O.D. Scene

THE ENTERTAINING SIDE OF OPTOMETRY

O.D. Scene creator, writer and editor Jack Schaeffer, O.D.

This month, I speak with three key optometric leaders who use their versatile skills to further the profession. They are Mile Brujic, Art Epstein and David L. Kading.

Drs. Brujic and Kading are “up-and-comers,” with an insatiable passion for optometry, while Dr. Epstein is a seasoned O.D. whose fervor for the profession is well known. These optometrists employ their vast knowledge to teach the latest in diagnostic and treatment modalities from the podium, advise the profession’s industry partners on the needs of our patients and practices and are active in several research endeavors.

Here, they discuss CE, today’s optometry students, comanagement, their predictions for the future of the profession and some personal tidbits, such as their mentors.

Key Optometric Leaders Weigh in...

Mile Bruijic, O.D., Bowling Green, Ohio; Art Epstein, O.D., F.A.A.O, F.A.B.C.O., F.B.C.L.A., D.P.N.A.P., Phoenix; and David L. Kading, O.D., Kirkland, Wash.

Q: Can you describe your practice?

MB: I am a partner of Premier Vision Group, which is a three-location optometric practice in Northwest, Ohio. I practice with Drs. John Archer, Cheryl Archer, Christa Heckman and Brian Dietz. We practice full-scope optometry and embrace technological advancements that improve patient care. I have a particular interest in anterior segment disease and specialty contact lenses.

AE: I practice with my wife, Dr. Shannon Steinhauser. We built the practice from the ground up as a high-tech dream practice. It’s located in North Phoenix in a busy medical building on a hospital campus. My primary focus is ocular surface disease. Shannon focuses on retina and glaucoma.

DK: My wife, Dr. Kristi Kading, and I own two Vision Source practices in Seattle, Wash. She sees neuro-ophthalmic, binocular vision and pediatric patients. I focus on primary care about 40% of the time and then dry eye, anterior segment disease, specialty contact lenses and our research center, which focuses on the same specialties.

Q: What have you seen change through the last five years in the professional acumen of your CE audiences?

MB: An increasing knowledge base and a higher level of patient care. With all the new advancements in technology, it is important to discuss how to incorporate those technologies into clinical practice. Audiences are incorporating these changes at a remarkable pace.

Dr. Kading and family.

AE: I’ve seen a steady improvement in the base knowledge and comfort with complex topics across the board. You would expect this with our younger colleagues. But, as I see it, the entire profession has remained engaged and interested in expanding their knowledge.

DK: Differentiation. I love it when our audience wants to CRUSH IT in their practice. I love it when they look at new ways to bring in technology and treatments to fix old problems in new ways. I love it when they are looking for the long-term solution. I am so proud of optometry when the questions from the audience center around how much they care about their patients.

Q: How do you see doctors getting CE in the future?

MB: There are definite benefits to large-meeting CE because of the interaction with the educator, the camaraderie with other optometrists and the sharing of ideas with other colleagues. For these reasons, large O.D. meetings will continue to thrive as a primary source of obtaining education for years to come. Saying that, online, interactive CE is increasing and will be a larger part of CE.

AE: I think we will see increased online CE. But in a profession that lacks hospital-based grand rounds and other programs that also bond practitioners socially, state and large national meetings will always be a part of the optometric landscape.

DK: Future CE will revolve around technology. In 10 years, we won’t need computer projection screens. Rather, I will link my lecture to your device (electronic contact lenses, video display glasses — or if you are low tech — your mobile device). You will be able to interact with my presentation so that your learning will be individualized. The point of the meetings will be collaboration and connection.

Dr. Brujic and wife Sonia.

Drs. Brujic and Kading on a trip to Alaska.

Q: Where do you get your CE credits?

MB: Most I get at meetings where I lecture.

AE: I am so busy speaking and doing other profession-related things at large meetings, that most of my CE is from our exceptional state meetings.

DK: I get my CE a little at a time as I travel the country lecturing. Also, I like state meetings for my CE, as they are intimate.

Q: Where was your favorite lecture and why?

MB: Several years ago, I was invited to speak at the Asian Cornea & Contact Lens Conference. It was on the island of Boracay in the Philippines. Dr. Epstein gave a lecture on ocular surface disease that, even to this day, was the most insightful discussion on the topic I have ever heard.

AE: It was at Vision Expo West probably 10 years ago. I was speaking with Mike DePaolis, O.D., and the humongous room was packed. We made it through about three slides before the questions started and continued unabated for the next two hours. It was the most amazing interactive, fun lecture I’ve ever done.

DK: Lecturing on a 360° stage at the Dutch Contact Lens Congress, the time I spoke in a suite at a professional baseball game and anytime I am at a school and the students ask tons of questions.

Q: Through your lectures, you meet a lot of students. What do you see as the future for the optometry student?

MB: A bright future with continued support from organized optometry to help create an infrastructure supporting professional growth.

AE: Whatever they make it.

DK: The students we encounter are hungry. They recognize that it is the job of our fantastic optometric educational institutions to give them the nuts and bolts. In the last five years, many of the schools have developed a private practice club. These have been instrumental in helping to keep the ball rolling.

Q: Do you think participating in a residency is important?

MB: I see this as being increasingly important. I was not residency trained and in looking back on my career, it is the one thing that I wish I would have pursued, given all the medical eye care optometrists are doing today.

AE: I see residency training as invaluable. When we look to add an associate, residency training will be a major factor.

DK: For optometrists who want to take themselves to another level faster, optometric residencies are a must. My residency catapulted me 10 years ahead in my knowledge and skill.

Q: What kind of advice do you have for students regarding purchasing or joining a private practice?

MB: I would recommend two things: 1) Decide the geographical area you want to practice in, and 2) make as many phone calls to private practitioners in the area as possible. This will give them a sense of the market place and any opportunities that may exist.

One of Dr. Epstein’s cars. Check out the license plate!

AE: I would recommend turning to some of our excellent practice management consultants for advice. They can be of tremendous help. Also, I suggest that students look for an established and successful practice, make sure they feel they fit and join as an associate. If it works, they can buy in and help expand the practice. If not, they’ve lost little.

DK: Mile and I have a company around this very thing. It’s called Optometric Insights, and it focuses on escalating and inspiring success in emerging practitioners. We are actually writing a book on this very topic. Look for it later this year.

Q: Cataract surgery comanagement is at the forefront of practice today. How do you feel optometry should expand this?

MB: Understanding the patient’s journey through the process of cataract progression and cataract surgery, including postoperative care, is something we need to be more cognizant about. I truly view optometry as being at the center of patient care in the cataract patient with the ophthalmologist providing the surgery, similar to the way a cardiologist and cardiac surgeon care for patients.

AE: Find a surgeon you can work with, a technology you believe in, and make sure you are involved in this critical aspect of patient care.

Drs. Bruijic and Kading looking dapper.

DK: My head has been in the sand. It wasn’t until recently that I realized how poor we are as a profession with comanagement. Somewhere around 40% of optometrist are active comanagers. I am fortunate in Seattle to have a very optometrist-friendly referral center. We co-refer each other patients. I refer them surgery patients, and I get specialty patients referred to me. Comanagement is crucial to keeping our patients. A good referral center will send your patients back to you; find one, and keep your patients.

Q: According to ASCO, almost 65% of the student body in optometry schools is female. What is your advice for this powerful demographic post-graduation?

MB: Make sure to be involved in organized optometry. This is the legislative key that continues to help move the profession forward. Also, find a mentor to help provide some guidance, and look for leadership opportunities in the profession. Find what you are most passionate about, and get involved.

AE: Get residency training to increase your value to a practice.

DK: I am so excited for the female growth of our profession. My favorite optometrist on the planet is a female (my wife). As Mile and I encounter student doctors (as interns in the office or through workshops at schools), we see a trend that the caring side of them is stronger than it is in us males. This is awesome for patients. But we have also seen a general trend in the females that we encounter, that fewer of them desire to own a solo practice. Rather, more of them desire associate or partnership settings. Our profession just needs to make sure that those opportunities are available to them.

Q: Who is your optometry mentor, and why?

MB: My senior business partner, John Archer. He has provided me with direction and has helped me professionally in a number of ways.

AE: I am blessed to have many. Donald Korb, O.D., Ralph Stone, Ph. D., John Yanni O.D., Jerry Sherman, O.D., Hank Perry, M.D., and Eric Donnenfeld, M.D., all contributed to who I am today. My primary focus has always been clinical and scientific, and each of these extraordinary individuals has generously and patiently shared their knowledge, insight and expertise. Some have been role models like Jerry Sherman. John Yanni inspired my intense interest in ocular allergy. Eric Donnenfeld and Hank Perry are brilliant clinicians and teachers and created incredible opportunities for me. Donald Korb has literally paved the path of my career, and Ralph Stone has been an inspiration, dear friend and teacher as much as he has been a mentor.

DK: Donald Korb, O.D., and Caroline Blackie, O.D. I respect these two because of how they look beyond what is “normal” and attempt to look for what is best for patients. They do this by seeing a problem and then doing research to answer that question. The inventions and mindsets that they have brought into eye care are innovative. They taught me to look beyond and to answer my own questions through literature and research. Pacific University’s Mark Andre and Pat Caroline were instrumental in my understanding of how to approach contact lenses. They revealed the science of contact lenses, not just the art. Additionally, these two, more than anyone else, inspired my speaking career.

The Brujic family.

Q: Who are the members of your family, and what do you like to do for fun?

MB: My wife Sonia and my daughters Zoe (age six) and Ava (age four). I enjoy exercising at least five day a week, playing the guitar and spending time with my family. We love opportunities to do things together!

AE: My wife Shannon, my two daughters Rebecca (33) and Emily (29), our dog Tallulah and cat Hooligan. Bec is a writer, and Em is studying nursing. I usually get to see my daughters when I add a day to a lecture or business trip. For fun, I enjoy spending time and traveling with Shannon, target shooting, landscape photography, playing guitar and going fast in cars.

DK: Dr. Kristi Kading is my wife, business partner and favorite person. I have two daughters Via (Olivia age 3) and El (Elise age 1). I love travelling and going out to dinner with my wife and spending time with the entire family playing and listening to music, working in the garden and hiking.

Q: If you could have dinner with anyone, living or deceased, who would it be and why?

MB: Nikola Tesla. He thought differently than everyone else. He challenged the system and in the end was credited with a number of inventions, including being instrumental to the design of the modern alternating current electrical supply system.

AE: My brother Irwin. He was a brilliant physician, an outdoorsman, a pilot and an amazing brother. He passed away in 2000. I miss him and would just love to see him again.

DK: My deceased grandfather who farmed his whole life. He knew the value of a day’s work and was a man’s man. He knew how to make life complete by valuing family and simplicity.

Dr. Epstein with wife and fellow O.D., Dr. Shannon Steinhauser.

Q: What is your favorite book, movie, band and adult beverage?

MB: Book: “Start With Why”; Movie: Rudy; Band: Pearl Jam; Adult beverage of choice: Crown Royal and Diet Coke with a lime (heavy on the Crown and light on the coke).

AE: Book: “Have Space Suit - Will Travel”; Movie: Groundhog Day; Band: Counting Crows; Adult beverage of choice: Lagavulin neat

DK: Book: I love Bill O’Reilly’s “Killing” series; Movie: The Godfather: Part 2; Band: I like Punk, Ska, Bluegrass, Folk and Rock/Pop.

Q: What is your prediction for the future of the optometric profession?

MB: I think optometry will continue to evolve and be more involved in the medical management of ocular disease. Ophthalmology will continue to become much more focused on surgery. Additionally, pharmaceutical advancements will continue to provide us additional opportunities to better care for our patients. The profession of optometry will continue to be a more integral part of the greater healthcare system.

AE: Optometry has earned its place as the primary provider of eye care in the US. That trend will continue to increase with a greater share of primary care going to optometry, as ophthalmology concentrates on specialty surgical care. I see the eventual convergence of the two professions as likely.

DK: I am excited for our future. I think that we will continue to move medically as Gen X and Baby Boomers age. In fact, I think we’ll have to embrace more medical, especially as ACOs take a larger role in the health care system.