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Name:  James L. Fanelli, OD, FAAO

Name of Practice:  Cape Fear Eye Institute ODPA

Type of Practice:  Private, group practice, started in 1985

Location:  Wilmington NC

High School:  Cardinal O’Hara High School, Springfield PA

University:  St. Joseph’s University, Philadelphia PA

Optometry school:  PCO

Family: Wife, Kimberly, Realtor extraordinaire

Children:  Caroline, Grayson, Hannah. All three kids live in Wilmington and are gainfully employed. Very blessed

Interesting facts about me:

Played high school and college ice hockey, still, play in adult leagues. Won (shared) the Vezina Trophy in College hockey during my senior year (lowest goals against in the league) and won the league ECCHA championship in 1981. I went skiing for the first time with college hockey teammates, thinking that if I can skate on a thin blade, snow skiing would be way easier. That first day was a rude awakening.

I have been skiing ever since, with annual trips to Utah, for the past 34 years as part of the EyeSki conference, which I coordinate with Dr. Joe Pizzimenti. Occasionally will hit locales in Colorado and the Dolomite Alps.

From some of my posts on OD’s on Facebook, you know that I enjoy scotch and bourbon, and a good cigar, usually Cuban. A good Italian red is always in the background, most likely a Brunello. And of course, there is the Aperol Spritz….it’s always Spritz-30! There’s a time to work, and a time to play. Finding that life balance is the key.

I enjoy hunting, in particular, upland bird hunting. Also, hunt big game occasionally. My favorite hunts are in Italy, as the driven pheasant hunting there is top-notch, European style hunting, in some of the prettiest places in Italy. Have also hunted wild boar there (a delicacy) and will soon be hunting fallow deer. I enjoy target and sporting clays shooting as well.

Being a hunter, I’ve also become somewhat of a gun collector, and my preferences for shotguns are, naturally, Italian shotguns. Some of the world’s best shotguns are from Italian makers and are works of art. I’ve had the opportunity to have custom shotguns made for me by an Italian manufacturer, and after having visited the facility and the family that runs it, my wife and I have become friends with them. This, in turn, has led to making connections for outfitters in Italy and Europe.

Being a first-generation Italian American, Italy is close to my heart. My parents were born in Italy, and I still have relatives and friends there. My wife and I also have a home in a small hilltop town in eastern Tuscany, which we visit frequently. The love of Italy and all things Italian bring me to Italy 3 or 4 times a year, and we get to spend about 3-4 months there each year, in divided doses.

This brings me to the continuing education programs I run in Italy and Europe…..  Spending so much time each year in Italy has given me insights into Italian and European travel that many folks find beneficial when they take a trip to Europe. What better way to see Europe and Italy than to combine continuing education with a trip of a lifetime? From this idea, the CE in Italy/Europe program was born. Sharing my homeland with others is a passion. We will run meetings in Italy and in desired cities in Europe throughout the year.  From making recommendations for hotels to even what table to sit at in what restaurant, the CE in Italy/Europe program enables the European optometric traveler to relax, see some magnificent sights, and also pick up great, clinically relevant CE. With the help of some dear friends and colleagues who are expert speakers, we bring to OD’s fantastic CE in fantastic locations.

My Mantra:

At this stage of my life, it’s quite simple: Work hard, play hardER!

Professional Practice:

I am passionate about optometry. Not just what the practice of optometry affords me, but also what I can offer optometry. This passion was born while at PCO. During my time at PCO, in the early ’80s, the initial move toward the medical practice of optometry was in full bloom, and I embraced it thoroughly. Not only learning how to diagnose and treat various diseases of the eye germane to optometry, but I was also educated on, for example, how to surgically deal with eyelid issues. The challenge, however, was the fact that at that time, there were only two states where we were actually able to do the things we were taught:  North Carolina and West Virginia. Having grown up in suburban Philadelphia and spending summers at the Jersey shore, and since West Virginia didn’t have any beaches, it was time to move to North Carolina. It was there that I opened a cold start practice, with the goal of practicing at the highest level. With time, and with the good fortune of being able to help many patients with difficult ophthalmic conditions, the practice has mushroomed. For the most part, my practice is limited to glaucoma and optic nerve conditions, retinal disease and acute care and trauma. Cosmetic contact lens fittings and evaluations are things I just don’t do anymore.

In the interest of giving back to the profession, I have taken on the role of teaching externs from several schools of optometry exactly what optometry can be and what optometrists can and should be doing. My site is known as an exceedingly difficult site for externs, but that is because I am passionate about what optometry should be doing. I am concerned that there is a detect and refer mentality overtaking the profession, and that is a bad thing, short term, and long term. I require my interns to stay at the location for 6 months, and during that time they are exposed to a huge variety of conditions that are amenable to truly integrative care with other health care providers. Having the reputation of being a tough educator is OK with me. Not practicing in an academic setting puts the onus squarely on the shoulders of the providers insofar caring for the patient. One can have a very productive and fiscally healthy practice without depending on material sales if one truly embraces integrative care. 

Most Rewarding and Least Rewarding Aspects of Practice:

By far, taking care of patients is the most rewarding part of the practice. And anything that gets in the way of taking care of patients quickly becomes the least rewarding aspect of practice; leading the list is government and 3rd party intrusion of the doctor-patient relationship.

My Advice for New Practitioners:

Don’t take the easy route. You’ve invested hugely in time and money to get your education. And I fully understand that chances are high that you have a significant debt to service. Push yourself. Don’t take the easy route. Treat that cornea that makes you a bit anxious; once you’ve successfully done that several times, that condition becomes ‘every day’. Then treat the next one that increases your anxiety…staying up at night and seeing the improvement of the patient the next day makes you a better clinician.

As you are in practice longer, you’ll naturally tend to begin to take it easier. But if you start out of the starting gate taking the easy route, you’ve created the perfect recipe for mediocrity. Don’t be that guy or that gal.

James Fanelli, OD, FAAO
Associate Editor, Systemic Disease for odsonfb.com. Dr. Fanelli has over 25 years of experience in the fields of glaucoma and ocular disease. He has lectured to his colleagues around the world and has published countless articles in educational magazines. Dr. Fanelli was presented with the prestigious John D. Robinson Clinical Excellence Award, one of the highest honors given by the North Carolina State Optometric Society.

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