The faculty at the University of Washington’s School of Dentistry say the plan to reduce the school’s $29 million deficit is full of erroneous assumptions. Faculty leaders recommend closing a UW-run clinic in Magnuson Park and admitting more high-tuition international students.
The plan to erase a $29 million deficit at the University of Washington’s School of Dentistry relies on faulty assumptions and could put the school in financial danger, a number of its professors are warning.
In a letter to UW Provost Jerry Baldasty, the dental school’s six-member faculty council rejected the financial-stability plan approved by the UW’s regents board a month ago. The members of the faculty council, which represents all professors at the dental school, say the plan was not shared with them before it was approved by the regents. And they say they’re worried the school is being financially mismanaged.
The letter puts them at odds with the dental school’s dean, Joel Berg, who developed the plan with help from UW finance staff.
Berg has been dean since 2012. Privately, some faculty are urging the administration to review his performance or even replace him. Many said they did not want to be quoted for fear of retaliation.
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Like other dental schools, the UW’s School of Dentistry trains its students by providing dental care to the community; students are closely supervised, and while the appointments can take longer, they are also less expensive.
Eighty percent of patients at the school’s pediatric center, and 50 percent of patients at its adult clinic, are on Medicaid, which doesn’t fully cover the cost of patient care.
Berg said the deficit is largely the result of the UW’s role as a safety net for patients on Medicaid, the escalating cost of a dental education, and the absorption of a 10 percent budget cut during the recession.
He says he thinks the faculty rejected the plan because they don’t have an overall picture of how the finances fit together. “It’s not that they’re incorrect in their individual positions, but when you look at the big picture, all together, it’s a different view,” he said.
Berg speaks passionately about the center’s role in serving children with special medical issues. About 20 percent of its patients are autistic or have other special medical needs. “Other practices and programs see some of these types of patients, but on a very small scale,” he said.
The faculty have a different view on what caused the deficit, and what can solve it. They say much of the deficit can be attributed to the creation of the Center for Pediatric Dentistry, a UW-run clinic in Magnuson Park in northeast Seattle which opened in September 2010. It was a signature project for Berg, a pediatric dentist.
Faculty say the financial plan for the center was based on faulty projections that were never publicly vetted, that the center’s location in a relatively wealthy neighborhood has kept its patient numbers low, and that it will be difficult to attract enough full-paying patients to make it financially sound.
Opening the center in the Sand Point neighborhood “was like building a clinic for poor children in Beverly Hills,” said Peter Milgrom, a professor of oral health sciences at the UW.
Its location “means high costs of operating and terrible accessibility because of the traffic and lack of public transportation,” said Milgrom, who described the financial-rescue plan overall as “financially irresponsible.”
The faculty council proposes closing the center, eliminating new administrative positions, teaching fourth-year dental students in community health centers, and accepting more international students into the program. International students pay about 30 percent more than in-state students.
Faculty members are also willing to forgo salary increases to help solve the budget woes, said Donald Chi, associate professor of oral health sciences and head of the dentistry school’s faculty council.
Berg, in contrast, thinksthe school can increase the number of patients seen at the Sand Point center, and also at the adult clinic at the UW’s Health Sciences Center building. A new system for booking patient appointments will allow the clinics to see more patients, he said, and the school is also looking for ways to get the word out about its services.
Berg believes the proportion of Medicaid patients in the adult clinic can be reduced to 35 or 40 percent by booking more self-paying or privately insured patients.
But faculty members have their doubts. It will be difficult to increase the number of privately insured patients because there are already so many private dental clinics serving the city, Chi said.
According to the Washington State Dental Association, there are 106 dentists for every 100,000 people in King County — well over the national average of 61 dentists per 100,000 people.
In its letter, the faculty council wrote that the clinic spaces in the Health Sciences Center “are outdated and in poor repair, receiving care from students is inefficient and requires numerous visits, and UWMC parking is expensive.” It’s more likely, members say, that the UW will see an increase in Medicaid patients, rather than an increase in self-pay patients — and since Medicaid doesn’t reimburse for the full cost, that could make the deficit worse.
All of this is playing out amid sharp increases in the school’s tuition, although Berg says no tuition dollars are going to help erase the deficit.
A year of dental-school tuition is now $43,000. It went up 10 percent in 2014-15, another 10 percent in 2015-16, and will go up 8 percent next year. Berg said the cost increases are mostly due to the rising cost of medical care.
Kalob Lesh, a third-year dental student and president of the dental school’s class of 2017, chose the UW because of its affordability. But with the steep tuition increases and other costs, he now expects to graduate owing more than $300,000, including accrued interest, in student loans. Students who start now will likely owe $400,000 when they’re done because of the tuition increases, he said.
The UW dental school is highly rated, but Lesh worries that the nation’s top-caliber dental students will choose other highly rated schools that cost less.
Berg acknowledged that the high tuition cost is causing some students who are accepted into the program to go elsewhere.
“Paying dental school off is a huge concern for students,” Lesh said. He said most young dentists go to work for health-care corporations, which pay less than private practice. “Wealthy dentists are a thing of the past,” he said.