Voices in Health and Wellness

Exhale and Heal: Connecting the Dots Between Breathing, Sleep, and Pain with Dr Ryan Vaughn

• Dr Andrew Greenland • Season 1 • Episode 17

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Ever wondered why some patients with TMJ pain never find relief despite trying everything? Dr. Ryan Vaughan unlocks the hidden connection between nasal breathing and jaw disorders that's transforming outcomes for patients who've struggled for years.

Dr. Vaughan's journey began with a personal stake—his own mother developed TMJ issues—revealing glaring gaps in treatment paradigms. This sparked his mission to create something fundamentally different in specialty care. When he launched Exhale Sinus and Facial Pain Center in February 2020, the timing seemed catastrophic. The pandemic hit two weeks later, shutting down healthcare nationwide. Yet remarkably, this challenging start became his greatest advantage, giving him space to refine his approach while patients became increasingly receptive to breathing techniques and alternative treatment options.

At the heart of Dr. Vaughan's revolutionary approach is understanding that seemingly unrelated conditions—TMJ disorders, sleep issues, headaches, and sinus problems—often share root causes in breathing mechanics. His practice combines surgical expertise with a comprehensive evaluation of sleep patterns, diet, supplementation, and psychosocial wellness. What makes this approach unique? As he explains, "Somebody comes in, and yes, I can really laser focus on how to do a minimally invasive nasal surgery. But there's also extra effort spent understanding sleep restoration, meal timing, screen habits, and bedroom settings."

This holistic approach requires substantially more time per patient but yields transformative results. To make this financially viable, Dr. Vaughan has structured his practice with multiple revenue streams—combining insurance-based procedures with cash-pay ancillary therapies like red light treatment and infrared sauna. As healthcare grows increasingly fragmented, Dr. Vaughan positions himself as an "unfragmenter," coordinating care across functional medicine, dentistry, myofunctional therapy, and orthodontia.

Ready to discover how breathing mechanics might be the missing piece in your health puzzle? Listen now to understand the intricate connections between nasal breathing, jaw function, and total wellness that conventional medicine often overlooks. Share your breathing journey with us and subscribe for more innovations reshaping healthcare delivery!

📱 Guest Contact Info for Episode Bio 

Name: Dr. Ryan Vaughn, MD
Practice: Exhale Sinus and Facial Pain Center
Specialties: TMJ, Headache, Sleep, ENT
Website: https://exhalesinus.com
Phone: (773) 234-5880
Fax: (708) 273-5332
Location: 814 E Woodfield Rd, Schaumburg, IL 60173
Instagram: @exhalesinus
LinkedIn: https://www.linkedin.com/in/ryancvaughn/

Dr Andrew Greenland:

Okay, so welcome back to Voices in Health and Wellness. This is the podcast where we explore the challenges and innovation shaping the future of private healthcare practice. Today, I'm excited to welcome Dr Ryan Vaughan, a dual force in medicine and entrepreneurship. He's a board-certified otolaryngologist and founder of Exhale Sinus and Facial Pain Center, where his team specializes in TMJ disorders, sleep and healthcare, and advanced ENT solutions. Dr Vaughan brings a unique lens to the conversation, combining deep clinical expertise with an entrepreneurial mindset to rethink how specialty care is delivered in a private healthcare setting. If you're a clinic owner, specialist or anyone navigating the evolving world of health delivery, you're going to find this one insightful. So, Ryan, thank you so much for joining us today. Really appreciate you jumping on the call.

Dr Ryan Vaughn:

Yeah, thank you for having me.

Dr Andrew Greenland:

And where are you calling from? Just so all our listeners know.

Dr Ryan Vaughn:

I'm in my satellite office in Rockford Illinois.

Dr Andrew Greenland:

Wonderful. Okay, so I'm in the UK. Well, nice that this is a global thing. Perhaps we could start off. Could you share a little bit about your role and how Exhale Sinus came to be?

Dr Ryan Vaughn:

Sure, yeah. So I trained as a general otolaryngologist, meaning that I was seeing anything related to the ears, nose, mouth, throat, neck, and was treating anything from birth all the way through end of life. Through that process I actually had a couple of patients, including my own mother, uh, who developed TMJ issues and within the United States we really don't have great, I would say, worldwide my experience. Uh, we don't have great treatment paradigms on how to manage these TMJ issues. Um, it became such a passion for me. Uh wanted to become singly focused on TMJ, tmd and all of the surrounding things and really then marrying the idea of doing minimally invasive procedures to help with those conditions, as well as seemingly unrelated conditions of nasal obstruction, sleep disorder, breathing and sinus issues. And as I started creating more and more of a treatment paradigm that was treating TMJ, through what the actual triggers are, I started realizing, wow, that most of these TMJ patients have nasal obstruction as their primary driver of what's developing their issues and if we fix that, sometimes we fix their whole problem. Or, conversely, if we don't fix the nasal obstruction, they can have less success with the dental therapies that are done.

Dr Ryan Vaughn:

So at the time that I finished my training in residency. I joined a group and was part of a 10 member group. I had worked my way up to become a partner, tried to do something just uniquely different in that practice, but you know, the practice had been around for 60 years. People were very entrenched in how they wanted to see healthcare delivered, and so doing something different just really didn't fit their model. Because I was so passionate about doing something different, I decided I'm just going to leave that Left behind my partnership contract and said I'll walk away from that and start my own thing, really telling my wife that, even if I never made more money by doing my own thing, but actually had more flexibility and freedom, that it was worth it. So that was February 1st of 2020 that I quit my job and decided to open my own practice. So then, two weeks later, the pandemic hit and all of healthcare was shut down.

Dr Ryan Vaughn:

So 2020 was bumpy, it was rocky and at the same time, though, it was really an amazing time. People were more open-minded, patients were coming in to me more interested in learning about nasal breathing and nasal techniques, and I had the opportunity to slow down and learn some more things. So, through that kind of bumpy start, it actually was an amazing gift that I was able to really dive deep into.

Dr Ryan Vaughn:

What are the things that we are doing that are helping our TMJ and nasal patients, um, what's working, what's not working, how do we set up uh protocols for evaluating success? How do we Define success, um, and how do we see what's not working and how do we cut that away? So that brings us to today, where I've built out a team. We have three surgeons, six mid-level providers we call them physician assistants and nurse practitioners here in the US, three different locations and we continue to grow off of this paradigm, this base, understanding that if we can help our patients breathe better through their nose, that we can start to really get at the triggers for the TMJ, much of the migraine headaches, much of the headaches, as well as the sinus issues that these patients have.

Dr Andrew Greenland:

Amazing. So is your secret sauce this kind of more holistic approach to a given problem, or do you have any specific sort of techniques which are your secret sauce?

Dr Ryan Vaughn:

Yeah right, I think that's a great question, super insightful. So I really think the secret sauce is what you said in the former statement there, that it is a holistic approach. You know, said in the former statement there that it is a holistic approach. You know, somebody comes in to see me and, yes, I can really laser focus on how do we do a minimally invasive nasal surgery. But then there's also an extra effort that is spent. Well, we know that there's a ton of restoration that happens during sleep, for example, and we may get a sleep study that shows some disruptive sleep. We can put on a CPAP, we can do oral appliance, but what else is contributing? What time are you eating? When's your last meal? When are you last consuming liquids? When are you turning screens off? What does your bedroom setting look like? We're diving into patients' know we're diving into patients diets. We're diving into their supplements. We're diving into their psychosocial wellness. All of this understanding gosh. You know, yes, I can help make a crooked nasal septum straight, but that's only a small part of the puzzle.

Dr Andrew Greenland:

Amazing. Is anybody else caught onto this? Because it sounds like I mean, I'm very much a holistic practitioner myself, so I appreciate the way that you dive into all these different aspects of the patient's lifestyle and their current problem. Is anybody else doing this in the ENT world? So-? To the level you are.

Dr Ryan Vaughn:

Yeah, right, Like. So. This is where, like I've hired two other surgeons and really trying to mold them into this way of thinking and understanding, we are unique approach XL sinus is unique. There are other folks. There's one other ENT physician out in New York that advertises as a functional ENT. I have not been able to connect with her so I don't know exactly how she's approaching things. But to my knowledge, really our angle of trying to holistically approach nasal sinus, TMJ and headaches, I don't see it anywhere else.

Dr Andrew Greenland:

I mean, do you think? I mean how much have you been able to reduce surgery by using this approach and not necessarily have to do something more? Interventional, surgical? Yeah right.

Dr Ryan Vaughn:

You know I would. I'd kind of reframe that to say, like, how do you define surgery In that we can do minor procedures that are not a big sign of surgery, and how much do I back somebody off who maybe needed, if I would have seen them 10 years ago done a significant sinus surgery operation, and now I can do something invasive, 80% of the time, taking somebody who has you know? So it's part of this holistic approach, right? Like when I was trained we talked about you know, all the way back to training. You have two options for breathing your mouth or your nose and I was trained that they were equivalent, that there's no advantage to breathing through the nose over the mouth.

Dr Ryan Vaughn:

And we were taught in a way that somebody who's complaining of nasal congestion we'd throw medicines at them, never really give much thought to diet and certainly didn't give a whole lot of consideration to just like a functional nasal surgery. That obviously, as I was out of residency and in more private practice world, was not acceptable. Patients really wanted better options than just throwing medications at them, options than just throwing medications at them. But sometimes it's not just the nasal septum, right? And so then the holistic approach comes like okay, what could a dentist do where, understanding that the hard palate is the floor of the nose? And if we get a thoughtful dentist who can do a palate expansion, they can actually make a meaningful difference in some of our patients who have extremely narrow nasal airways.

Dr Ryan Vaughn:

It's funny. It seems very common in my practice now, but even in the United States it's not widely accepted. I will interact with orthodontists even within the last month who quite frankly thought that I was crazy talking about doing expansion on a four-year-old. Thinking in our thought is okay, let's get this kid the best nasal airway possible, let's not move the. It's not really about moving the teeth, it's really about expanding the palate so that they can breathe. And so again back to your question of surgery versus procedures. So again back to your question of surgery versus procedures. Most of the time when I'm seeing a patient they're getting some sort of intervention, and that may be a dietary intervention, but typically it's going to be something along the lines of making the nasal airway work better.

Dr Andrew Greenland:

Interesting. So what does your typical day look like at the moment? I guess you're fairly clinical hands-on. You've got your scrubs and everything on. How much of it is sort of managing the business and the sort of strategy side of things.

Dr Ryan Vaughn:

Yeah, yeah. So, as my wife says, I work all the time. I work five days a week clinical, so that turns out to be typically one day a week doing a procedure or surgery day. Four days a week treating patients just clinically in the office. Um, the the mornings um are are typically involved. I will. Most mornings I woke, uh, I my. My pattern is I wake up at six o'clock pretty much no matter what's going on for the day. Um, I start doing some sort of work until my wife wakes up, and then we always have coffee, I work out, uh, hang out with my daughter before she goes to school and then off to the office. So typically they're starting to see patients around 9 am, seeing patients until about 3.30, and then the afternoon is where I do most of my business meetings, and that's anything from podcast interviews to social media. We're doing a lot of social media pushes, meeting with the C-suite folks at our practice, the attorneys, you know, whatever. And then I try to limit to one business dinner per week, just so I'm not away too much. Yeah, I could fill my schedule with as much stuff as I want.

Dr Ryan Vaughn:

I really have a passion for teaching and teaching this stuff, educating people about what are minimally invasive. What's the importance of nasal breathing, why do we care about nasal breathing, what are the impacts of not nasal breathing, and then what are the minimally invasive ways to do that? So I again try to stop myself and only do one of these types of educations per week. But it's another area of passion. And then that bleeds into the business side of things, where the more I educate, then the more referrals we get, and and so it's uh. It is a uh a cycle where it feeds itself, um, but it keeps me energized, uh, that I keep going. You know, when you start doing what you love, you just keep going amazing.

Dr Andrew Greenland:

So I've been doing a number of these um interviews and I've been hearing a lot from other private clinic owners, particularly in the us, around so rising operational pressures around insurance reimbursements and the rise of corporate roll ups. What's your kind of take on these things?

Dr Ryan Vaughn:

Yeah, so obviously, to be successful in running a business, you need to. The ability to manage a team comes from having a good management team, right? So I have my finance guy, who just takes care of the finance stuff. I have my operations woman who takes care of all of the operations, and really I get involved only at the highest level. I'm a visionary, long-term, big picture type of thinker, and so then them having all their roles allows me to really focus on what the vision can be and needs to be.

Dr Ryan Vaughn:

We are in a healthcare model where private insurance pays for a lot of what we do, and so the private insurance side of things we need to figure out, like, how do we have enough volume coming through the office in order to keep the lights on? But, part of this holistic approach, we can't have high volume, right? Like we have to be able to spend 30 to 45 minutes with our patients to ask them all these deep, probing questions and really get to know them and their situation. So we've incorporated other therapies and things that can be going on in the background in order to have multiple revenue streams. So we have a small retail product line. We have ancillary therapies of red light therapies. We'll do infrared sauna. We're bringing in dentistry to do so instead of like referring out, so then we'll just keep internal. So the business side of my brain is really geared towards how do we optimize the ancillary income that is not so driven by insurance.

Dr Ryan Vaughn:

We opened our third location in a different state, and by opening in a different state there's just different regulations, and so in the other state we can actually charge what's called a facility fee, and so by charging a facility fee it allows us to get reimbursed not only for surgical and procedural work but actually for the overhead costs of the equipment.

Dr Ryan Vaughn:

In the state of Illinois they don't allow that, and so it's. You know, clearly the laws of Illinois were written in such a way that favors the bigger hospital systems because they can charge the facility fees. But if you're a small private clinic like myself, you cannot, and so I've had to be creative in adding things to patients, procedures that allow us to be able to actually cover our costs, and that's like the idea of red light, and it really has been a self-fulfilling cycle, if you will. If I add on an ancillary treatment that actually has research backed, I really believe in it, but insurance isn't going to cover it. Then we can ask patients to pay cash for it, and our population seems to really understand the benefits of these types of say like pick red light therapy. Um, so then I can add in an ancillary treatment through a procedure got it amazing.

Dr Andrew Greenland:

Um, what about trends in sleep and ent, shifting your model from the point of view of? Often, patients are much more informed these days. They've read the internet, they've gone on dr google, they've gone on Dr Google, they've gone on to chat GPT but also from the point of view of perhaps being more fragmented in their care. How have these sort of things shifted and how do you see them?

Dr Ryan Vaughn:

Yeah, yeah, I'm going to go to your last point there, the fragmentation that you're absolutely right that they do start to get fragmented, and I see my role as actually an unfragmenter and I really try to bring in whether it's functional medicine, whether it is dentistry, myofunctional therapy I don't know if you're familiar with that but kind of like speech therapy, orthodontia I often will see myself as a quarterback of okay, I'm going to try to help kind of fan you out to like here's each of the areas that you really need in order to to defragment your care, allowing them to really get the benefits of treatment. I spend a tremendous amount of time, whether it's educating other providers, but educating patients. Right, so they come in and Dr Google may have said, okay, so here's what I know, here's what I can do. It's really incredible what you can find on Google and ChatGPT, but it's often not the whole picture.

Dr Ryan Vaughn:

I just saw a patient this morning and, based on online learning, he was able to start a breath program, start a dietary program. He was mouth taping. He's doing everything he can to breathe through his nose, but he's still getting sinus infections and he still has a deviated septum and so he's like this guy that we went through a scan this morning and I'm like you know we could send you to an orthodontist for expansion. That won't straighten your septum but it at least help you breathe through your nose and unfortunately won't help your sinus issues. And so he's a guy back to your one of your first questions like we're going to actually do a pretty big surgery for him because that's what he needs.

Dr Ryan Vaughn:

He's failed everything else and so he's the guy that's going to start here, but then we will defragment that stuff. And how does he do? Later We'll decide. We'll determine. Ok, do we send you to this, our sleep dentist for dental appliance, or who are the other ancillary folks that we're going to bring in? And not everybody needs it, not everybody wants it. But it's something that when we find that patient who really needs to dive deeper, that Google, chatgpt, youtube unfortunately just doesn't give them the ability to really get as deep as they need to go Got it.

Dr Andrew Greenland:

On a similar vein. I don't know how it is in your area, but what's your take on the rise of telehealth and retail clinics? I mean, do you see them as a threat or a complement or something else entirely?

Dr Ryan Vaughn:

Yeah, yeah, yeah, definitely not a threat. We're so specialized that they're not a threat. The only threatening part of that is that when somebody comes to whether it's a retail clinic or telehealth complaining of ear pain and hearing loss, they're likely to be diagnosed with an ear infection and given an antibiotic and they may not need it, and so it's not so much a threat as much as a I see really as an opportunity. I've worked hard to educate a lot of the retail clinics around us in not in any way to be demeaning, but really not in any way to be demeaning but really an ear examination is really really difficult and even as an ENT doctor accurately diagnosing middle ear fluid, we're only right about 80% of the time, and so that's all we do is look in ears and we're still wrong 20% of the time. So the expectation that a nurse practitioner at a retail clinic can get it right 100% of the time so the expectation that a nurse practitioner at a retail clinic can get it right 100% of the time is just unrealistic. And so giving them the freedom to say I don't know can be super empowering. And then we actually get a bunch of referrals from these centers that say, wow, this guy was actually really nice, taught me something and I think he'll take good care of you. Really nice, taught me something and I think he'll take good care of you.

Dr Ryan Vaughn:

Telemedicine I actually just I educate throughout the United States we could say internationally here and we get a lot of out-of-state referrals and so I work with whether it's local ENTs or local dentists, to review imaging and then do a telemedicine visit. And so I do some telemedicine visits, even in what's considered kind of a heavy procedural practice, really trying to make sure that these patients are all optimized. Because, back to another one of your early questions, not many ENTs really want to do this, they don't really want to dive into this stuff, they don't want to think about.

Dr Andrew Greenland:

TMJ. Besides, how do I get this TMJ patient out of my practice as fast as possible? What would you say is working really well for you right now in terms of your patient care and business operations? Because you talked a little bit about how you structure your business and the various team members that you have, but what's really kind of killing it for you at the moment?

Dr Ryan Vaughn:

yeah, yeah. What business-wise. What's really killing it is adopting new technology. So adopting new technology for minimally invasive sinus procedures has really allowed us to capitalize on doing less for the patient.

Dr Andrew Greenland:

Brilliant, so obviously a very high-tech clinic using all the latest procedures and everything Amazing. And on a similar kind of vein, what's the most frustrating part of doing what you do? Do you have any particular bottlenecks or challenges that you're kind of kind of working on?

Dr Ryan Vaughn:

yeah, yeah. So I'm sitting in our um expansion satellite clinic out in rockford, which, um is a medically underserved community, and in being medically underserved um, it kills me that. So we've been in this location for less than a year, but trying to get the traditional internal medicine doctors and family practice doctors to understand the importance of nasal breathing and that not every patient with a headache needs to be put on medications has been a much greater challenge than I've really expected. I thought that we'd kind of walk in and people would welcome us with open arms and as we're coming in and saying let's try to, I'm capturing a lot of the fringe, if that makes sense, but I'm struggling to really capture the mainstream and so I'm working hard to figure out. Is it messaging? Is it I'm not getting in front of the right people? What is it that's limiting my ability to really help as many people as possible? I understand.

Dr Andrew Greenland:

How do you see the role of private speciality care sort of like yours, but not just exclusively yours evolving over the next three to five years? So people doing your kind of niche work, or you work, or a much more focused approach to a particular problem?

Dr Ryan Vaughn:

Yeah, well, I think it depends on what happens with nationalized healthcare in the United States. I don't think it's really going to change in the next three to five years, but say that it does. I think there's going to, and I think what we're seeing is just two pathways, or two tracks, if you will. There's the nationalized healthcare track that your average patient is going to just go through that track, and then there's going to be the private, and so I think the subspecialty niche care clinic, like myself, is going to really thrive in that secondary track, being independent of national health care and working on more of private insurance or cash pay model. I think that, like the practice that I left, is going to have to adopt more and more national health care, more and more of the crummier private insurances, just to stay afloat because their margins become so thin.

Dr Ryan Vaughn:

I see more patients becoming educated about the current health care system now that you know. You see a patient who's, for the first time in their life, using US healthcare and they're just blown away by how much they have to pay in order to actually get healthcare and they thought they had this amazing insurance policy and they want to deny half of the procedures that the patient needs and so there's much more disenfranchisement that's building within the United States. I don't think we're three to five years away from anything really changing dramatically. I think it needs to change dramatically, probably more. In a time horizon of like 20 years I think there'll be major changes, but three to five years I have a feeling it's going to be basically the same major changes but three to five years.

Dr Andrew Greenland:

I have a feeling it's going to be basically the same. Where do you want to be in the next sort of six to 12 months with Excel signers? Is this sort of more growth, new services?

Dr Ryan Vaughn:

team changes. All of the above. All of the above, yeah, yeah, we want more growth. So we're just opening the doors to our third location here in a couple of months, to our third location here in a couple of months. With that, we have other plans for satellite clinics there and other major hubs through different states.

Dr Ryan Vaughn:

It's really we just hired a friend of mine who used to do device sales and she's gonna start doing some like outside sales for us, of approaching other surgeons, of we could do this differently, we could do this together. Consistently, I meet dentists throughout the United States and the dentists seem to be some thought leaders in how to really focus on airway and they're frustrated because they can't find an ENT doctor that really is interested in actually helping nasal airway, and so I'm working really hard in the next 12 months to connect with more ENT doctors to teach them not only the importance of nasal airway but also how to financially do it in a way that makes sense that they can either be as successful or even more successful just by doing it on their own. Brilliant.

Dr Andrew Greenland:

And if you could solve one big challenge, what would it be? And it might be the education piece around the doctors, I don't know, but is there anything else that you'd like to solve in your kind of growth?

Dr Ryan Vaughn:

You know, from a business perspective, it'd be educating other providers. From a technical perspective, the challenge that's constantly in front of me is how do I do a procedure on somebody and give them the best, fastest recovery possible? And that's where all these other ancillary things from red light to saunas to hyperbaric oxygen everything's really coming into. What can I do to give somebody the fastest recovery possible?

Dr Andrew Greenland:

Okay, amazing. Ryan, thank you so much for your time this afternoon. It's been a really interesting conversation. Thank you for your insight, your honesty and the depth of the answers has been really fascinating. I'm sure people are going to find this an interesting lesson, but I really appreciate your time giving up your time this afternoon.

Dr Ryan Vaughn:

My pleasure. Thanks for inviting me.

Dr Andrew Greenland:

Thank you.

Dr Ryan Vaughn:

Take care.