Transcript

Dr. Mile Brujek (0:00)

This next statement that I'm going to tell you changed everything. She looked at me and she said, did my new glasses cause dry eye? And when she said that, I realized I had to change everything in terms.

Dr. Mile Brujek (0:13)

Of the way I was doing it.

Dr. Mile Brujek (0:15)

She thought that I did something wrong with the glasses. And now she's thinking that her glasses.

Dr. Mile Brujek (0:20)

Caused the dry eye that I'm not finding at the second visit.

Dr. Mile Brujek (0:24)

So in an attempt to identify these.

Dr. Mile Brujek (0:26)

Patients before they got glasses just started staining everybody. And what we saw was tremendous.

Eugene Shotsman (0:41)

I'm your host, Eugene Shotsman, and today we're talking about something that a lot of practices get wrong, bringing new technology into the office. My guest is Dr. Mile Brujek, a name that many of you know from podium and from journals. And what I love about Mile is that he doesn't really chase shiny objects. He has a very intentional way of deciding, deciding what technologies and treatments actually belong in this practice, when to bring them in, and how to make sure they don't end up as very expensive dust collectors. So in this episode, we unpack Melee's framework for turning technology into real patient care upgrades and also real profit centers. And then we get into some really practical, I guess I'll call them Melee nuggets. These little things that he does and says that lead to consistently high treatment acceptance rates, like in his treatment of dry eye and scleral lens acceptance rates. And then we zoom out to some of the biggest mistakes that practices make when they buy equipment and also how you can avoid them. So this episode's got no hype, no gadget talk, no sponsored content. Just as a much smarter way to think about technology, patient care, and growth. What I really loved about this conversation is that Milei brings more than just 20 years of experience, but he also has a ton of real world, here's what I learned the hard way type of insight. So if you listen closely and it pick up a lot. And before we jump in, quick reminder, if you have an episode idea, a question, you want to work with us, or if you want to share what's working in your practice, you can always reach out to me@eugene shotsman.com or at the Power Hour website. I do read every single message and respond. And I want to make sure that you're subscribed on YouTube, Spotify and Apple podcasts. So whenever, wherever you listen, you'll know when a new episode drops. All right, let's get into it. Here's my conversation with Dr. Mile Brugic Mile. Welcome to the Power Hour. Excited to have you on the show.

Summary

Podcast Summary: Power Hour Optometry

Episode Title

Why Diagnostic Tools Go Unused — and How to Make Them An Asset to Your Practice
Guest: Dr. Mile Brujic
Host: Eugene Shatsman
Date: December 19, 2025

Episode Overview

This episode dives deep into a persistent challenge in optometry: Many diagnostic and therapeutic technologies, despite their promise, often remain underutilized—or even unused—after being purchased by practices. Host Eugene Shatsman welcomes Dr. Mile Brujic, a leading clinician and educator, to discuss the smart, patient-centered framework for incorporating new technologies to improve both patient care and practice profitability. Dr. Brujic provides practical strategies, communication tips, and actionable insights drawn from over two decades of real-world experience.

Key Discussion Points & Insights

1. The Right Approach to Adopting New Technology

Start from Patient Needs, Not Shiny Objects
- Dr. Brujic emphasizes the critical mistake many make: buying technology first, and only then figuring out how to use it. Instead, identify true gaps in patient care and seek technology to fill them.
- Quote:
  "What technologies actually do is they fill gaps. So as we care for patients, constantly I'm looking...for those technologies that'll fill gaps." — Dr. Brujic (04:03)
Beware of Sales Hype
- Sales teams often pitch technology as a path to 'center of excellence' status—but unless it fits a clinical need, it risks becoming a costly "dust collector."
- Quote:
  "We oftentimes look at it in the exact opposite direction. We're looking at it and saying, all right, here's the piece of technology. Now bring this in. Now let's start using it. When that's the exact opposite way that we should be looking at this." — Dr. Brujic (04:27)

2. Real-World Technology Integration — Case Study: IPL for Dry Eye

Identifying the Care Gap
- Dr. Brujic shares his decade-long journey exploring dry eye and the role of facial rosacea, leading him to question traditional pharmaceutical management and eventually adopt IPL (Intense Pulsed Light) therapy.
- Critical insight: Observing patient populations, especially masked signs like makeup concealing rosacea, can reveal unmet needs.
Stepwise Adoption: Risk Mitigation
- He started with low-level light therapy for experience, then brought in IPL when patient demand and clinical evidence justified it.
Effective Communication Drives Utilization and Acceptance
- Patients respond when you explain technology as a solution to their specific problem, not just as an 'offered service'.
- Quote:
  "I'm filling a true gap with patients. And patients feel that, patients know that." — Dr. Brujic (11:56)
Persistence and Documentation
- Every recommendation is documented, and treatments are discussed at each follow-up.
- Quote:
  "It's always documented. And every single time I see that patient for a follow up, guess what the discussion is. Remember last time we talked about this procedure?" — Dr. Brujic (12:17)
High Treatment Acceptance Rates
- IPL recommendations see 60–70% initial acceptance, with many more patients opting in at follow-up.
- Quote:
  "It's high. So it's 60 to 70% of patients say, yep, I'll do it." — Dr. Brujic (16:15)

3. Patient-Focused Communication (Cost and Clinical)

Transparency Builds Trust
- Clinicians should not shy away from discussing cost—they should initiate the conversation to avoid patient distrust and increase acceptance.
- Quote:
  "We in the exam room need to give our patients some level of perspective on what they're going into...we always talk about cost." — Dr. Brujic (17:06)
- Memorable Moment: Eugene shares a negative example where clinician avoidance of cost discussion eroded patient trust and lost a sale. (19:10)
Provide Options & Be Binary
- Clearly present options, pros/cons, and pricing to empower patient choice and simplify acceptance tracking.

4. Underutilized Technologies: Scleral Lenses & Imaging

OCT in Scleral Lens Fitting
- Despite availability, many don't use anterior segment OCT for every scleral lens patient at every encounter—a missed opportunity for both clinical outcomes and revenue.
- Quote:
  "The OCT for scleral lenses is probably one of the most underutilized technologies that I've seen...when it comes to what can we do to make outcomes better for these patients." — Dr. Brujic (26:42)
Diagnosis Drives Opportunity
- Take a proactive approach with conditions like keratoconus and EBMD—don't wait for 'end-stage' before using fitting and imaging technologies.
- Practical Tip: Use fluorescein and imaging on all appropriate candidates and leverage easy, repeatable workflows for staff.

5. Billing and Practice Management Pearls

Know Your Payers
- Vision and medical plans have different rules—know them, communicate clearly, document everything.
Prompt Pay Discount
- Offer a transparent, policy-wide 20% prompt-pay discount for cash patients (without ever framing it as an 'insurance discount').

6. Top Mistakes in Technology Purchases (Rapid Fire)

[37:36 – 43:38]

Mistake 1: Restricting Use to Only Advanced Cases
- E.g., Only running diagnostics on severe cases, not building it into routine flow.
- Fix: Integrate into pre-test protocols; review schedules with technicians each morning.
Mistake 2: Inadequate Communication Planning
- Fumbling through explanations when tech is new; overexplaining or spending too long.
- Fix: Pre-plan & rehearse your "script" for patient conversations.
- Quote:
  "Make sure you're coordinating your conversation around the technology. Before you get the technology, figure out what you're actually going to be...Otherwise you're going to learn it on the spot and you're going to stumble." — Dr. Brujic (39:57)
Mistake 3: Overestimating Usage and ROI
- Don’t get swept up by shiny new tech at expos or from peer pressure.
- Fix: Underestimate early usage to set realistic expectations and avoid disappointment or wasted expenditure.

7. Team Buy-In & Change Management

Limit Big Initiatives
- Focus on one practice-wide initiative per quarter to avoid staff burnout and boost successful adoption.
- Quote:
  "You can only put so many things on that plate in a day...with new mental effort, they become habit. And when they become habit, they take up less of that plate." — Dr. Brujic (47:12)

8. Leadership & Prioritization Wisdom

Prioritize, Don’t Just Say 'No Time'
- A key lesson from Dr. Brujic’s mentor: Saying "I don’t have time" is dishonest—say it's a lower priority and know your top priorities.
- Quote:
  "Tell me that whatever I'm presenting to you is lower on your priority list and let me know where it is...otherwise not having time is the worst excuse you could give somebody." — Dr. Brujic (49:36)

Notable Quotes & Memorable Moments

On Integrating New Tech:
"I didn't take it from here's capital investment that's going to turn me into a dry eye expert... I've actually created this advanced dry eye practice where we're helping a lot of these patients." — Dr. Brujic (12:51)
On Scleral Lenses as a Growth Area:
"Don’t wait till the end to consider scleral lenses. Start moving it closer to the beginning." — Dr. Brujic (32:05)
On Practice Philosophy:
"Do what's in the best interest of the patient. It's in the best interest of the practice." — Dr. Brujic (33:01)
On Staff Engagement:
"If you’re trying to do six of those in a quarter...the staff are just hoping this is another shower thought that the doctor had." — Eugene Shatsman (47:01)

Timestamps for Key Segments

04:03 – Dr. Brujic on filling care gaps with technology
08:30 – 12:29 – Case study: IPL for dry eye (clinical insight, workflow, and communication)
16:15 – High treatment acceptance rates for IPL
17:06 – 19:10 – On cost transparency & avoiding trust erosion
25:22 – 26:59 – Underutilized diagnostic workflow for ocular surface disease & specialty lenses
37:36 – 43:38 – Rapid fire: Top mistakes with practice technology adoption
47:01 – 47:57 – Quarterly "one major initiative" advice
49:36 – Prioritization wisdom from practice mentor

Practical Takeaways

Systematize Diagnostic Use: Integrate advanced imaging and diagnostics into pre-tests, not just advanced cases.
Rehearse Patient Communication: Prepare concise, confident patient explanations for any new tool or service—record yourself if needed.
Prioritize Patient-Centric Investment: Match every technology purchase to an existing, repeat clinical need.
Be Upfront About Cost: Clinicians should initiate cost discussions and present clear options.
Cultivate a Deliberate Change Culture: Implement only one major initiative per quarter and involve the whole team in the rollout.

Resources and Additional Learning

Close – Collaborative Learning of the Ocular Surface Education:
Year-long clinical education program for developing dry eye practices (in partnership with Woo U and Optometric Insights).
Scleral Consultative Institute:
Weekend, hands-on training in Nashville, focusing on scleral lens fitting, billing, and practice integration.

Contact information and links provided in the episode description.

Host's Note:
This episode is packed with practical, no-hype guidance for clinicians who want to turn technology into a true asset—improving care, boosting revenue, and avoiding common traps. Dr. Brujic’s “Melee nuggets” of communication and workflow wisdom are worth revisiting and sharing with your entire team.

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Why Diagnostic Tools Go Unused — and How to Make Them An Asset to your Practice with Dr. Mile Brujic