The 20/20 Podcast

Harbir Sian, OD
  • 5.0 (11)
  • Entrepreneurship
  • Updated Weekly

Dr. Harbir Sian is an award-winning optometrist based in Vancouver, Canada. In The 20/20, Dr. Sian interviews guests from various backgrounds and industries to share their struggles and successes. Guests include business owners, entrepreneurs, world-class athletes, media personalities, medical professionals, and more. Through conversations with these guests, Canada's number 1 optometry podcast brings clarity to business, entrepreneurship, and eyecare. Dr. Sian also shares his personal experiences through his shorter Eye2Eye segment. In these short episodes, Dr. Sian opens up and provides a vulnerable look into the challenges he has faced (and overcome) in his personal and professional life. The 20/20 Podcast gives you a look through different lenses and helps you focus on your growth.

  1. 5d ago

    From Myopia Management to Myopia Business: Building the Systems That Scale - Dr. Fallon Patel

    Myopia management has quickly become one of the most important areas in modern optometry. But knowing why it matters is very different from knowing how to actually build it into a successful practice. In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with Dr. Fallon Patel, multi-practice owner, speaker, and myopia management leader, to break down what it takes to move from simply believing in myopia management to consistently delivering it in everyday clinical practice. Dr. Patel shares the systems that helped her scale myopia management across multiple clinics and a large team. From starting with just one or two treatment options, to developing a "myopia champion," training the entire staff, mapping the patient journey, and creating repeatable protocols that make it easier for every doctor and team member to participate. The conversation also dives into the importance of tracking simple KPIs. As Dr. Patel explains, clinicians may genuinely believe they are recommending myopia management consistently, only to discover that the numbers tell a very different story. Tracking creates visibility, accountability, and an opportunity to improve both patient care and practice performance. Dr. Patel explains why young patients can be excellent contact lens candidates and introduces her "3 Cs" of pediatric contact lenses - convenience, confidence, and compliance. She and Dr. Sian explore why clinicians should be cautious about deciding what a child can handle - or what a family can afford - before the conversation has even taken place. The episode also looks at MySight and MyDay MySight, patient compliance, staff delegation, and why giving families a complete picture of their options may be just as important as the treatment itself. Ultimately, this is a conversation about turning good intentions into action. Whether you are just starting a myopia management program or trying to scale one across multiple doctors and locations, the message is simple: start the conversation, build the system, measure what you are doing, and stop making decisions on behalf of the patient before they have had the opportunity to make them for themselves. 3 Key Takeaways ·      Keep myopia management simple at the beginning. You do not need every technology or treatment modality before starting. Dr. Patel recommends beginning with a manageable number of options, building confidence, and expanding from there. ·      Your entire team has to understand the patient journey. Front desk staff, technicians, doctors, and team members responsible for insertion and removal training all influence whether a myopia management recommendation actually turns into treatment. A clear system makes the process easier for both patients and providers. ·      Track what you actually do - not what you think you do. Simple metrics such as the number of eligible children seen and the number of treatments initiated can reveal the gap between clinical intention and clinical behaviour. Tracking creates the visibility needed to improve patient care and practice performance. **Correction: MiSight is supported by a 7- year study. During the conversation, Dr. Sian and Dr. Patel stated it was 8 years. About Dr. Fallon Patel Dr. Fallon Patel is a multi-practice owner in the Greater Toronto Area with more than 15 years of clinical experience. She is a recognized speaker and key opinion leader in myopia management and contact lenses, with a particular focus on building practical systems that help optometry teams deliver consistent, scalable myopia care. A special thank you to CooperVision Canada for supporting this episode of The 20/20 Podcast and for their ongoing commitment to advancing myopia management education, technology, and resources for eye care professionals across Canada. Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/

    From Myopia Management to Myopia Business: Building the Systems That Scale - Dr. Fallon Patel

  2. Sep 23

    Screens, Cosmetics & Dry Eye: What Optometrists May Be Missing - Dr. Etty Bitton

    Dry eye care has changed dramatically over the past decade—but with more diagnostics, pharmaceuticals, in-office treatments, and technology than ever before, it can also feel increasingly complicated. In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with Dr. Etty Bitton, Professor at the Université de Montréal, Head of its Dry Eye Clinic, and a Canadian ambassador for the Tear Film & Ocular Surface Society (TFOS), to discuss how optometrists can simplify their approach while staying aligned with the latest evidence in dry eye disease. Dr. Bitton explains why clinicians should start with diagnosis before investing in treatment technology, including the importance of standardized symptom assessment with the OSDI-6 and a systematic approach to evaluating tear-film stability, osmolarity, ocular-surface staining, eyelid disease, inflammation, and other anatomical contributors. She also discusses how the evolving TFOS DEWS III framework moves beyond simply categorizing dry eye as evaporative versus aqueous deficient and instead encourages clinicians to identify the specific structures and mechanisms involved. The conversation also explores several issues increasingly relevant to everyday optometric practice: screen time, incomplete blinking and meibomian gland dysfunction in younger patients; Demodex and its connection with dermatological conditions; cosmetics, retinoids and products used around the ocular surface; and the value of building referral relationships with other optometrists, dermatologists, rheumatologists and specialists. Dr. Bitton's message is ultimately a practical one: before building an advanced dry eye clinic around expensive equipment, make sure you understand the disease, use evidence-based diagnostic tools, and speak the same diagnostic language as your colleagues. 3 Key Takeaways 1. Get the diagnosis right before worrying about the technology. Dry eye management can become overwhelming when clinicians start with IPL, RF, meibography, pharmaceuticals or other treatments. Dr. Bitton argues that the first priority should be a consistent, evidence-based diagnostic process—including standardized symptom assessment such as the OSDI-6. 2. Screen time may be affecting the ocular surface much earlier than we think. Screen use is associated with more frequent partial blinking, which can interfere with normal meibomian gland function. Dr. Bitton discusses seeing significant gland changes even among optometry students in their early twenties and emphasizes the opportunity for earlier patient and parent education. 3. Dry eye history-taking needs to extend beyond the eyes. Cosmetics, skin-care products, retinoids, dermatological conditions and systemic disease can all provide important clues. Asking patients about what they put around their eyes—and developing collaborative relationships with other healthcare professionals—can become an important part of comprehensive dry eye care. Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/

    Screens, Cosmetics & Dry Eye: What Optometrists May Be Missing - Dr. Etty Bitton

  3. Sep 16

    Are Optometrists Undervaluing Contact Lens Patients? Private Label Lenses Can Fix That - Dr. Harmin Chima

    What if one of the most overlooked opportunities for growing an optometry practice is already sitting in the contact lens room? In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with Dr. Harmin Chima, VP of Professional Services at West Point Optical Group, to explore the business case for private label contact lenses and why optometrists may be underestimating the value of contact lens patients. The conversation examines how private label contact lenses can create stronger margins, improve patient retention, increase in-office purchasing and help differentiate an optometry practice from online contact lens retailers. Harbir and Dr. Chima also challenge a common mindset in optometry: that contact lens sales simply aren't an important source of practice revenue. They discuss the long-term value of contact lens patients, the importance of proactively introducing contact lenses as a vision correction option, and why doctors shouldn't wait for patients to ask. Harbir shares his own approach of discussing contact lenses with patients across virtually every age group — including offering simple in-office trials to patients who may never have considered themselves contact lens candidates. Beyond the numbers, this episode is ultimately about delivering better patient care while building a healthier optometry business. From selecting lenses based on lifestyle and clinical needs to allowing the product to “do the talking,” the discussion offers practical ideas ODs can immediately bring into the exam room. If you're an optometrist, practice owner, corporate or sublease OD, or anyone looking to improve contact lens profitability, patient loyalty and practice growth, this conversation may change the way you think about private label contact lenses and the role contact lenses can play in your business. 3 Key Takeaways Private label contact lenses can strengthen both margins and retention. By creating a product patients associate directly with the practice, private label can help keep more contact lens purchases in-house while improving the economics of each sale.Optometrists may be underestimating the lifetime value of contact lens patients. Contact lens wearers tend to return more frequently and can create additional professional-service and optical opportunities over time.Don't wait for patients to ask about contact lenses. Proactively presenting contact lenses as a vision correction option — and reducing friction with simple in-office trials — can uncover demand that patients may never express on their own. A special thank you to CooperVision for supporting this episode. Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/

    Are Optometrists Undervaluing Contact Lens Patients? Private Label Lenses Can Fix That - Dr. Harmin Chima

  4. Sep 10

    Dry Eye Done Differently: Systems, Staff and Profitability - Dr. Trevor Miranda

    Optometrists see the opportunity in building a dry eye clinic but often get stuck on how to get started. In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down once again with Dr. Trevor Miranda to explore the business of building a successful dry eye clinic, from creating treatment protocols and developing your team to improving patient conversion and generating a meaningful new revenue stream. Dr. Miranda shares how dry eye has grown to the point where his practices now generate more revenue from dry eye products and services than from contact lenses. He breaks down his LION approach — Lids, Inflammation, Obstruction and Nutrition — and explains why having a structured clinical philosophy makes it easier to develop treatment plans, train staff and create consistency across a practice. Just as importantly, Trevor explains why doctors should not be doing everything themselves. By developing highly trained ocular hygienists, his clinics are able to run dry eye treatments alongside primary eye care, creating greater efficiency while giving patients more education and support. The conversation also dives into the systems behind a thriving dry eye business: creating a dedicated dry eye assessment pathway, clearly recommending the optimal treatment rather than simply the cheapest option, training team members to confidently discuss treatment, establishing a dry eye champion, setting revenue targets and tracking KPIs. Trevor explains why implementation — not simply acquiring knowledge — is what separates practices that dabble in dry eye from those that truly build a successful specialty service. Finally, Harbir and Trevor discuss the Dry Eye Summit, which brings together doctors, staff, industry partners and dry eye leaders for focused education, hands-on exposure to new technology and practical business strategies. The Summit also offers dedicated training for ocular hygienists and an advanced procedures lab, making it an opportunity to elevate not only the doctor’s knowledge but the capabilities of the entire dry eye team. And because the Dry Eye Summit is now held only once every two years, this year's meeting represents a valuable opportunity for practices looking to take their dry eye services to the next level. Key TakeawaysBuild systems, not just a collection of technology. Successful dry eye clinics need structured treatment protocols, patient pathways and clearly defined roles for the doctor and team.Empower an ocular hygienist or dry eye champion. Properly trained team members can educate patients, coordinate treatment, perform delegated services and help the dry eye clinic operate alongside primary eye care.Treat dry eye like a real business unit. Set revenue goals, track referrals and KPIs, hold regular team meetings and continue investing in education and training.About Dr. Trevor MirandaDr. Trevor Miranda is the owner of Cowichan Eyecare in British Columbia, operating five clinics with a team of 12 doctors. He has built two dedicated dry eye centres and a team of ocular hygienists, and is one of the founders of the Dry Eye Summit alongside Dr. Richard Maharaj and Dr. Jeff Goodhew. Dry Eye SummitThe Dry Eye Summit takes place November 21–22, 2026, with an Advanced Procedures Lab on November 20. The ocular hygienist course takes place November 21. Learn more at mydryeye.ca. Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/

    Dry Eye Done Differently: Systems, Staff and Profitability - Dr. Trevor Miranda

  5. Aug 12

    The Slippery Slope: Corporate Optometry, Oversupply and Falling Compensation - Dr. Keyur Patel

    Following our eye-opening episode on Australian optometrists unionizing in response to growing corporate pressure, The 20/20 Podcast turns to the United Kingdom—and the warning signs are just as important. Dr. Harbir Sian sits down with Dr. Keyur Patel, an experienced UK optometrist who has worked across corporate, hospital and independent practice settings and also trained in the United States. Together, they examine how decades of undervaluing clinical services, increasing corporatization and a growing dependence on retail revenue have reshaped optometry in the UK. Keyur also shares his own experience of being dismissed from a refractive surgery company despite no concerns about his clinical ability—because he was not converting enough patients to laser surgery. The conversation then moves to one of the most consequential issues facing the profession: workforce oversupply. With more optometry schools opening and more graduates entering already saturated markets, compensation can be driven lower while individual optometrists lose negotiating power. Keyur and Harbir discuss reports of locum positions paying as little as £25 per hour and the uncomfortable economics behind it: when there are more optometrists competing for fewer desirable jobs, employers gain leverage, salaries decline, and clinicians may feel increasingly pressured to accept working conditions or business models they otherwise would not. Combined with low reimbursement for eye examinations and diagnostic services, that environment can push practices further toward KPIs, spectacle sales and other commercial metrics simply to remain profitable. For optometrists in Canada and the United States, the UK and Australia may offer a glimpse of what can happen when these changes are allowed to compound over decades. More schools, more graduates, lower professional compensation, weaker negotiating power, increasing corporate influence and the gradual erosion of clinical autonomy do not happen overnight—but they can fundamentally change a profession. At the same time, Keyur offers a powerful counterexample: his independent practice walked away from the low-fee NHS sight-test model and built a practice where patients willingly pay more because they value the quality of care, relationships and experience they receive. The message is clear: if optometrists do not actively protect the value of their clinical services and the independence of the profession, others will define that value for them. Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/

    The Slippery Slope: Corporate Optometry, Oversupply and Falling Compensation - Dr. Keyur Patel

  6. Aug 6

    Australia’s Optometry Rebellion: Why Optometrists Are Unionizing and Why North America Should Pay Attention

    What happens when highly trained healthcare professionals are measured more by sales targets than by the quality of care they provide? In Australia, growing frustration over workplace conditions, corporate key performance indicators, declining salaries and the rapid expansion of the optometry workforce has led employed optometrists to take an unprecedented step: organizing through the Health Services Union. In this urgent international edition of The 20/20 Podcast, Dr. Harbir Sian speaks with Australian optometrists Johnny Van Ling and Rory Dowdall, two of the leading voices behind the country’s optometry labour movement. They describe a profession in which some optometrists report struggling to take lunch or bathroom breaks, being pressured to meet targets for spectacle sales and privately billed imaging, and fearing replacement by a growing supply of new graduates. What began as frustrated conversations between colleagues developed into an online community involving thousands of Australian optometrists and eventually became the country’s first optometry union movement. The discussion goes far beyond salaries and working conditions. Johnny and Rory examine how deregulation, corporatization, new optometry programs and industry influence within education may have shifted the balance of power away from clinicians. They also discuss the tension between commercial metrics and independent clinical judgment, including the potential professional risk to optometrists when business expectations begin influencing decisions about imaging, appointment length, billing or patient care. For optometrists in Canada and the United States, Australia provides both a warning and a lesson. The guests explain how changes that initially appeared small—or were promoted as improving access to care—gradually affected professional autonomy, employment security and the public perception of optometry. The conversation explores tele-optometry, workforce saturation, the role of professional associations and why individual clinicians may be unable to resist systemic pressure without collective organization. This episode is not simply a discussion about whether optometrists should unionize. It is a deeper examination of who controls the future of optometry: the clinicians responsible for patient care or the corporations, institutions and commercial interests shaping how that care is delivered. For every optometrist concerned about clinical independence, corporate optometry, professional advocacy, workforce planning or the long-term value of the profession, this is a conversation that cannot be ignored. Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/

    Australia’s Optometry Rebellion: Why Optometrists Are Unionizing and Why North America Should Pay Attention

  7. Jul 22

    The Conversation That We Have Been Missing About Women's Eye Health - Dr. Janice Luk

    Women experience dry eye at significantly higher rates than men—but the reasons extend far beyond age or screen time. In this episode of The 20/20 Podcast, Dr. Harbir Sian sits down with Dr. Janice Luk to explore the often-overlooked connection between women’s health, hormonal changes, beauty routines, and ocular surface disease. From birth control and pregnancy to perimenopause and menopause, Dr. Luk explains how fluctuations in estrogen, progesterone, and androgens may influence meibomian gland function, tear-film stability, inflammation, and dry-eye symptoms. The conversation also examines how optometrists can address makeup, lash extensions, lash lifts, and other beauty treatments without simply telling patients to stop doing the things that matter to them. Dr. Luk shares practical questions clinicians can ask, strategies for maintaining eyelid and lash hygiene, and ways to build trust through collaborative patient education. The episode concludes with a discussion of the evolving TFOS DEWS III approach to dry-eye management, the value of introducing multiple treatment modalities earlier, and the role of immunomodulatory therapies in reducing inflammation and improving patients’ comfort and quality of life. 3 Key Takeaways 1. Hormonal health should be part of the dry-eye conversation. Hormonal fluctuations throughout a woman’s life—including those associated with oral contraceptives, pregnancy, perimenopause, menopause, and hormone-replacement therapy—may affect the ocular surface. Asking thoughtful questions about hormonal changes can help uncover contributing factors that patients may not realize are connected to their eye symptoms. 2. Beauty routines should be discussed, not dismissed. Rather than simply advising patients to stop wearing makeup or getting lash treatments, optometrists can help them make safer choices. Asking about makeup removal, lash-extension cleaning, product ingredients, and eye discomfort can protect ocular health while respecting the patient’s lifestyle and identity. 3. Dry-eye treatment is becoming more integrated and proactive. The newer TFOS DEWS III framework moves away from a rigid, step-by-step treatment ladder and encourages clinicians to consider the whole patient and introduce complementary therapies earlier. Addressing inflammation promptly—with prescription medications, at-home care, in-office procedures, or other appropriate options—may lead to faster and more meaningful improvement. Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/

    The Conversation That We Have Been Missing About Women's Eye Health - Dr. Janice Luk

  8. Jul 16

    Effective Beats Efficient: Building a Better Independent Practice - Part 2 with Conor Heaney

    In Part 2 of this conversation with Conor Heaney, founder of Optical Success Academy and owner of Jones & Co. in Manchester, Harbir and Conor continue their discussion on what it really takes to grow an independent optometry practice. Picking up from Part 1, they explore the difference between being efficient and being effective, and why some of the most meaningful improvements in a practice come from slowing down, becoming more intentional, and focusing on the experience you actually want to create for patients. Harbir shares more of what he has implemented at Clarity Eyecare after a year inside Optical Success Academy, including better team meetings, improved phone conversations, stronger follow-up, more Google reviews, and a clearer focus on attracting the right clientele. Conor explains why practice owners need a “North Star”: a clear understanding of who they want to serve and what kind of practice they want to build. From there, decisions around pricing, service, marketing, team training, and patient experience become much easier to align. The conversation also dives into team development, delegation, and the shift from doing the work of the optometrist to doing the work of the business owner. Harbir shares a valuable lesson about putting the right person in the right role, while Conor explains how developing your team can create more freedom, better service, and a stronger business. For practice owners who feel busy, stretched, or stuck in the day-to-day, this episode offers practical insight into how small habits and consistent implementation can create meaningful change. Key Takeaways Effective beats efficient.The fastest or most efficient option is not always the best one. Sometimes slowing down, adding thoughtful service touches, and creating a better patient experience leads to stronger relationships, better word of mouth, and a more successful practice.Your ideal client should guide your practice decisions.Conor explains that when you are clear on who you want to serve, it becomes easier to make decisions around pricing, service, marketing, appointment flow, and team behaviour.Team development creates freedom.Harbir and Conor discuss how putting the right people in the right roles, trusting your team, and delegating more effectively can help both the practice and the practice owner grow. Free Report from Conor Heaney Conor is offering listeners access to his report, The Nine Keys That Unlock the Hidden Profits in Your Practice. To request the report or learn more about Optical Success Academy, email info@opticalsuccessacademy.com. Love the show? Subscribe, rate, review & share! http://www.aboutmyeyes.com/podcast/

    Effective Beats Efficient: Building a Better Independent Practice - Part 2 with Conor Heaney
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5
out of 5
11 Ratings

About

Dr. Harbir Sian is an award-winning optometrist based in Vancouver, Canada. In The 20/20, Dr. Sian interviews guests from various backgrounds and industries to share their struggles and successes. Guests include business owners, entrepreneurs, world-class athletes, media personalities, medical professionals, and more. Through conversations with these guests, Canada's number 1 optometry podcast brings clarity to business, entrepreneurship, and eyecare. Dr. Sian also shares his personal experiences through his shorter Eye2Eye segment. In these short episodes, Dr. Sian opens up and provides a vulnerable look into the challenges he has faced (and overcome) in his personal and professional life. The 20/20 Podcast gives you a look through different lenses and helps you focus on your growth.

Information

  • Creator
    Harbir Sian, OD
  • Years Active
    2022 - 2026
  • Episodes
    222
  • Rating
    Clean
  • Copyright
    © Copyright 2025 Harbir Sian, OD | The 20/20 Podcast | All Rights Reserved
  • Show Website
    The 20/20 Podcast

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