Optometry Practice
Many people have asked me how I decided to be an optometrist.
When I was in Aptos Junior High School, there was a project to research and write a paper about a choice of a future occupation. I was interested in health care, but not as a physician, so I chose pharmacy. Most of my father’s friends were in the retail business; one, Philip Marshall, father of my future brother-in-law, owned a drug store at West Portal. My father took me to visit him.
At the time, I was near-sighted, which increased as I grew. My mother was near-sighted. I needed an eye examination once a year, sometimes at 6 months. My optometrist had his office upstairs in the Flood office building on Market Street. His father was an ophthalmologist who had examined me and referred me to Dr Bockman. who was tall, blonde, and well-groomed, wore a white coat, and was dignified and considerate. Most importantly, he prescribed eyeglasses that restored my good vision with eyeglasses. He inspired me. I credit him for my choice of optometry.
My father took me to see another optometrist he knew who practiced upstairs in an office building in S.F. My father told me about his acquaintance, Max Blechman (1909-1979), who was practicing optometry in Visalia, who later was president of the COA in 1954.. My image of optometry was that it was a professional practice.
When I was discharged from the USAF near Sacramento, my classmate, optometrist Joe Farrinigton in Sacramento, offered me to practice in his office. I looked at practices for sale in his office. I also looked at practice for sale in Tracy and in Salinas.
When I was in the Air Force, I worked part-time for an optometrist, Dr. Crosswhite, in Lodi. I used to drive to and back to Mather AFB along a road with tall, mature grape vines on both sides. Soon after I signed a lease in San Mateo, his wife called me and said he had died, and would I like to buy his practice. It was too late to do so, or else my family could have lived our life in Lodi.
My education at UCSO emphasized that we should practice in a professional location and manner, to develop into a recognized profession, such being dentistry. That was more difficult financially, but I was young and idealistic, and that appealed to me.
Elliot Shane was the grandson of Jennie, who was my grandfather Licht’s second wife. He was an optician who, when in Japan, had made eyeglasses for General Mc Arthur. After the army, he owned Shane Michael Optical Co. in SF, which fabricated Rx eyeglasses and also manufactured and sold frames. When I had a license, he arranged an interview with his relative, who owned the Shane Jewelry store in Oakland. Many optometrists were in jewelry stores and department stores, where they had free eye examinations, and their profit was from selling glasses. I went, saw an environment I didn’t like, and I knew I didn’t belong there.
Instead, I was hired by Green’s Eye Hospital, of two brothers who were ophthalmologists. They were known for designing the B&L Greens phoropter, the most popular way to do a vision examination. My friend Leonard Osias, an optometrist, was working there at that time. After about 6 months, they didn’t need me anymore, and I was getting ready for Air Force active duty.
After I was discharged from the USAF, I hadn’t considered the Peninsula until I heard Bernie Feldman, after being discharged from the US Army, was opening his practice in Redwood City. My father liked the idea of my being on the Peninsula, close to him and my mother.
I went into the office of Mr Reynolds, a Realtor on Third Ave. San Mateo. He had a listing for a small on-street space in the Fox Theatre building on the same block as his office. After consideration, I leased it. It had to be remodeled for an office, and I hired the nephew of Mr Reynolds. It was at 68 Third Avenue. Years after that, the Canzians were closing their men’s clothing store next door, and I rented that space and remodeled it, which was twice the size of my first office
My father introduced me to some people he knew in San Mateo, one wrote an announcement notice to be printed in the local San Mateo Times. He took me to meet Mr. Ward, manager of the Wells Fargo branch, where I got a small loan to buy necessary equipment.
I had a short course in practice management in optometry school, but the business aspect of a practice had to be learned on the job. My father-in-law said he had gone to the “school of hard knocks”; Wells Fargo helped him save his cigar store business in the 1929 depression. When I was deciding whether to practice on the Peninsula, my father took me to get advice from my two uncles, brothers-in-law of my mother, Fred Goldstein and Nathan Golden. He took me to visit a well-known attorney in Millbrae, David Wexler. When my practice was new, two men would stop by to encourage me. Attorney Harry K Wolff (1881-1959) knew my father in B’nai B’rith in S.F., after listening to me talk to a patient, advised “you need to learn how to end a conversation”, to save my time. Architect G Albert Lansberg (1876-1969), who had designed the S F War Memorial Opera House and the Golden Gate Theatre, was retired and lived nearby in San Mateo. He visited me when he was near my office. I received income tax and financial advice from my brother-in-law, Stanley Wiener, CPA.
A friend was an engineer who worked for large corporations and the large Stanford Research Institute (SRI), who knew both science and the arts, when he learned I had my own private practice office, asked me, “How did you get patients?” At first, many of my patients were friends of my parents, who came from the Peninsula and also San Francisco. My father introduced me to people at social events. He would sometimes stop at my office, driving back from the furniture mart in SF, to introduce his customer to me. I had patients come to me who knew me at the Downtown San Mateo Lions Club. As Vision Service Plan (VSP) grew, that became a significant source of new patients.
It was prepaid vision care insurance, and the subscribers often selected a panel optometrist by office location, or other ways, ie, the optometrist’s name. Another source was my activity in the SMCOS. There were frequent news items in the San Mateo Times with members’ names, which came from the public information program. Also, from my membership in the AOA and the AAO, especially true for contact lenses, when an optometrist had a patient move away, he referred to a colleague from the membership list. Satisfied patients referred friends or relatives. I got new patients one at a time.
When three optometrist friends left their practices, I bought the case records and we notified their patients: Robert Rosenberg and Melvin Bradfield of San Mateo, and Angus McCloud of Belmont.
We rented a duplex on nearby B Street, south of Third Avenue. The first day, the house shook, and we learned the train track was behind our back fence. We got used to it, and our young son Ron loved to stand at the fence and wave to the train engineer, like the book he had read to him: “The Red Caboose”. He wore a cowboy hat, a fireman’s hat, and played with a black and white panda toy, which was bigger than he was.
We moved to a home in Fiesta Gardens, San Mateo. Some of our Jewish friends lived there. We lived on a block with little traffic, so the many young children there went from house to house playing together. There was a community swimming pool, good for Ron and Diane.
Our daughter Diane was born in 1955 at the hospital in Burlingame. One day, after dropping Ron and Diane at Sunday school at Beth Jacob, driving home on the Alameda, I saw a sign “new homes”, and I went to see a street of new homes on Hewitt Drive in San Carlos. I looked at one I liked, went there again with Carolynn, and we bought it from builder Hansen, who was the son of a builder my father had known in S.F.
I moved my office, renting a one-story building on San Mateo Drive, which was a medical-dental area, with good neighbors for professional optometry. The manager of the Bank of America on Third Avenue, who managed my leased office for his niece, one day told me she had to sell the property. I negotiated with her son, an attorney, with advisers, and successfully bought the building.
When I began private practice in 1955, optometry was at a serious disadvantage to ophthalmology, because optometrists had no way to measure intraocular pressure for glaucoma detection without anesthesia. They relied on visual fields performed manually using a tangent screen. In 1959, Dr. Elwin Marg at UC in Berkeley invented and introduced the Mackay-Marg tonometer, which was a significant advancement for optometry. Rapidly, it was used by optometrists for glaucoma detection, without anesthetic eyedrops. Later, the air-puff tonometer was introduced, also used without an anesthetic.
My education at the UC School of Optometry had the main emphasis on refraction, both theory and practice. There were many textbooks, but the bible was “Clinical Refraction” by Irwin Borish. We studied optics, ray tracing through lenses, aberrations, aniseikonia, low vision, and visual training. There was also education in the detection of eye diseases, visual field testing, anatomy, and physiology. I was especially interested in fitting contact lenses, as explained in another page on this website titled Contact Lens History.
An eye examination began with retinoscopy. The optometrist used an instrument in hand, which shone a light into the eye, and, watching a shadow at the iris, viewing through lenses, estimated the refractive error to be corrected. Later, this was replaced by an automatic instrument, which the patient looked into, which did the same thing. Similarly, an optometrist placed glasses in an instrument and manually read the Rx. Later, this was done by placing eyeglasses in an instrument that read the Rx automatically.
I had an assistant to help me including frame selection. In time, assistants did more services, using the automatic instruments. When I did an eye examination, I spent about 45 minutes, but now the optometrist sees the patient for a much shorter time, due to automatic instruments and the services of an optometric assistant. This trend is also true of medical care.
Another change was when I started practicing, optometrists used no drugs. This changed when the legislature approved an increased scope of practice of optometry, as explained in a page on this website titled Organized Optometry.
I loved practicing optometry from the start and throughout my 40-year career. I took that for granted, thinking everybody liked their work, which I learned was not so. Michael Harris told the students he taught, “You’ll be happy in your career if you do what you love, and love what you do”. Every patient had different eyes and vision, and most had a problem to solve. It was like solving a puzzle. Optometry was as enjoyable as a hobby would be. That was especially so for contact lens wearers, as there was continuous improvement in lens design and fitting techniques, which made it very interesting and satisfying.