In this episode of Power Hour, host Eugene Shatsman sits down with Dr. Patricia Poma-Nowinski, Owner of Birmingham Vision Care, and KOL for Johnson & Johnson Health and Wellness Solutions Inc.

What makes this conversation critical is her disciplined approach to growth: building one specialty at a time until it becomes a “beautiful beast” that is sustainable on its own.

As Dr. Poma explains, the journey to high profitability involves shifting toward non-doctor-driven revenue and medical-heavy specialties that enhance both patient care and the bottom line.

What a Specialty-Driven Practice Actually Is

At its core, Dr. Poma’s model integrates various “clinics” or pods within a retail setting.

Instead of focusing only on traditional eyewear, the practice offers specialized care factions that meet specific patient needs.

These include:

• Vision Therapy programs with trained therapists
• Dry Eye Aesthetics (IPL, RF, and LLLT)
• Myopia Management clinics
• Specialty Scleral lens fittings
• Nutritional supplements and skincare lines

And unlike standard retail offices, each specialty is managed by a staff “ambassador” who handles education and compliance. As Dr. Poma explains, the objective is to ensure the office remains sustainable and profitable whether the doctor is in the exam room or not.

Why Medical Specialties Beat Standard Retail

Practices have long struggled with vertical integration and online competition that drives down contact lens and frame margins.

However, Dr. Poma has built resilience by “future pacing” patients — screening for conditions like dry eye and presbyopia years before symptoms arise. This proactive medical screening allows the practice to:

• Eliminate low-reimbursing vision plans in favor of medical billing.
• Achieve a 98% daily disposable contact lens rate by emphasizing eye health and hydration.
• Increase patient trust through “root cause” holistic medicine and science-backed testing.
• Capture recurring revenue through in-house supplement subscription programs.

The Math: Achieving Over $1,000 Revenue Per Patient

One of the most eye-opening parts of the conversation is how these specialties stack financially.

In a standard practice, revenue might average $400–$500 per patient. Under Dr. Poma’s model, focusing on chair-time fees for complex fits and high-margin procedures dramatically boosts the average.

The profitability is driven by several factors:

• Charging appropriately for chair time in multifocal and specialty lens fits.
• Dry eye workups that lead to high-value aesthetic and medical procedures.
• Supplement subscriptions that generate passive income four times a year.

Instead of hoping patients return only for a frame refresh, the specialty model ties them to the practice for ongoing care and recurring purchases.

And unlike retail sales, this revenue is built on clinical expertise and long-term relationships.

Once patients are established in a specialty, they are significantly more likely to:

• Follow strict medical compliance
• Use in-office “convenience” options for ordering
• Refer family members to the “innovator” practice
• Maintain loyalty regardless of online price games

What Actually Works: Specialty Ambassadors and Culture

High performance isn’t just about machines; it’s about the people operating them. Patricia discusses how she empowers her staff to lead her specialty clinics.

By creating “ambassadors,” the practice provides expert-level service while freeing the doctor’s time. This turns a job into a career for the team.

Key implementation strategies include:

• Ambassador Program: Assigning a “go-to” expert for Dry Eye, VT, or Myopia to handle deep-dive education.
• Culture First: Hiring for a “Janet Jackson smile” and warm, diverse energy that primes patients to buy.
• Frictionless Onboarding: Using in-house subscriptions and trained checkout staff to make returns and ordering easy.

Dr. Poma also warns against buying equipment without a 90-day plan, urging doctors to shadow experts to avoid making a $200,000 “coat rack” in a closet.

Building a specialty practice is a strategic shift that ensures independence and profitability.

It’s built through intentional systems, strong patient communication, empowered teams, and a willingness to continuously evolve the practice over time.

Eyecare BOSS Live Summit

If you’ve been to conferences before, you’ve probably left with many great ideas and intentions, and then when you get back to your practice, nothing actually changes.

Eyecare BOSS Live is designed specifically with that in mind so you can not only know what to do to reach your goals, but also have the tools, strategies, and plans to implement lasting changes once you’re back. to change that.

This is a 2 and a half-day, invitation-only event (September 16–18 in Cleveland) designed specifically for practice owners who want execution, not just inspiration.

Inside the room:

• 200 growth-focused operators
• Peer-level masterminds
• Real conversations around revenue, staffing, leadership, AI, and specialty growth

And everything is built around one outcome:

You leave with a 90-day plan you can actually implement.

If you want to be considered, click the link below:

• Build Slowly, But Intentionally | Learn why sustainable specialty growth comes from mastering one system before moving to the next.
• Non-Doctor Revenue Matters | Discover how subscriptions, supplements, and team-led systems create recurring revenue beyond chair time.
• Confidence Changes Patient Decisions | See how clear, direct communication improves patient trust and acceptance of recommendations.
• Culture Drives Performance | Understand why patient experience, team energy, and internal ambassadors play a major role in growth.
• Technology Needs a Strategy | Learn why specialty equipment succeeds only when paired with systems, education, and patient demand.

Connect with Dr. Patricia Poma-Nowinski

Dr. Patricia Poma-Nowinski is the Founder and Owner of Birmingham Vision Care, and KOL from Johnson & Johnson Health and Wellness Solutions Inc. With over 20 years in practice, she holds a fellowship in binocular vision and pediatrics and is an industry leader in building high-revenue specialty clinics.

• LinkedIn: https://www.linkedin.com/in/patricia-poma-nowinski-00631648/
• Website: birminghamvision.com 

Connect with Eugene Shatsman

Eugene Shatsman is Host of Power Hour, Managing Partner of National Strategic Group, Co-Creator of The Eyecare BOSS, and a TEDx Speaker. A growth strategist and consultant to hundreds of optometric practices nationwide, Eugene specializes in scaling independent eye care businesses through structured strategy, marketing science, and operational clarity.

• LinkedIn: https://www.linkedin.com/in/eugeneshatsman/ 
• Website: eugeneshatsman.com