Dr. William Norcross
  ... loves older people.

"I think that's because I had such a wonderful relationship with my grandparents," said the geriatrics specialist, family physician and Professor of Clinical Family Medicine at UCSD since 1978.

Unfortunately, many doctors don't feel that way. As a result, there's a real shortage of geriatric physicians in the United States. Part of the blame, says Norcross, is the health care system, in which doctors are measured by their productivity. Older patients typically have more problems requiring special attention, but that's how Norcross likes it.

"The more complicated people are, the more I enjoy taking care of them," he said. In a nutshell, that's what being a family practitioner is all about - caring. It's a quotient that's enabled Norcross to look deeply into the eyes - and hearts - of many a patient. And maybe even save a life or two.

Such was the case four years ago with a 72-year-old former colleague who came to him "not feeling right." He knew she wouldn't come to see him unless something was wrong. Looking into her eyes, he agreed. A complete history and battery of tests later picked up a large tumor on her pancreas. It was removed and she's doing fine.

"I know if I didn't have that relationship with her and know her as well as I did, I wouldn't have thrown myself into that evaluation," said Norcross, whose role model was an old family physician in Toms River, N. J., where he grew up. "He did the whole thing, taking care of me from the time I was born, taking care of old people, delivering babies and even doing occasional surgery," he said. "That's my idea of what a doctor should be.

"I just didn't see being a physician as someone who didn't know how to deliver a baby or look into the ear of a child or assess the function of an elderly person," Norcross said. "Being a physician means you can do all of those disciplines."

In the same tradition, Norcross' residency program has delivered babies of mothers he himself delivered 26 years ago, and he is in regular touch with at least 60 percent of the 145 doctors who have gone through the program since he took over.

After 27 years, Norcross, 53, has lost none of that sense of enthusiasm which he tries to instill in his students.

"I tell them you have to give your patient your best. You have to be alert and treat your patient like a puzzle. Don't let yourself fall into routines because they can be dangerous."

Norcross decided to heed his own advice four years ago when he turned over the reigns of the residency program in family medicine to Dr. Tyson Ikeda, who had been a resident under him. It's allowed him to spend more time with his own practice and further his work with PACE (Physician Assessment and Clinical Education), a program he founded four years ago for physicians with problems.

"Typically, they have made a mistake," he explained. "It may have been detected through malpractice, or a medical board investigated them, or they may be deficient." The PACE program is a remedial measure to get them back on track. While they don't have direct patient responsibility or write prescriptions, they participate in general procedures, such as making rounds, and are incorporated in educational activities.

"We assess their physical health, a neuro-psychological battery of tests, their clinical knowledge and judgment," explained Norcross. After two days, a program that best attacks the specific problem and needs of the physician is adopted. "In most cases, we bring them back into residency education. There's no other program like this in the United States or Canada," he said.

Ultimately, what Norcross hopes to do is engender a spark - the same sort of spark that ignited him while still in high school.

"Basically, I thought then that this was the most wonderful thing a person can do with their life, and I still feel that way," he said.


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