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.