Speaker 1 (00:07):
You're listening to The La Jolla Cosmetic Podcast.

Monique Ramsey (00:14):
Welcome everyone to The La Jolla Cosmetic Podcast. I'm your hostess, Monique Ramsey. And to celebrate our hundredth episode of our podcast, we are returning to our roots and have our founder, Dr. Merrel Oleson and Marie Oleson as our guests. And I'd like to also introduce Lulu and Charlie as well, their dogs. You might hear them comment throughout the podcast as we're chatting today and they're part of the family too, <laugh>. So with that, we'll get started. Dr. Olesen, welcome.

Dr. Olesen (00:45):
Nice to see you.

Monique Ramsey (00:47):
So you founded the Cosmetic Practice, La Jolla Cosmetic Surgery Center in 1988. And what was your main inspiration and motivation to do that?

Dr. Olesen (01:00):
Uh, I had been in charge of the plastic surgery division at a local large medical clinic and it was a wonderful place to work. I might have been happy there all of my life, but the clinic would not easily respond to what I felt were the needs of our patients and they wouldn't give me a dedicated scheduler. They would not give me a special place for our patients to wait in the waiting room. And they really somehow wanted elective cosmetic surgery patients to be like every other ill or sick or person who came through the clinic. And I felt like our patients needed to be treated a little bit differently. And eventually we parted ways and I started La Jolla Cosmetic Surgery Center.

Monique Ramsey (02:04):
Now Marie, welcome to you too.

Marie Olesen (02:06):
Thank you. Thank you.

Monique Ramsey (02:07):
And what do you remember about that area where he practiced at the clinic?

Marie Olesen (02:12):
Well, I remember a couple stories. One is that, you know, cosmetic patients in 1988 were still embarrassed and sort of wondering if they were doing the right thing. And so someone came in to have her talk about having her eyes done and she was sitting in a waiting room with sick people and she came in and Merrel came home and told me that, she said, "You know, I wanted to have my eyes done but sitting in your lobby with all these sick people, I need to get a life". And so that was a problem. And then when it came, you have to give a fee estimate. So they had to go into a bullpen of secretaries and four people were overhearing whatever the patient was going to have. And the patient was reluctant about having it. And so their need for privacy was much greater than it is now.

Marie Olesen (03:12):
So those are just two examples of, and I would say the third is that there wasn't a real consensus in plastic surgery, uh, nationwide, that the cosmetic patient was a legitimate patient. In other words, someone who's sick deserved the care of these esteemed and highly trained specialists. But the person who was being driven by emotional needs or appearance was somehow second class. And he saw all that and felt it was wrong and wanted to get into an environment where he could take care of patients in the way that he felt they needed to be taken care of.

Monique Ramsey (04:03):
And Dr. Olesen did colleagues think you were kind of crazy to do this, you know, you're head of the division and to just like walk away and start something completely different. That was really trailblazing at the time. I mean, people didn't do this in the way that you did.

Dr. Olesen (04:20):
I can't really answer that question. I think that some people were a little jealous of how we went about it. We ended up redoing sort of a semi historic small building that had been the previous nursing residence for the Scripps or for the clinic in its prior location. And we had a beautiful office and maybe more beautiful than many of the other offices in town.

Monique Ramsey (04:53):
Do you remember how many other cosmetic practices were in San Diego at the time?

Dr. Olesen (04:59):
Oh, I think there were 10 or 15 maybe.

Marie Olesen (05:03):
And the other thing that he did, because the new location was about 20 minutes from the hospital, is we got a Medicare certified or in 1988 and for an all cosmetic practice. And so that was extremely unusual. And then we taught patients that they had to look for or certification because it was the Wild West. And in those days there were no requirements at all for OR certification. And so we went to the highest standard.

Monique Ramsey (05:42):
And really the reason you did that was safety driven.

Marie Olesen (05:46):
Yes.

Monique Ramsey (05:47):
Yeah. So what were some of the challenges, Dr. Oleson from your perspective and then we'll get Marie's perspective? Just challenges in those early years.

Dr. Olesen (05:57):
I would say the biggest challenge was figuring out how to run our office properly. We, even though I had been in plastic surgery at a, at a large clinic and the part of the reasons that I wanted to leave had to do with how we dealt with patients. Once we had the patients in our own facility, it took us a while to figure out the best way to treat them the way that we wanted to treat them. Do you agree with that, Marie?

Marie Olesen (06:31):
Yes. Yes. And I decorated this historic building to look like I told the designer a 1930s hotel, just a timeless, but we started advertising, which was is another huge story. And somebody came in and looked at this gorgeous place and said, "I'm not paying for this". And I thought, oh my gosh, we don't even know who our patient is. And so we began surveying immediately in 1988. And we have been serving the patients now for almost 35 years and using their feedback to tell us what they like and what they don't like and then we try to fix what they don't like.

Monique Ramsey (07:26):
So you perfectly segued right into my next question, which was, what was marketing like in 1988?

Dr. Olesen (07:34):
It was new. There were a lot of plastic surgeons who thought that it was not appropriate. We were not the first people to market in San Diego. There was another prominent physician who had marketed for maybe a year before we started, but we tried to market very ethically and we tried to do essentially informational uh, marketing that would just disseminate information about plastic surgery.

Marie Olesen (08:11):
One of our early ads, I was reminding him today that headline was excellence and plastic surgery takes teamwork. And it was a picture of him with the anesthesiologist, the or nurse, the clinic nurse, the patient coordinator, the administrator to show. And there was then verbiage accompanying it, explaining all these specialties that were necessary to provide optimal outcomes and experiences for patients. And he knew instinctively that he needed his team to be happy and to be of what they were doing and their part in the total. And so he was never a "Me Tarzan" type leader. It was always teamwork.

Monique Ramsey (09:09):
So with that marketing, you know, you had the Yellow Pages and maybe you had some magazine ads, or how did people find the practice?

Dr. Olesen (09:19):
You know, back then, the medium that we used the most was the newspaper. We just put small or medium sized ads in the newspaper and it brought patients to the office.

Marie Olesen (09:31):
We did a campaign, a countdown campaign, and it was the side of a surgeon's face operating. It said 30 days, 29 days. When we opened, we had 500 phone calls. In those days there was no internet. Then we realized we don't know how to answer the phone, we don't know what to ask them, we don't know what a patient coordinator does, we don't know what a surgeon is supposed to do in a cosmetic consult. I mean, it was all brand new. And fortunately because we surveyed the patients or started surveying them, we were able to ask questions and they were to get able to give us insights. And then we used those to come up with what is essentially what we carry on today.

Monique Ramsey (10:27):
So really it's kind of, you change the approach to marketing, I think, beyond just your own practice. It's sort of, don't you think that sort of at the society level, the way you marketed helped? What did they say? A rising tide?

Marie Olesen (10:44):
Yeah. Floats all boats.

Monique Ramsey (10:45):
Floats all ships or something. Yeah.

Dr. Olesen (10:47):
There was a moment back then prior to when we started La Jolla Cosmetic where marketing was really considered to be essentially almost unethical within the plastic surgery world.

Marie Olesen (11:06):
And he was called up before the California Society for Our Marketing and he said, I feel like I'm on a a do you beat your wife panel? There's no answer I can give you because you have decided that what I'm doing is questionable. And the fact is a lot of the people who were advertising at the time were not board certified plastic surgeons and lots of people move in and outta San Diego. So the people who were using marketing to make a decision in choosing a doctor, if all the plastic surgery exited the field and refused to be visible in that medium, then the patient was going to choose all these wannabes. And we thought that was terribly wrong. And so our marketing was educational, it was elegant and it worked.

Monique Ramsey (12:06):
Yeah. And I think from what I remember, cuz I came at the end of 91 and in 92 or 93, 1 of the things that you did that was really different, and it was actually before the term was invented, infomercial <laugh>, you guys did some 30 minute segments that you would pre-record and that ran on the local and Yuma cable TV stations. And those were really helpful cuz it would be the doctor talking either with a patient or there was a lady interviewing you to really get down into helping to, and again, because like you mentioned, there's no internet, so patients doing their own research, there wasn't a lot of tools out there to do your own research. So having that little TV show <laugh> was really, I think that was another kind of trailblazing thing that you did. And it was all to, again, help patients make really good decisions.

Dr. Olesen (13:08):
That was a moment in time when doing what we did worked perfectly. The return on our investment for doing those little TV shows was huge. And we've never, ever gotten back to that level of return on

Marie Olesen (13:29):
Investments was like 50 to one or something <laugh>. Yeah. You know, the other thing we did, Monique, was, and I don't know why I did this, but those days there were secret shoppers. So we hired a secret shopper and had her make appointments at our practice. We didn't know who she was, the staff didn't know who she was. And so make an appointment, come and have a consult, what did they receive and what it was apparent, you made an appointment, nobody acknowledged the appointment, uh, you came for a consult, you might receive a fee quote, you might not, there was no follow up. And somehow people still operated despite those very lousy systems. But we decided, okay, if you make an appointment, you're gonna get a, a letter in the mail for the, in those days from the doctor thanking you for making the appointment and looking forward to meeting you and helping you, there would be calls and follow up notes from the coordinators. And we just really distinguished ourselves as a practice that communicated openly and readily about something that, again, in those days people were still really pretty reluctant to be discussing.

Monique Ramsey (14:53):
So at what point Dr. Olesen did you decide I wanna have a partner or partners be a group versus being just a solo practitioner?

Dr. Olesen (15:06):
Well, it just sort of happened organically, I guess. A young lady came to us who was a trained plastic surgeon but had basically quit to have children and so she wanted to reenter the market and so we let her try. And over time she became one of the very best surgeons I've ever seen. And then

Marie Olesen (15:35):
She just retired after 34 years.

Monique Ramsey (15:38):
And Lori Saltz.

Marie Olesen (15:38):
Right.

Dr. Olesen (15:41):
And then as we got busier, there came a time when we just needed somebody else there. And so we found that the easiest and best way for us to add new doctors was to find doctors who were successful in our community who just for one reason or another wanted to change locations or be with the group or

Marie Olesen (16:10):
They didn't wanna run a business. They were really good doctors.

Dr. Olesen (16:14):
That was probably the most, the best driver is we had an office that ran that eventually ran very well. And running an office is not easy. So they could come and work and let leave the office running to us.

Monique Ramsey (16:32):
So Marie, tell us about your background. What led you to be in cosmetic medicine besides your husband

Marie Olesen (16:41):
Besides marrying into it <laugh>. Well my, my background was that I'd actually been a nursing home administrator and owner. And so I was used to taking care of defenseless patients 24/7, 365 through caretakers that I had to monitor and motivate. And so I, my heart was already there. My own personal mission statement since high school had been that I wanted to help good doctors take better care of patients. And so when he left the clinic where I could play no role as a spouse then and starting the the center, there was a lot of things to be done and I just filled in and I never actually, I had a side role all the time, which was trying to understand the patient, trying to take these questionnaires and figure out what we needed to learn from them. But I wasn't actively working in the practice on a day-to-day basis or having a leadership role. I was more in an advisory role, I would say.

Monique Ramsey (17:57):
And how did you know to survey patients in the first place? Because now we all get surveys everywhere we go, every time we see the doctor. But back then, was that sort of, was there anything that gave you that idea besides the 500 phone calls <laugh> that started on day one

Marie Olesen (18:16):
Uh, there was another early incident, which was, you know, typical medicine. He had a four page medical history. And so someone came in, was given that four page medical history and came back and literally threw it at the receptionist and said, I'm not filling this out, I haven't even decided that I'm going to hire you yet. And I went, whoa, we do not know who we're serving and we better figure it out ASAP. Because we had a big lease and expensive buildout and a lot of employees and everybody was counting on us to know what the right thing to do was. And so in my mind it was ask them and I couldn't find a medical survey. And so I took a hotel survey and converted the hotel survey. And this is obviously a paper survey in those days.

Marie Olesen (19:21):
And we had books in our waiting room notebooks, three ring leather binders filled with these surveys and it was like reading ratings and reviews. You just sat there and flipped through reading what hundreds of other people had said and people were happy and we took very good care of them and they wrote lovely things and they also said, I didn't li I don't like this or that, whatever it was, if it was a process we could fix, we would fix it. But we were just patient driven. We decided he left over the care of the patient, the staff came to help him take care of patients. And so we were all joined in let then let's find out what the patients want. And since nobody in the industry seems to know, let's find out ourselves and then act accordingly. If you go back to my original thing about wanting to help good doctors take better care of patients, when you get to hiring of your staff, you need to be sure that your staff have the same values you have.

Marie Olesen (20:41):
And so it took me a long time to figure out, to ask them why they were choosing to come into medicine. In other words, somebody could be a receptionist anywhere at an office. Why do you choose to work for a doctor? And what the underlying story that I hear from them is like myself, I wasn't gonna be a physician, but I wanted to be around medicine and I wanted to be part of medicine. And so we do a great deal and, and the ratings and reviews really help this to encourage the staff to put their hearts into their work with the patient and for them to give of themselves in ways that many offices would not give them permission to do. And I think it's part of what creates the magic of the patient experience and of the long-term employment history that we have with so many people.

Monique Ramsey (21:47):
Mm-hmm. <affirmative>. So Marie, I know one of your favorite movies is Moneyball for many reasons, but there's a quote from that movie that says, "The first guy through the wall, he always gets bloody". Did you ever feel like that?

Marie Olesen (22:02):
That's funny that you had asked that. I would say we just knew we were out there alone. People did not understand what we were doing, but bullied by the fact that we were doing what the patients told us to do, then we didn't really question ourselves. We felt we were being guided. And later I remember one of the plastic surgeons in town who at first were horrified that we were advertising, said to us, you know that I really respect you guys because you really teach people how to choose a plastic surgeon. And all of us are benefiting from that.

Monique Ramsey (22:45):
Well, I think anytime you're a trailblazer are you, you're gonna make mistakes and it's gonna be more evident and you're gonna make successes that are more evident because nobody else is doing it. So I think it's really interesting. Now, in the early nineties, plastic surgery was really changing quite a bit and a lot of that was driven by the breast implant kind of scare slash crisis when, you know, the F D A said no more breast implants from silicone gel for right now. And so did anything in that experience or that environment change how you approached the patient experience?

Dr. Olesen (23:27):
Well, it was a bad time. A lot of our income and work related to breast implants and you know, it hurt us for a while, but gradually things improved and we did other things, other surgeries.

Marie Olesen (23:47):
Well the big thing that happened, we had this huge overhead and all of a sudden we have half the patient activity and Merl said, look, if I'm not operating nothing comes from nothing. So we need to figure out how I can keep operating, even if it's half the cost, but then work will come from the work I do. And so we just became very open and I can remember we came up with a little line of how patients pay. Oh, they pay with checks and credit cards and two credit cards and a check and they, we offer payment plans and just to make it so that they could then feel comfortable discussing their personal finances and how they were going to pay for what they wanted.

Monique Ramsey (24:45):
Mm-hmm. <affirmative>. Now something else that happened, I think right around that same time was you started creating a computer program or a software program in the office and you took it to be a company and other doctors used it. It was called Inform and Enhance. And my, my recollection of that time was really with all the craziness with the breast implant crisis, looking at your informed consent process was sort of like these photocopies of some other photocopy. And it was very generic and really didn't explain the process to the patient. And so I remember you, Dr. Oleson and Dr. Saltz writing out for every procedure that you did, all the risks and the post-op instructions and the healing instructions as you get into going back to life after your surgery. And I think at that point that was a really big thing. I mean you, you had written it for only for our patients, but then I think some of your colleagues thought that was a pretty good idea.

Marie Olesen (25:53):
Well, if you recall Monique, we had 200 word documents and using the technology at the time, it took 20 minutes to put all the pages together in the order that we wanted them. And someone came and said, we've heard about your pre-op books. A doctor in New York, one of our patients had mailed her pre-op book to her friend because her friend didn't get a pre-op book. And so we decided, okay, let's hire a programmer. And we said, you don't want it the way we have it. Let us see if we can get it into a format that you could use. And because it greatly enhanced patient satisfaction, reduced phone calls, we actually eliminated a nurse position because there were so many fewer phone calls, peri-operatively asking questions because they had had a really good pre-op appointment. So Merrel hired and this person to work, try to do it out of the office.

Marie Olesen (27:03):
And in those days I was doing Olympic volunteerism. My role as the wife of a plastic surgeon was to be in the society, chairing balls, all this kind of stuff, which is what I was doing. And so he called me one day and said, we can't do this in the office, you have to take this programmer and you have to take over this project and here it is. So I'm not a crier. And I mean that guy brought me to tears multiple times and we, it was, you know, you're taking little disks and you're moving them back and forth, there's no way to, to transfer data. So we finally got the whole thing written and we called Karen Zco and said, Karen, we have this thing and we don't know what to do with it, but it really helps and is this something that you would be interested in taking and running with?

Marie Olesen (28:07):
And she said no. And so then we called ASPS and we called the chair of the informed consent committee and we said, we have this all ready to go. Do you guys want it? Here it is. And no, they didn't want it. So suddenly we're in business. And so we went to the first meeting in 1994 with the pre-op book, I wanna say 49 surgeons bought the software. And then within a few months, one of them called me and said, Marie, I would love to give your little pre-op book to a patient, but honey, I have to have a patient first. And I said, oh, well I have all these systems that we've developed and I never knew that anyone would be interested in those. So I went back and we added all the CRM features of what we were doing, putting in the letters, putting in the to-do list, all the things that optimized patient experiences, and I'm losing his name right now.

Marie Olesen (29:26):
But unbeknownst to me, we were so naive that the then president of ASAPS was one of our customers and he came at the ASAPS meeting in 95 and literally stood Gustavo Cologne and stood outside the booth and said, you gotta buy this software. This really helps <laugh>. And I didn't even know who he was. And so it just led to ultimately 1200 plastic surgery practices using our software coming many years we had trainings where we would bring the doctor, the nurse, the PC and the manager to our practice for a weekend of training basically in how to run a cosmetic practice, how to create a great cosmetic experience because we by then knew how to do it and we're measuring and managing everything. And some of those people are in the hierarchy of the organizations now. And we both have a great deal of pride about the part we played in helping plastic surgeons understand the aesthetic patient.

Monique Ramsey (30:49):
Yeah. Now something else you did <laugh> that ha it was a very big source of pride in more writing is you literally wrote the book on cosmetic surgery with The Cosmetic Surgery for Dummies book. And tell us Dr. Oleson, how did that come about?

Dr. Olesen (31:08):
It came about because we knew a person, a young woman who had written a cooking book for

Marie Olesen (31:19):
Sushi for Dummies.

Dr. Olesen (31:20):
Sushi for Dummies. And she said, why don't you do it for cosmetic surgery? And it dragged on. And one thing led to another, but eventually we wrote this book of which some copies were sold, but it was not a huge runaway success <laugh>, but it was a good book. We put in real information and if somebody read the book and wanted plastic surgery and they followed what we suggested, they were able to find the right doctor and the right circumstances.

Marie Olesen (32:01):
We taught about medical specialization and training and I say I did 34 pages on how to choose a doctor ending with the recommendation they choose someone from ASAPS because ASAPS had a significant bedding program to ensure competency in cosmetic procedures. But that many books didn't sell. And 34 pages is far too complicated. And so it was fun to do, it's a nice thing to hang on our wall, but it was at that point I realized that it wasn't enough to help good doctors take care of patients. You also had to help the patients find the good doctors.

Monique Ramsey (32:49):
Mm-hmm. <affirmative>, Sort of a matchmaker, right? <laugh> So would you say that same thing, okay, that was in 1995, no, excuse me, 2005, right? 2005? Mm-hmm. <affirmative>, Would you say that same thing now in 2023 of how to choose the surgeon?

Marie Olesen (33:05):
Yes, most of it is very much the same. There's a little more variety in the, in the specialties that do certain procedures like liposuction is now done by facial plastics or, and even by some OB's. But for the key procedures, yes. Uh, you know, it's important to know the training and to look at before and afters and to see if the office is clean and know how you're treated by the staff and whether they follow up and do what they say they're go going to do. So lots of little clues along the way about post-op, when you're gonna need them is are they gonna be there for you and in an organized way.

Monique Ramsey (33:56):
So if somebody came up to you on the street, Dr. Olesen and said, how do I find a good plastic surgeon? What would you tell them?

Dr. Olesen (34:05):
Well, I almost think the easiest thing for patients to do is to make appointments with two or three plastic surgeons and really critically look at their before and after photos. And I think that's almost more important than whether they like the doctor because the pre and post-op photos do not lie. And the problem is the patients just straight off the street probably don't really have the critical knowledge to figure out which are the really good ones and which are the really bad ones. But they certainly have a general sense of what looks good and what doesn't.

Marie Olesen (34:51):
Of course these days you have ratings and reviews, right, right. And Merle retired in 2005, and so for a couple few years we weren't involved actively in the practice. Then in 2010, the doctors who were there asked me, uh, because I'd been consulting for years, just would I come in and help them run the practice? And so I did and very quickly I saw, well, we had like 18 Yelp reviews in a 3.7 rating. And I'm going, that's a damn lie. We're one of the best practices in the country and we know it. And we're we're not our story. And so I thought of real patient ratings and I founded real patient ratings and we then began serving, we went back and surveyed a year of patients over 150 reviews came in very quickly and we were a 4.9. And then I thought, so the practice has to be able to show to the patient that their quality. And so now real patient ratings is very close to publishing a million reviews. And the situation now for consumers is like, it's 99.5% of consumers are using ratings and reviews to make buying decisions.

Monique Ramsey (36:27):
Yeah, that's, that's something that's been such a good change over the year from the paper survey, which they can't read unless they were on site to see that book full of, of surveys to kind of help with the, I guess it helps with the trust, right? Like if all these other people had a good experience, I think I can too. So with the benefit of hindsight, like in this whole last almost 35 years, you know, is there anything either of you wish you would've done differently?

Dr. Olesen (36:59):
Hmm. I've never heard that question before.

Marie Olesen (37:03):
It was not discovered until 1993 in a book called Patient Satisfaction Pays The Incredibly Positive Business Outcomes Related to High Patient Satisfaction. And that involves teamwork, quality, patient satisfaction is a team delivered experience. And so while we were always very, very good to our staff and we have, we have a work family is how we regard it. And I, I can't remember if we shared the feedback with everybody or not, they were certainly there in the books. But once I did RPR then I started sharing every response with the entire team. And once people really understood what patients wanted based on those ratings and reviews, what they valued, then an even higher level of care ensued and a much greater staff satisfaction. So I think I, I wish we had had that information all along because I, uh, it was very motivating and encouraging.

Monique Ramsey (38:22):
You brought up earlier that you were kind of the queen of chairing different balls or different benefits around the community or very actively involved in the community, but really volunteering has been something, or I should say charity work and volunteering have both been kind of a, a keystone of the practice. And so Dr. Olesen, I know that you used to go to Mexico. Can you tell everybody a little bit about what you did there?

Dr. Olesen (38:54):
On a strange random encounter at a party, I met a nun who, I talked to her and she turned out to have been a twice divorced mother of seven who had been at the penitentiary in La Mesa, in Mexico.

Marie Olesen (39:19):
In Tijuana,

Dr. Olesen (39:20):
South of Tijuana. And she had decided that she really wanted to help them. So she showed up at the door of the penitentiary and said, I have been sent to help. And this was after she'd gone out and tried to get an appointment or be able to join an order. And the bishops in Los Angeles and San Diego turned her down. So she went out and bought a habit and showed up at the penitentiary and said, I have been sent to help. And she moved into the penitentiary and slept on a concrete pallet for quite a period of time. And eventually she wanted to be able to rehabilitate prisoners when they were going to get out. And they had little tattoos and facial blemishes that she wanted to help get rid of. So when she found out I was a plastic surgeon, she said, would you come help me? And I said, sure. So for about 10 years, Marie and I went down once a month and did any small operation that we could do under local anesthesia.

Marie Olesen (40:46):
He did one adult cleft lip. That was probably your most, most fun.

Dr. Olesen (40:52):
Yeah. And we even brought one patient across the border to the hospital and got the hospital to donate services and the anesthesiologists to donate services. And we took a young woman in conjunction with an oral surgeon. She had fallen from a second story building at age two or three, and her jaws had fused to the skull and she could not move her mouth at all. Anyway, we fixed her up, got her functional again, 10 or 15 years later, she found me when I was working at the clinic. And in the meantime she'd become some kind of minor movie star. And yeah, she was functioning perfectly, was wonderful.

Monique Ramsey (41:49):
Marie, what do you remember about going down on those days?

Marie Olesen (41:54):
Well, we're very blessed. We were blessed to find each other, blessed to have interest in common. And this was just, this was such an unusual woman and she's now died and is actually in what in the Catholic church is a process to become a saint. And it's a four step process and she's at that servant of God's status. And the Pope John Paul II ended up giving her an order called the Udith Servants of the 11th Hour. And it is anyone married, divorced, whatever, but older who wants to work with the, the poorest of the poor. And so it was amazing to be, she never saw evil. She's surrounded by all these prisoners and they're, she calls them her children and it was a, you know, amazing to encounter someone like her.

Monique Ramsey (42:58):
You know, we've always supported local charities like Las Petros cuz they do so many good works around San Diego. But tell us a little bit about why that is important in the practice.

Marie Olesen (43:12):
Well, you know, if you think about it, it's less so now, but there's still an element of it that people who are doing something for themselves feel slightly guilty about that investment in their themselves. And if the organization with which they're choosing to have their work done has a component of giving to the community, I think that that's meaningful to them. And we've done it since the beginning and we weren't as public about it initially, but later when it became apparent that really consumers wanted to know this information, then we became much more public about our giving. And we give to Humble Design, which is a national organization that helps homeless off the street and puts them into apartments. And we help the food bank and we help arts organizations. It's a, it's a wide variety of things that are meaningful to us and meaningful to the community.

Monique Ramsey (44:24):
Okay. I'm gonna throw you for a loop now, Dr. Olesen, if you could go back to any time in your career, any moment, when and where would you go?

Dr. Olesen (44:37):
Well, I loved my plastic surgery career. I was good at what I did. I'm not sure there was really any part of it that I didn't love. You know, there were some moments that were stunning to me and those were fun, but there really weren't any bad moments. There were very few.

Monique Ramsey (45:01):
Marie, do you have any thoughts on that?

Marie Olesen (45:03):
Yes, he's a stunning surgeon and he was very kind and he, we used to say he's a gentle man and the maddest that he would ever get when something happened in the office, he would go, how can this be? But it was never yelling at people, demeaning people. In fact, he asked a couple of surgeons who joined us to leave because their behavior toward the staff was hierarchical or inappropriate or whatever. So he did work that everyone could admire and headed a culture that everyone loved being part of.

Dr. Olesen (45:53):
I would say the most magical moment. I had reconstructed a patient's nose where she was missing the end of her, the left side of her nose, and I reconstructed it using forehead flaps, et cetera. And she was from out of state and I forgot about her and maybe 10 years later she came to my new office and walked in and asked to see me. And I went out to see her and she looked totally normal and she had looked very un-normal when I started and I could not see any deformity and it was thrilling.

Monique Ramsey (46:41):
Oh, I bet that's a huge impact for somebody, for you to see what it changed her life completely. And I think, you know, looking at all the opportunities for hundreds, if not thousands of others to serve patients through your inventions, I guess with Inform and Enhance and with real patient ratings and just kind of bringing the level up. So what would you each of you like to see as the future of La Jolla Cosmetic?

Dr. Olesen (47:15):
I'd like to see them continue doing what we're doing now. Uh, I think we've gotten the ability to serve the patient, the ability to get very good results, and the end result of making it a very happy workplace is really at a high level.

Marie Olesen (47:37):
And we have the listing systems to find out when they're changing. You know, I say when I, we started all this, I could be the mother of our patients. Well now I'm the grandmother. And so how do you know what they're thinking, where, what they want? You just have to constantly be asking. And I think that to the extent that any surgeon doesn't really understand how powerful teamwork is in creating great experiences, I wish more of them understood it and I wish more would measure and manage based on that information. There's still, still to my mind, too much fear and manipulation of ratings and reviews when just having better patient care and communication systems is the greatest protection to quality and will help grow the practice.

Monique Ramsey (48:39):
Yeah, I think it's really amazing to be able to have this hundredth episode with both of you to celebrate the past almost 35 years of La Jolla Cosmetic and kind of the innovative things between just surveying the patients on paper and that leads to real patient ratings or whether you're talking about better education for patients through marketing or through the booklet that they're gonna get prior to surgery. All of those different touch points around, you know, have made it a very wonderful first 35 years. And it's exciting to see what will happen in the future.

Dr. Olesen (49:19):
You know, I don't want to give the impression that we think that we're better than anybody else. There are lots of people providing plastic surgery care at the same level that we have tried to do it and,

Marie Olesen (49:35):
And providing great patient experiences.

Dr. Olesen (49:37):
And you know, this is just our little story of what has happened to us, but it's happened all across the country. There are just many, many, many great people involved in plastic surgery.

Monique Ramsey (49:54):
Last question before we go, Dr. Oleson, what do you do with your time these days?

Marie Olesen (50:01):
<laugh>?

Dr. Olesen (50:04):
My main recreational activity is I have become a duplicate bridge player. So I play both online and in person at local clubs and I enjoy it.

Marie Olesen (50:20):
And he's a few points from being a Silver Life master, which is a big achievement.

Monique Ramsey (50:27):
Wow, that's nice. So online and in person. And Marie, what, what do your days consist of when you're not watching your husband play Bridge <laugh>?

Marie Olesen (50:38):
I still work at the office a little bit, mostly remotely, mostly at strategic levels with the physicians or, or marketing or processes. The one thing that I would add about the future of the practice is that, again, because of the changing of the consumer, the expectation is that many more people are going to non-surgical services. And so we started our own med spa 10 years ago. We've took in investors a couple of years ago, we just, they just built a second location. And as I see it, the combination of a surgical practice with a very trustworthy, strong med spa is just the ultimate best for patients. Because, you know, if all you have is a hammer, then all the world's a nail. If you have a surgical practice associated with a med spa, then everything on the continuum can be performed. And what is done or recommended to the patient is defined by what their needs are, their own personal feelings about anesthesia or no anesthesia. But you can do what's right. And I think that what I see also in our practice is the pride of staff and all providers, surgeons and med spa providers about the fact that we give good advice. We're, we're highly trusted and that gives everyone a great deal of pride.

Monique Ramsey (52:25):
Here, here. I totally agree with that. All right, well if you're listening today and you have any questions or need information about anything, we're gonna put it in the show notes for you. And please take a look at all of our other episodes. There's some really interesting ones and, and now we're at number 100 or 101. So it's really fun. Thanks again, Dr. Olesen and Marie for joining us.

Marie Olesen (52:47):
Thank you.

Dr. Olesen (52:48):
Thank you.

Speaker 1 (52:55):
Take a screenshot of this podcast episode with your phone and show it at your consultation or appointment, or mention the promo code PODCAST to receive $25 off any service or product of $50 or more at La Jolla Cosmetic. La Jolla Cosmetic is located just off the I-5 San Diego Freeway in the XiMed building on the Scripps Memorial Hospital campus. To learn more, go to lj csc.com or follow the team on Instagram at lj csc. The La Jolla Cosmetic Podcast is a production of The Axis, the axis.io.