The "business of dental sleep medicine" shouldn’t feel like a dirty secret - and PROFIT shouldn’t be a curse word in sleep. In this episode, Jason Tierney, Dr. Erin Elliott, and Dr. Max Kerr stop apologizing for building healthy businesses. Dr. Kerr explains how his own "rheostat regret"—a deep-seated dislike for traditional drilling and filling—led him to master the Entrepreneurial Operating System (EOS) and scale a massive sleep practice.

From identifying the "Toxic Tammys" in your office to setting the 90-day "Rocks" that move the needle, this conversation is a roadmap for any dentist who wants to stop being the bottleneck in their own business.

What’s on the Menu:

• The Handpiece Allergy: Why Max traded the handpiece for systems and how that shift allowed him to scale patient care without burning out.
• The Foundational “Underwear” of Business: Max explains why EOS is the "base layer" of a successful practice—if your socks and underwear have holes, your whole outfit (and your day) is ruined.
• The "Screw Tammy" Protocol: How to handle the high-performing "Toxic Tammy" who is a hit with patients but a cancer to your team culture.
• Vision vs. Hallucination: Why a mission statement isn’t enough. You need the Vision Traction Organizer (VTO) to ensure your team is actually following the map.
• Setting DSM "Rocks": A breakdown of the 90-day sprint and how to keep your team focused on big-picture projects instead of just daily fires.
• Voted Off the Island: Erin and Max discuss building a culture so strong that toxic employees self-select out before you even have to fire them.
• Managing by the Scorecard: How to use objective data to predict your month's success before you even look at a revenue report.

The Value Add:

• It Connects Business Health to Patient Care: This episode makes it clear that strong care and strong operations belong together. A healthy practice can serve more people, more consistently.
• It Gives Owners a Clearer Leadership Framework: Instead of living in constant reaction mode, listeners get a practical model for building alignment, accountability, and better decision-making.
• Cross-Functional Buy-In: Dr. Kerr emphasizes involving key team members in vision and accountability so the practice runs with more alignment and less confusion.

The Wisdom of Max:
"None of us are doing this for free. If you don’t care about people, dentistry will eat you alive—but you can quantify that you’re helping someone live years longer. What is that worth to bring to market?"

Clinical Concepts & Terminology:

• EOS (Entrepreneurial Operating System): A proven set of simple concepts and practical tools used by entrepreneurs to get what they want from their businesses.
• Rocks: The 3 to 7 most important things (objectives) the company must get done in the next 90 days.
• The People Analyzer: An EOS tool used to clarify if you have the "Right People" in the "Right Seats."
• VTO (Vision Traction Organizer): A powerful tool that helps a leadership team get 100% on the same page with where they are going and how they are going to get there.
• Scorecard: A weekly tracking tool of 5–15 high-level numbers that allow you to feel the pulse of your business.

Featured Experts & Resources:

• Dr. Max Kerr: Clinical Director of Sleep Better Austin and a certified EOS implementer.
• Traction by Gino Wickman: The essential reading for any practice owner looking to implement EOS.
• Sleep Better Austin: The systems-driven sleep practice referenced as a case study in this episode.

You did your job. You addressed the patient’s breathing and airway issues. But they are still spending their days feeling like they haven’t slept. What’s the deal?

This week, sleep expert and psychiatrist Dr. Shane Creado joins Jason Tierney and Dr. Erin Elliott to solve the mystery of the "tired-but-treated" patient. We are diving into the "busy brain," the trap of sleep trackers, and why your bedroom might be training you to stay awake.

Whether you are a doctor helping patients or just someone tired of being tired, this episode is a wake-up call. It is time to stop focusing on how long you stay in bed and start focusing on how well you actually sleep.

What We Discuss in This Episode

• Pills vs. Skills: Why retraining your brain with CBT-I is better than using sleeping pills like Ambien or Xanax.
• The Airway Isn’t Everything: Why opening the "pipe" does not always turn off the "alert" button in the brain.
• Bedtime Math: Why spending too much time in bed can actually make insomnia worse.
• The Busy Brain Problem: How to stop your brain from treating 2:00 AM like a stressful business meeting.
• The Tracker Trap: Is your Oura Ring or Apple Watch giving you "Orthosomnia"? This is when you are so stressed about your sleep data that you cannot actually sleep.
• Sleep Like a Pro: How small changes can turn an average person into an elite athlete.
• Social Jet Lag: Why sleeping in late on Saturday feels like a five-hour flight delay for your brain.
• The Golf Secret: How to talk to patients about sleep so they actually listen. (Hint: Talk about their golf score, not their blood pressure.)

The Big Idea

Most people think sleep is just something that happens when you aren't awake. Dr. Creado explains that sleep is actually a skill. If your brain has "learned" how to stay awake and anxious, a CPAP machine or a dental appliance cannot fix that on its own.

This episode is about moving past the hardware (the airway) and fixing the software (the habits and the mind).

Resources and Links Mentioned

Dr. Creado’s Tools

• The Book: Peak Sleep Performance by Dr. Shane Creado
• The Course: Overcoming Insomnia Program (Search "Amen University")
• Dr. Creado’s Patient Resource Guide: Download Here
  
  

Research and Studies

• The Stanford Sleep Extension Study: Research showing that getting just 30 minutes more sleep can improve athletic accuracy by up to 40%. Link: https://pmc.ncbi.nlm.nih.gov/articles/PMC3119836/
• The MLB Sleep Study: Data showing that 72% of "sleepy" Major League Baseball players are out of the league within two years. Link: https://www.sciencedaily.com/releases/2013/05/130531105506.htm
• The Sauna Study: Research indicating that regular sauna use can improve sleep quality in 83% of users. Link: https://pubmed.ncbi.nlm.nih.gov/31126560/
  
  

Key Concepts for Further Reading

• CBT-I (Cognitive Behavioral Therapy for Insomnia): Find a specialist via the Society of Behavioral Sleep Medicine.
• Paradoxical Intent: The psychological trick of "trying to stay awake" to lower sleep anxiety, famously used by psychiatrist Viktor Frankl.
• Orthosomnia: A term for the unhealthy obsession with achieving "perfect" sleep data from wearable devices.