highly regarded agency. It is among the very best of such institutions in health care competence testing. It is a star in optometry's cap! Norman's vision of what should and could be done has always been far ahead of the crowd, and he sometimes found resistance because of that. He deserves tribute and acknowledgment. His efforts were filled with challenges, lots of important battles, and some occasional small thinking by others that he had to be overcome. He showed admirable persistence and could see farther “down the tunnel” than most can appreciate.Figure: No caption avaliable.On June 30, 2005, Norman E. Wallis, PhD, OD, DSc (Hons), FAAO, FCOptom, ended a more than 26 year career as executive director of the National Board of Examiners in Optometry. The NBEO board of directors decided to move the NBEO office from Bethesda, Maryland, to Charlotte, North Carolina, and Dr. Wallis chose not to make the move. I first met Norman Wallis when we were both graduate students in the mid-1960s at Indiana University (IU). The IU graduate program in physiological optics was an international fraternity, with graduate students from the U.K., Australia, Canada, the Philippines, India, Denmark, and, of course, the U.S., including a number of military officers working toward graduate degrees in physiological optics. This international flavor was stimulated by then Dean Henry W. Hofstetter, OD, PhD, an internationalist, who encouraged many young and future leaders of our profession to earn graduate degrees from IU. Norman and I became close friends and have remained so to this day. He had come to IU following his optometric education at the U.K. at the City University, London, and several years of practice. His selection of optometry as a profession was second to his original plan for a career in the Royal Navy. A serious explosion when he was 15 years old left him with 20/200 vision in his left eye, and so a Naval career was out of the question. However, this experience piqued his interest in vision and so optometry was a natural second choice. What is not widely known about Norman Wallis is that at the same time as being a practicing optometrist in the UK, he was also a professional musician. An amateur trumpet player from an early age, he was admitted to the Royal Academy of Music in London, following his optometry training and prelicensure year, from which he graduated with the L.R.A.M. in trumpet. He performed with a number of the major symphony orchestras in the U.K., and first visited the U.S. in 1964 as a musician with the Royal Shakespeare Company. Predictive of his decisions in the years to follow, he willingly gave up that interesting dual career to undertake a new professional challenge. Norman and I were typical graduate students and challenged everything about the program and the administration. Our intense discussions about the future of the profession and how to put right everything in optometric education often went on late into the night. No doubt Hank Hofstetter and Gordon Heath, who was the chairman of the graduate program at the time, wondered what they had inherited from overseas! I left IU in 1968 to take a position at UC Berkeley, where I developed my own career. Norman, on the other hand, became a “peripatetic” faculty member and administrator. After IU, he accepted a position as an assistant professor at the University of Houston College of Optometry. There he made his mark as an academic administrator by establishing the UH graduate program with a master of science in physiological optics. He developed the proposal for the university's Board of Regents, recruited a multidisciplinary faculty from other colleges on campus, and steered it to its first class status. He was then appointed assistant dean by Dean Chester Pheiffer, OD, PhD, FAAO, and got a real taste of academic administration in addition to his teaching and research. He even tried to recruit me! In 1971, he was recruited by William Baldwin, OD, PhD, FAAO, then president of the New England College of Optometry (NEWENCO), as the Director of Special Studies. In that position, his imagination and enthusiasm was given full reign to develop a number of programs; including a graduate program with Northeastern University, a two-year associate degree program in optometric technicianry with Fisher Junior College, the continuing optometric education program, and the two-year OD program for holders of PhD degrees. This latter program continues today and has produced some outstanding faculty members and Academy members. However, his term at NEWENCO was limited to one year when he was selected to become only the third president of the Pennsylvania College of Optometry (PCO) in September 1972. At the age of 34, many in the profession wondered if he was ready for such a major responsibility. But with typical energy, enthusiasm, and foresight, Norman turned that institution upside down. He re-energized and brought in new faculty members, upgraded the curriculum, instituted a nationwide continuing optometric education program that had a major impact on drug legislation, and developed and funded the Eye Institute of PCO. This latter development was no small achievement. PCO had already received one construction grant under the Department of Health, Education and Welfare federal grants mechanism for the health professions a few years earlier, but here was PCO, through its young president, arguing forcefully for an even bigger grant to develop a first class clinical facility. But it was not just an optometry clinic that Wallis foresaw; it was a multidisciplinary eye-care center that he, appropriately and against much opposition at the time, named “The Eye Institute.” Today, 30 years later, the Eye Institute still stands as an example of what optometric creativity can do in bringing together faculty, students, patients and other professions in the delivery of eye care as a complement to education, not as a teaching laboratory. At the time, the concept an “eye institute” of an optometry school, much like the teaching hospital of a medical school, was unique; most schools provided students with clinical experiences using a clinical laboratory mentality. But Wallis established the model that patient care and clinical education are co-equal, and that the highest quality of patient care was not to be overlooked by the need to educate optometry students and ophthalmology residents. As PCO's president in the ‘70s, Wallis also was a tireless advocate for the expansion of optometric practice and the use of drugs for therapeutic purposes. He worked with the leaders of North Carolina and West Virginia, including testimony in state legislatures and meetings with the governors, to advocate the role of optometry as a primary health care profession that included the treatment of eye diseases. This commitment led to the creation of a number of major courses that were provided by PCO in over 20 states throughout the country. The model of these courses came directly from Wallis' experience at NEWENCO, where he was responsible for developing a course for the first drug legislation enacted in Rhode Island in 1971. At that time he worked with the Massachusetts College of Pharmacy and Science to develop a multidisciplinary faculty, and approximately 100 Rhode Island ODs attended this major program of 96 hours to become eligible for certification to use drugs for diagnostic purposes. This model was expanded at PCO for the diagnostic use of drugs and further expanded for those states seeking therapeutic privileges. Wallis testified in most of the states in which PCO was providing education and became an eloquent advocate for optometry's role as a true health profession On January 1, 1980, a new chapter in Wallis' career began when he was selected as executive director of the National Board of Examiners in Optometry (NBEO). I was a member of the NBEO board of directors at the time, and I vividly remember the interview process and the decision to hire him as only the second full-time executive director in the NBEO's 30-year history. I have to admit it was with some trepidation that the board of directors hired this assertive and challenging man. At the time, the NBEO was under a great deal of scrutiny in terms of its programs, its finances, and its overall position within the profession. Only 35 of the states accepted the “national boards,” and the annual budget was approximately $200,000. Even with only $38,000 in reserves, Wallis took on the challenge with relish. He told me at the time that he saw the National Board as the next logical step in his overall career goal of impacting the profession's future. Coming from a regional perspective that he had experienced at UH, NEWENCO, and PCO, he astutely recognized that the NBEO could play a critical role in elevating the stature of the profession and its prestige with other health professions. Continuing his trademark ability to recognize, encourage, and support talent, he recruited the NBEO's first full-time psychometrician, Leon Gross, PhD. In the ensuing quarter of a century, the Wallis and Gross team completely reformed the NBEO, and brought it to a pinnacle of excellence in competence assessment and measurement, and by doing so secured the profession's identity as a legitimate profession in the eyes of the other health professions. Similar to his emphasis on the co-equality of patient care and clinical education embodied in the Eye Institute of PCO, he created a mantra of co-equality of optometrics and psychometrics. During his tenure, Wallis reconstructed the national board examinations three times, introduced the Treatment and Management of Ocular Disease (TMOD) examination that set the gold standard for the profession's move into the use of therapeutics, and created the first national “hands-on” clinical skills examination of any of the doctoral-level health professions. Today all state regulatory boards accept Parts I and II and 47 states accept Part III. In essence, Wallis created a single pathway to licensure for the profession. Those of us who can look back to the 70s and 80s, and perhaps even before, can reflect on the ease by which candidates can now become licensed in every state of the Union. While this may seem automatic to current students and relatively recent graduates, this outcome was the fruit of a collaborative effort between Wallis, as a skilled, classy, insistent and forthright executive, and a board of directors that rose to the challenge of implementing many of Wallis' proposals and ideas. Just this year, the NBEO administered its first assessment of Advanced Competence in Medical Optometry (ACMO) for VA residents, and the NBEO completed an historic study of the conditions encountered in the general practice of optometry that will impact the NBEO, optometric education, and the profession for years to come. He also was a shrewd financial manager, building the NBEO's annual budget to over $3 million and creating net assets of over $6 million. I served on the board of directors from 1978 through 1988 and was privileged to be in at the beginning of the revolution that Wallis caused in the NBEO. It was a lot of fun, it was exciting, and we all knew that this was a major step forward for our profession. But Wallis' influence was not limited to the U.S. Being an international optometrist himself, he was always interested in what was going on with our profession around the world. Very influential in this activity was Henry Hofstetter, who himself was a leader of the International Optometric and Optical League (IOOL), now the World Council of Optometry (WCO). In fact, Wallis was tapped to be the chairman and facilitator for a “Think Tank” held in Paris in 1992, which set a new course for the IOOL. With 26 invited international leaders, Wallis skillfully coordinated the effort that produced a report that changed the face of international optometry. One critical element of the report was the “concept of optometry” statement that has been accepted as a unifying statement of scope of practice of optometry worldwide, despite the differences in education and scope of practice that existed at the time and still exists today. He then chaired a task force of five international optometrists that laid out a business plan for the future of the new World Council of Optometry, which next year is celebrating its tenth anniversary. More recently, he chaired another WCO task force in 2003, including an international conference of regulators, practitioners and educations, that developed a competency based model of optometric practice. This is certain to impact both optometric practice and education around the world. He is respected by international leaders in our profession throughout Europe, in Australia and New Zealand, and in China and Mexico. The National Board also has been influential in helping other testing agencies in Canada, the UK, Europe, and Australia develop quality and standardized competence assessment programs directly as a result of Wallis' leadership. Perhaps one example of his foresight, tenacity, and professional vigor came when the NBEO took on the American Optometric Association (AOA) on the American Board of Optometric Practice (ABOP). With his experience in credentialing, Wallis thought this was an inappropriate method of achieving “board certification.” He had served on the second AOA Commission on Optometric Specialties and also served 8 years as the only nonphysician health care professional member of the board of directors of the National Board of Medical Examiners (NBME). Wallis had developed a keen sense of what he saw as right and wrong regarding credentials in our profession. His position paper, endorsed by the NBEO board of directors, became important in the professions decision to oppose the development of the AOA's program. Wallis always thought that the ABOP plan was a useful continuing education program worthy of support, but not a program for board certification of advanced competence. At times the politics were heated, and Wallis, the National Board, and others took a lot of flack. Ultimately, ABOP was put to rest. I have met most of the leaders of our profession, but few have had the visionary insights of Norman Wallis. While argumentative and persistent, he is always thoughtful and intellectually honest. He has been an eloquent spokesperson for our profession and an advocate of our profession's development. There is no question that the profession in the U.S. stands today at a pinnacle of its development, and Wallis' creativity over the last thirty years, as both an academic leader and the leading credentialing executive of our profession for a quarter of a century, has been a major player in that development. His contributions to our profession have been recognized by the award of four honorary Doctor of Science degrees, Life Fellowship in the College of Optometrists (U.K.), and this fall he was inducted into the Optometry Hall of Fame. Wallis is not retiring in his career. As he often puts it, “I am really a builder of organizations who happens to be an optometrist.” But optometrist he is—true and through! And his optometry colleagues, especially Fellows in the Academy, are very aware of that. Not many Academy fellows realize that in 1982 Wallis was chosen to assume management responsibility with the move of the Academy office from Owatonna, Minnesota, to Bethesda, Maryland, during the presidencies of Dr. Bradford Wild and Dr. Merton Flom. For twelve years from 1984, Wallis' PAI Management Corporation then managed the Academy. During this period, the operating budget increased from $400,000 to over $2 million, membership grew by 75% to close to 5,000, attendance at the annual meeting expanded from 1,800 to over 3,500, and the scientific exhibition was established and grew from zero booths to around 200. Also, the American Optometric Foundation (AOF), which was another client of Wallis' firm, became an affiliate of the Academy. Those twelve years saw the maturation of the Academy as an organization with a sound business sense, a strategic plan for the future, and the desire to move to the next level of development. When the Academy branched out from his management firm to its own staff and office in 1996, Wallis was a loyal Fellow assisting in the transition and providing advice and support. Many of us who saw this in action from the mid-80s to the mid-90s, reflect that the superb management by Wallis and his team laid the foundation for the Academy we know today. As he now moves on, I am confident that his energy, intelligence, management style, and tenacity will significantly benefit others through his PAI Management Corporation. But it is time to stop, pause, reflect, admire and pay tribute to the tremendous accomplishments of this professional colleague. For the Academy and the profession at large, I wish him health, happiness, the joys of his grandchildren and continued professional success. Anthony J. Adams Editor-in-Chief Optometry and Vision Science Berkeley, California

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