Dr. Feulner is the Founder, President, and CEO of Advanced Eye Care & Aesthetics in Bel Air, Maryland.
Please share with us your background.
The youngest of three children, I was born and raised outside of Philadelphia by parents who were academically driven and culturally well-rounded. My father was an architect, and my mother was a clinical social worker. Both of my parents were affected by World War II; my father fought on D-Day and in the Battle of the Bulge, and my mother was evacuated from England to live with a foster family in Canada during the war. As a result, they had children later in life (my father was 43 when I was born). These experiences heavily influenced my upbringing. My mother worked full time when most women stayed at home with their children. We didn’t have a lot of “things,” and we were only allowed to watch TV (Jacques Cousteau and PBS exclusively) for 30 minutes on Sundays. Instead, we were encouraged to read, play outside, and be creative. Family time was filled with shared athletic interests, visits to the symphony and art museums, and travel. Although this lifestyle felt strange compared to my friends’, I realized in retrospect how extraordinarily fortunate I was to have such incredible role models as parents.
Once during my allotted TV time, I watched a PBS program about how memory is retrieved by the brain. Around the same time, my sixth-grade science teacher assigned a project on the human body systems. Between the PBS program and my subsequent report on the nervous system, I discovered at 12 years old what I wanted to do with my life: I wanted to study the brain—more specifically, memory. From that point on, my future was focused on achieving this goal.
I obtained my bachelor’s degree in biochemistry from Case Western Reserve University, with a research focus on molecular biology. After graduation, I spent a year doing research at Temple University School of Medicine to determine if a research career was right for me. Ultimately, I decided to apply to medical schools as an MD-PhD candidate. I was accepted to the Medical Scientist Training Program at the University of Rochester School of Medicine and Dentistry, where, 9 years later, I received my MD and PhD degrees. My PhD is in neurobiology and anatomy, and my thesis focused on a model of alternative splicing of the amyloid precursor protein gene, which plays a role in the pathogenesis of Alzheimer disease. My dream of studying the brain and memory was fulfilled, but as a medical student I was faced with a choice of what to do next.
I learned early in medical school that I love surgery, and my basic science lab work emphasized how much I enjoy working with my hands and with innovation and technology. Although interesting, neurology didn’t align with what I needed in my career. Neurosurgery residency is grueling, and at the time there were very few women neurosurgeons. By the time I finished medical school, I was much older than my peers, was married, and knew I wanted a family. At 32, I already felt like I, as a woman, had been fighting to be accepted, taken seriously, and respected for my intelligence and skills. A career in neurosurgery seemed like an uphill battle that would be hard on my spouse and limit my ability to have a family. My cousin, Norman Schatz, MD, was a neuro-ophthalmologist at Bascom Palmer Eye Institute. I shadowed his clinic for a month, and I spent all my elective time in the ophthalmology department at the University of Rochester. Ophthalmology was an instant fit for me, and I felt that it would always keep me connected to my passion for neuroscience. I loved everything about the field, and I still do today.
I completed my ophthalmology residency at the University of Minnesota School of Medicine, and I finished with an incredibly strong foundation in cataract, cornea, and anterior segment under the tutelage of legends such as Jay Krachmer, MD; Donald Doughman, MD; Edward Holland, MD; Richard Lindstrom, MD; and David Hardten, MD. I always thought I would stay in academia; however, I saw the few female academic ophthalmologists I knew leaving their institutions for private practice. Balancing the burdens of academic research, resident education, patient care, and family duties was overwhelming for many. I had my first child when I was a resident, and at 36 I realized I could never wear all those hats successfully. Although I had considered pursuing a cornea fellowship, I decided to move back east after residency to be closer to family and to continue to grow my own.
My first job was in a large multispecialty practice in Baltimore. Although my surgical volume was significant, I felt like I had possibly chosen the wrong career. I was seeing more than 60 patients per day, didn’t feel like I had relationships with my patients, and sometimes didn’t even know the name of the person on whom I was operating. After 15 months, I left and joined a much smaller solo practice that was a better fit for me. Unfortunately, the commute was more than 1 hour each way, and my time spent away from home was stressful on my family.
Almost 3 years later, in November 2003, I opened my own practice closer to home with one employee. My first office was a space-sharing arrangement with three optometrists. It worked well, as I referred all vision, contact lens, and optical patients to them, and they referred all medical and surgical patients to me. I initially incorporated aesthetic procedures such as Botox (Allergan), skin care, and dermal fillers to supplement my income while building my practice. I grew the practice by speaking locally and visiting and developing relationships with every optometrist, urgent care, and primary care practice in my county. I made sure they all had a steady supply of referral pads and received letters every time I saw one of their patients. I think the most valuable thing I did was to never say no to a referral, no matter the time or day. I made myself the “easy button” for all referring doctors. In 2006, we moved together to a larger office, and in 2011 I bought the optometry practice. By 2017, the ophthalmology and aesthetics practices were so large (at 30 employees) that we moved into a bigger, state-of-the-art office designed to be eco-friendly, highly efficient, and technologically advanced.
As my children have gotten older, I have become more involved in conducting clinical research, speaking and teaching nationally, and participating in clinical trials. I am one of the original members and a 2-year board member of CEDARS/ASPENS, a not-for-profit society of anterior segment surgeon educators whose mission is to expand the knowledge of ophthalmic surgery and foster excellence in patient care through clinical experience, peer-to-peer exchange, and practice education. In partnership with the medical community, CEDARS/ASPENS defines and shapes the future of corneal, cataract, and refractive management through innovation, collaboration, and education.
Outside of medicine, I enjoy spending time with my family, hiking, traveling, gardening, and volunteering in my community. Since 2010, I have been on the board of The Boys and Girls Clubs in my county. The Clubs inspire all young people, especially those who need support most, to become productive, responsible, and caring citizens and thriving members of their communities by providing them with opportunities for achievement. I believe that this is how we can change the world, one child at a time.
In 2018, I received the Athena Leadership Award, which honors individuals who achieve the highest level of professional excellence, contribute time and energy to improving the quality of life of others in the community, and actively assist others—particularly women—in realizing their full leadership potential. Being a mentor for women of all ages and career stages is vital to me. I didn’t have many female mentors in my career, so making the path easier for others will always be a priority for me.
How would you describe your leadership style?
I am not a micromanager, and I choose not to have my hands in everything that happens in the office. Instead, I surround myself with people who are more knowledgeable about their jobs than I am. We convene for regular meetings so that I can hear about what is happening in various departments, but I do not feel the need to be a part of all day-to-day decisions and happenings.
Instead, I prioritize a clear chain of command. Each department has a supervisor, who reports to the operations manager and practice manager. Ultimately, the buck stops with me, but for the most part employees bring any issues to their direct supervisors. I also make it a point to never undermine our supervisors. Just recently, a few patients canceled their appointments, and my surgical coordinator asked if I wanted to bump up the remaining appointments and finish the day early. Although I certainly wanted to do so, I told her that she needed to run the decision by our tech supervisor. It is important to me to empower my employees and show them that each person and each of their tasks are valuable.
With new employees, I aim to check in constantly. Whether in the hallway or the break room, I’ll stop to ask, “How’s it going? Do you feel like you’re learning everything you need to learn?” I recently checked in with one of our technicians and, by doing so, learned that he felt like he was struggling with Goldmann applanation tonometry. The next day, I went over some tips and tricks with him. It took 5 minutes of my time, but the experience empowered him to speak up and improve upon a skill.
What has your experience been collaborating with industry?
Working with industry through research, advisory boards, and speaking engagements has been incredibly fulfilling. I have had the opportunity to partner with both small and large companies, participate as a medical monitor for several clinical trials, conduct clinical research and beta-testing of preclinical technology, be involved in several product launches, and speak nationwide. In addition to being intellectually stimulating, these collaborations have enabled me to form lifelong friends in the industry who have enriched my life personally and professionally.
In your opinion, how is the role of women in ophthalmology evolving?
This is a time when women in ophthalmology are being not just recognized but sought out for leadership roles, research opportunities, speaking engagements, advisory board memberships, and positions on the podium. When I trained, there weren’t many women role models. After training, my first true role model and dear friend was Sheri Rowen, MD. She, along with other female greats, have paved the way for my generation, as we continue to pave the way for the next.
What hurdles do you feel women in health care still face?
Despite the growing number of women in medicine, there are still fewer women than men in all positions of leadership. Although the situation is improving, one only needs to attend a meeting or open a journal to see the disparities, with considerably fewer women on the podiums and editorial boards. It is also well documented that women continue to be compensated less than their male peers. It is encouraging that there are strong women and women’s groups who continue to push forward and fight these battles.
Another hurdle that will always exist is the challenge women face balancing their family and professional lives. I made a personal choice to take a different road in my career that allowed me to focus more on my family while my children were young. Going into private practice instead of academia and moving my job closer to my home, my children’s schools, and even the pediatrician shortened my commute, reduced stress, and gave me more time with my family. My husband has been my greatest support. Having a partner who supports your career, helps raise the children, and cares for the home equally makes finding work-life balance easier.
What advice can you offer to young female ophthalmologists who are still in training or just beginning their careers?
The most valuable point of advice I can give is to develop a support system. Start by finding the right partner and/or surrounding yourself with true friends, and establish a group of trustworthy, reliable colleagues. Life is challenging, relationships are challenging, family is challenging, and work is challenging. It is important to have people in your life who are reliable, who make you laugh, who are honest when necessary, and who pick you up when you’re down.
Furthermore, seek out every opportunity to develop relationships with mentors who can guide you and connect you with the resources you need to grow professionally. Get involved with groups like MillennialEYE, YoungMD Connect, AAO’s Young Ophthalmologists (YO) Committee, and ASCRS’ Young Eye Surgeons (YES). Attend meetings small and large. If you’re interested in working with industry, use these opportunities to make connections. If you want to speak, do research, or write, don’t be shy—speak up, ask questions, and ask for help. If you are deciding whether to do a fellowship, stay in academia, or join a private solo or group practice, participating in these groups and meetings can introduce you to people who can advise you and help you achieve your goals.
Finally, take time for yourself. Figure out what you need to maintain balance and happiness in your life. Carve out time from training, work, or family responsibilities to practice self-care. Make it a part of your everyday life, not an exception to the rule.
Can you propose a unique or creative idea that may help women in ophthalmic practices?
Discover your niche. Find something unique that you can bring to your practice setting that no one else does or that needs to be developed, and then become the best at it. Develop a business plan for your idea, meet with the administrators or partners who are involved in the decision-making, and, most of all, follow through. Once you have established this initiative, make a plan to bring another innovative idea, service, or technology to the practice in 6 months, in 1 year, or in another longer interval. Never stop learning and educating those around you to build and expand your position within your work environment and beyond.
- Talley Rostov A, Banitt M, Feulner L, Woodard L. Dense glistenings. Cataract & Refractive Surgery Today. July 2021. https://crstoday.com/articles/july-2021/dense-glistenings/
- Feulner L. Staff retention and turnover. Cataract & Refractive Surgery Today. June 2021. https://crstoday.com/articles/2021-june/staff-retention-and-turnover/
- Feulner L. Intracameral medications for cataract surgery. Focal Points: Clinical Practice Perspectives. 2018;XXXVI(9).
- Feulner L. OPD-Scan III: the best toy—make that tool—for the job. Ophthalmology Management. March 2017.
- Feulner L. Questions abound when faced with the issue of genetic testing. Ocular Surgery News. January 25, 2016.
- Fisher LJ, Jinnah HA, Kale LC, Higgins GA, Gage FH. Survival and function of intrastriatally grafted primary fibroblasts genetically modified to produce L-dopa. Neuron. 1991;6:371-380.
HONORS & AWARDS
- Athena Leadership Award | 2018
- Harford Award, Harford County Chamber of Commerce | 2017
- OSN Premier Surgeon 300 Innovators in Refractive Cataract Surgery | 2016, 2017, 2018
- Philanthropic Company of the Year Award | 2016
- SmartCEO Brava Award | 2015
- Doctors of Distinction, Harford County I-95 Magazine | 2015
- Harford’s Best: Advanced Eye Care | 2012, 2013
- Influential Women of Harford County, Harford Magazine | 2009
- Janet M. Glasgow Memorial Achievement Citation, American Medical Women’s Association
- Montgomery County Medical Society Scholarship
- Cum Laude, Case Western Reserve University
- Departmental Honors, Biochemistry, Case Western Reserve University
- Dean’s List, Case Western Reserve University
- Western Reserve Scholar, Case Western Reserve University
PROFESSIONAL SOCIETY MEMBERSHIPS
- Alpha Omega Alpha Honor Society
- American Academy of Ophthalmology (AAO)
- American Society of Cataract and Refractive Surgery (ASCRS)
- CEDARS/ASPENS, Board of Directors | 2020, 2021
- The Boys and Girls Club of Harford County, Board of Directors, Vice President
- Temple Adas Shalom, Board of Directors
- Maryland Physician Leadership Advisory Board
- The Maryland State Medical Society
- Harford County Medical Society
- Harford County Chamber of Commerce
- Maryland Society of Eye Physicians and Surgeons
- Ophthalmic World Leaders (OWL)
- Women In Ophthalmology (WIO)
- Patient Family Care Advisory Council for The Kaufman Cancer Center
- Women’s Giving Circle of Harford County
- Chesapeake Professional Women’s Network