Power Hour Optometry Podcast Episode: High-Touch vs High-Volume | Two Doctors. Two Philosophies. Two Exceptional Paths to Practice Growth Date: March 27, 2026 Host: Eugene Shotsman (The Power Practice) Guests: Dr. David Moore & Dr. Julia Zaden

Episode Overview

This episode explores two remarkably successful approaches to optometric practice growth, as embodied by Dr. David Moore and Dr. Julia Zaden. While both doctors share a passion for high-quality patient care and cutting-edge technology, their philosophies on scaling, managing staff, and structuring their practice diverge significantly. Through candid discussion, they reveal the real-world challenges, lessons, and rewards of pursuing either a high-volume, systematized model or a high-touch, deeply personalized one.

Key Discussion Points & Insights

1. Backgrounds & Practice Models (02:04–08:13)

• Dr. David Moore:

  • Graduated nearly 20 years ago; founded his first practice in 2007 in a converted dental office.
  • Now owns three practices (one rural, two urban) with a total of three ODs and is seeking a fourth.
  • Practices 40 hours/week and emphasizes scalable systems, standardized care, and middle management.

    "I started three just to kind of go back because I enjoy the process and running a practice, kind of the overarching ideas and themes... but I don't enjoy middle management." (08:13)

• Dr. Julia Zaden:

  • Founded Pine Vision Care 8 years ago in Philadelphia after working in various corporate and medical settings and wanting a non-transactional, patient-specific approach.
  • Grew to two locations (urban and suburban) with four doctors.
  • Focuses on patient pace, deep relationship building, and a high-touch approach.

    "I realized a lot of times patients don't even know how to explain what's going on with their eyes. So you truly need to spend more time and figure it out." (06:02)

2. Patient Care: High-Volume vs High-Touch (08:13–19:24)

• Dr. Moore’s Model:

  • Highly systematized with standardized exam flows and staffing protocols; sees three patients/hour plus one progress visit in each location.
  • Emphasizes teamwork—techs handle pre-testing; focus is on efficiency, consistency, and fostering genuine relationships despite volume.

    "If you want everyone to be offering the highest care, we kind of have to hire that doctor that wants to do that..." (08:13)

  • Uses technology (meibography, Optomap, topography) to streamline exams.

• Dr. Zaden’s Model:

  • Sees only two patients/hour, with doctors doing both pre-testing and exams themselves.
  • Prioritizes unhurried, in-depth conversations to uncover patient needs, personalize solutions, and build trust.

    "Majority of that time is spent with the doctor. There are no techs. I like—we all like—to do our own pre-testing, and that's the time where you start learning about patients’ needs..." (14:23)

  • Strong focus on hiring for personality and weekly team meetings for consistency.

3. Technology as Differentiator (16:18–34:24)

• Both practices utilize advanced digital imaging and integration.
• Dr. Zaden uses technology for patient engagement and trust:

  "When I show the patients their meibomian glands, their eyes in focus and up close, they always [are] wowed by that. They say that they've never seen anything like that before." (16:18)

  • Uses big monitors during appointments for better visualization and patient education.
• Dr. Moore also spotlights technology for differentiation and patient education:

  "If I'm looking at it, I show the patient. So optimap. So what we do—optimap, my biomography, OCT—all of those things are piped into the exam room… That quite honestly, it's an easy differentiator..." (31:24)

4. Treatment Acceptance & Practice Metrics (17:14–24:34)

• Dr. Zaden:
  • "About 80% for contact lenses conversion rates and then the glasses at about 50%. ...The conversion rate for [dry eye and myopia] treatment, it's actually quite high... majority of people are referred." (18:36)
• Dr. Moore:
  • Optical capture rates: rural ~45–50% (60% lenses), city ~60%.
  • Specialty treatment acceptance (dry eye, myopia) about 30%, noting that rural patients are more receptive due to relationships.

  "Our rural practice is far more accepting to the treatment plans that we present just because of the relationship that we have with them." (23:44)

5. Growth Strategies, Expanding Locations, and Hiring (36:15–51:36)

• Dr. Zaden:
  • Added her first OD much earlier than the traditional model—this allowed for rapid growth and a better work-life balance.

  "Not only was the practice was able to survive, but it grew so much. I was like, okay, this is possible." (39:22)

  • Advocates hiring for personality, not just skills, and standardizing tools and protocols.
• Dr. Moore:
  • Follows a more classic model: max out solo capacity, then add associates.
  • Grew from a "low cost startup" to opening a "more high end expensive startup," then acquired/rehabbed a third practice.

  "Once I got into that position and just didn't enjoy that kind of pull between patient care and, and then the day to day management of it, I realized like, okay, I gotta grow." (65:24)

  • Stresses the importance of staff and relationships for patient retention across locations.

6. Equipment Choices and Partnering (51:36–59:15)

• Both doctors emphasize after-purchase support as a key factor in choosing technology vendors.
• Dr. Zaden:

  "It actually how it's been. If I ever have a small malfunction... I can just text them and they text me back within a very short period of time. I think the biggest thing is probably support after the purchase." (52:09)

  • Noted the importance of durability and disaster readiness (flood incident with equipment covers).
• Dr. Moore:
  • Stressed the pitfalls of buying from lesser-known vendors; now only buys from established companies with reliable support.

  "I bought a few pieces of equipment... and that company was not... they just hadn't been around long. And I've never seen the company since... So I think buying from that lesson..." (55:58)

  • Prefers consistency of equipment/brand across locations for workflow and service reasons.

7. Reflections on Entrepreneurship & Philosophical Differences (59:15–End)

• Dr. Zaden:

  • Loves problem-solving, both clinically and as a business owner, and encourages listeners to "fall in love with the process" of owning a practice.
  • Recommends not waiting too long to hire associates to avoid creating patient attachment bottlenecks.

  "If you truly want to own your practice... be prepared to fall in love with the process and fall in love with solving the problems." (60:24)

• Dr. Moore:

  • Recognized his preference for being a CEO/visionary rather than a day-to-day manager; built systems and teams to match.
  • Advises that scaling becomes easier as you move to 3–4+ locations due to economies of scale and delegation.

  "I don't want to manage staff... I want to see patients and I kind of want to have the. I want to be the CEO. And, and so that impetus, once I kind of realized that I wish I would have known that like starting out..." (65:24)

Notable Quotes & Moments

• The Value of Trust and Time

  "You need slow down and dig a little bit deeper to learn what kind of problems patients have and learn about their lifestyle and how they use their eyes."
  — Dr. Julia Zaden (06:02)

• Standardizing Care

  "We try to systematize everything across locations to where all the doctors are functioning in the same way."
  — Dr. David Moore (08:13)

• Patient Engagement through Technology

  "When patients see these things... the trust goes up and the acceptance of the treatment goes up as well."
  — Dr. Julia Zaden (17:34)

• Lesson from Early Growth

  "That was that neuron connection that I made in my brain that never left me. I was like, okay, this is possible. So not only that I was a doctor with my practice—now I became a business owner."
  — Dr. Julia Zaden (39:22)

• Differences in Rural and Urban Practice Acceptance

  "Our rural practice is far more accepting to the treatment plans that we present just because of the relationship that we have with them."
  — Dr. David Moore (23:44)

Key Segments & Timestamps

• Introductions & Early Practice Stories: 02:04–06:45
• Defining Patient Care Philosophy: 06:45–12:28
• Standardizing Care & Flow: 08:13–14:07
• Building Patient Trust & Consistency: 12:28–18:26
• Use of Technology & Patient Engagement: 16:18–34:24
• Specialty Services Growth: 19:31–28:09
• Implementing New Programs & Change Management: 24:34–28:09
• Growth Stories: Hiring, Adding Locations, Lessons Learned: 36:15–51:36
• Equipment Choices & Practice Investments: 51:36–59:15
• Entrepreneurial Reflections & Advice: 59:15–End

Conclusion

This episode provides a unique window into two versions of thriving independent optometric practice—one leveraging high volume and systematization, the other doubling down on patient intimacy and personalization. Both paths succeed by staying true to core values, leveraging technology for better outcomes, and building genuine patient trust. For listeners, the discussion is rich with actionable advice, honest anecdotes, and clear takeaways for anyone interested in owning, growing, or reinventing an optometry business.