THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Saturday, May 18, 1996 TAG: 9605180554
SECTION: FRONT PAGE: A1 EDITION: FINAL
SOURCE: BY DEBRA GORDON, STAFF WRITER
LENGTH: Long : 144 lines
If Dr. William B. Ershler's vision becomes reality, Hampton Roads will be a great place to grow old.
In his vision, elderly residents will have access to ground-breaking research, specialized medical care and communitywide education on the problems of aging.
And the Glennan Center for Geriatrics at Eastern Virginia Medical School - which Ershler was recently named to direct - will become an internationally recognized program on aging.
Ershler moves to Norfolk in July from the University of Wisconsin, where he's spent the past seven years directing two geriatrics centers. His work there garnered him recognition in a national consumer magazine, American Health, as one of the 1,000 best doctors in the country.
He comes to town with an entourage, including several staff members and 30 research monkeys. He's moving into the fourth floor of Hofheimer Hall, but he's already got visions of building a separate building and starting a fund-raising campaign.
``Older people should be given the option of having the best treatment possible,'' Ershler says. ``We will work on making EVMS a true center of excellence in this area.''
Ershler is coming to EVMS, a tiny school compared to powerhouse Wisconsin, because it offers the chance to create a program from scratch.
Instead of recruiting faculty to meet the needs of an existing program, as he did at Wisconsin, he can create a center based on the strengths of some of the best geriatricians in the country - several of whom he is close to recruiting.
They include Dr. Stefan Gravenstein his peer at Wisconsin. Gravenstein's research focuses on infectious diseases in the old, and he is working on developing vaccines to fight those diseases.
Everyone Ershler recruits is bringing his or her own research money. Ershler himself has nearly $400,000 a year in grants, a pretty hefty amount in these days of pinched scientific funding.
The 47-year-old Ershler didn't set out to be a geriatrician, the term for a doctor who addresses the health needs of older people. He began his professional life as a cancer doctor. Early in his career, he submitted a paper to a medical journal on the effects of the immune system on lymphocytic leukemia, his area of specialty.
Interesting analysis, the journal's editors wrote back. But, since all of your subjects were 70 or older, did you consider how their age might have affected the results?
Much to his chagrin, Ershler had not. But the question piqued his interest, and he began studying the aging immune system as it relates to cancer. After all, he thought, more than half of all cancers occur in people 65 and older; cancer is really a geriatric disease.
Eventually, his fascination with aging led him to become immersed in geriatrics and to his appointment at Wisconsin.
There, he ran several specialty clinics for the elderly, which he plans to duplicate in Norfolk.
The first of the five clinics he plans for Norfolk should open this fall, Ershler said. They will be staffed by several of the 16 geriatricians already on EVMS's faculty, as well as new faculty he recruits.
The clinics will focus on major health issues affecting the elderly, including falling, incontinence, memory disorders and osteoporosis. The fifth clinic will provide head-to-toe medical evaluations for older patients.
Patients will visit the clinics one or two times for assessment and return to their primary care physicians with a treatment plan.
Each clinic will use a team-based approach, which draws on a range of specialists to develop coordinated treatment for each patient's health problems.
For example, a patient who is prone to falling would get a doctor's evaluation on balance and coordination. A social worker would go to the patient's home, checking for bright lighting, safe flooring and hand rails. A pharmacist would assess the patient's medications, checking to see if they could cause dizziness or lightheadedness.
Eventually, Ershler said, he hopes to begin a primary care practice in geriatrics, which would provide the same type of specialized care for the elderly that a pediatrician does for children.
Ershler also plans to train new geriatricians through a residency program. These specialized doctors will be desperately needed in the coming years as the baby boomers age, according to a report released this week by the Alliance for Aging Research, a Washington lobbying group. Ershler serves on its advisory board.
While patients receive medical care on the fourth floor of Hofheimer Hall, two floors down researchers will be looking for answers to some of the basic questions of aging:
What effect does nutrition have on aging?
Why do more than half of all cancer deaths occur in the elderly - even though they make up less than 13 percent of the population?
How can the bone-dissolving effects of osteoporosis be slowed or stopped?
What new vaccines for influenza can be developed?
Ershler's own research specialty is osteoporosis, a weakening and thinning of the bone that strikes up to 8 million American women.
He hopes to coordinate his work with other research on menopause under way at the Jones Institute for Reproductive Medicine.
He has more than a scientific interest in the disease. His 89-year-old mother died last year from complications related to osteoporosis. ``She could have been the poster child for the disease,'' he says.
Her illness motivated him to become interested in caring not just for older people, but for the frail elderly with their multitude of problems. This population needs intensive attention and specialized care from doctors who know how to look beyond the obvious.
``Hopefully,'' he says, ``We will bring that kind of spirit with us as we establish the medical program in Norfolk.'' ILLUSTRATION: Color photo
MOTOYA NAKAMURA/The Virginian-Pilot
Dr. William B. Ershler, new director for the Glennan Center for
Geriatrics at Eastern Virginia Medical School.
Graphics
SHORTAGE OF DOCTORS
A report released this week warns of a shortage of doctors
trained in geriatrics, a specialty which addresses the health needs
of older people. The report, issued by the Washington-based Alliance
for Aging Research, says medical schools are doing little to prepare
for that shortage.
The report notes:
With fewer than 7,000 geriatrics specialists, the nation already
faces a shortage.
At least 20,000 doctors with geriatrics training are needed to
provide appropriate care for more than 30 million older Americans.
By 2030 - when the baby boomers are 66 to 84 years old - more
than 36,000 physicians with geriatrics training will be needed for a
projected 65 million older Americans.
TRAINING PROGRAM
Dr. William B. Ershler is the new director of the the Glennan
Center for Geriatrics at Eastern Virginia Medical School and a
member of the Alliance for Aging Research advisory board.
A fellowship program in geriatrics is on his ``top priority
list'' for EVMS, Ershler said. The program would provide physicians
who are already certified in a specialty, usually internal medicine
or family practice, with additional training in geriatrics.
The school already requires that its medical students complete a
two-week clerkship in geriatrics.
``There is so much more to taking care of an elderly person than
caring for their medical problems,'' he said.
KEYWORDS: EVMS GLENNAN CENTER FOR GERIATRICS
ELDERLY by CNB