Yakima Grown: Future Dental School Planned for Yakima’s Pacific Northwest University of Health Sciences
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The Yakima area is already known as the home of some of the juiciest peaches, sweetest cherries, and tastiest wines. If all goes according to plan, it’s about to also become known as the home of a new dental school, Washington’s second and one of the country’s most innovative.
Pacific Northwest University of Health Sciences (PNWU) is a small, private non-profit institution founded in 2005 by a group of osteopathic physicians. After receiving its accreditation, the first class of approximately 70 students in its College of Osteopathic Medicine began their studies in 2008 and graduated in 2012. Within five years, the program had approximately doubled in size.
The school continues to grow and will welcome its first class of physical therapy students this fall, with hopes of adding an occupational therapy training program in the next few years. The plans for a new dental school are well underway, a founding dean has been hired (see sidebar on Dr. Fotinos Panagakos), and an initial class of 36 students is planned once clinical agreements, fundraising, and Commission on Dental Accreditation (CODA) standards are completed.
According to WSDA President Dr. Ashley Ulmer, “WSDA is completely behind the effort to create this new school.” The WSDA Board of Directors has met with school planners, and Association representatives participated in the interview process to select the school’s dean.
“More is more,” Ulmer said in describing WSDA’s interest in the initiative. “With the creation of this new school, students interested in dentistry will have more opportunities to pursue in-state training and rural communities will benefit greatly from having more professionals trained in rural settings.”
FOCUS ON RURAL HEALTH CARE NEEDS
That rural connection was one of the key factors in PNWU’s decision to create a dental school, according to its president, Dr. Michael Lawler.
“The developing School of Dental Medicine will advance PNWU’s mission to train health care professionals to serve rural and medically underserved communities throughout the Pacific Northwest. The future of healthcare is team-based, and dentists are critical members of the healthcare team,” said Lawler.
“For many communities, we know that oral health needs are frequently unmet and dental care is not always accessible. We want to help meet those needs by developing community-based, primary care dentists,” he added.
Many current PNWU students go on to serve rural communities. The hope is that students at the proposed dental school will as well.
PNWU focuses on a five-state region encompassing Washington, Oregon, Idaho, Montana, and Alaska. Most of its students come from this region, and many graduates go on to practice in smaller communities throughout the area, earning the school high marks from US News & World Report for preparing doctors to work in underserved communities.
“There was some initial skepticism of creating a health sciences university in a rural area,” said Adam Story, PNWU’s director of development and special projects. “But we now have a history of successfully putting providers into underserved communities. Because many of our students come from rural areas, they understand the needs from their own personal experiences. We expect that the same will be said for the dental program.”
While more traditional dental school programs typically marry two years of on-campus study with two years in a clinical setting, the plan for the new PNWU dental school will take a more innovative approach. After completing a year of on-campus studies, students will move on to three years of work in one of three Federally Qualified Health Centers (FQHC) around the state.
There they will continue to receive some lectures virtually, but will also receive practical training by serving low-income patients under the watchful eyes of supervising dentists. Each clinic will have a dedicated center, wing or building to provide this ongoing educational environment. These clinical teaching facilities will look and feel much like a regular dental clinic to patients, but will allow supervising dentists to observe multiple practicing students at once.
WSDA LEADERSHIP GETS ENGAGED
One of the participating clinics is operated by SeaMar Community Health Center in Tacoma, while the other two, in Yakima and the Tri-Cities, are operated by Yakima Valley Farm Workers Clinic (YVFWC). WSDA Board member Dr. Mark Koday was serving as YVFWC’s chief dental officer when the organization was approached by PNWU about participating in the creation of the new dental school.
“When I was in dental school, I would never have dreamt that I’d be serving on a committee making plans for a new dental school,” Koday said. “It was personally very exciting.”
Personal excitement soon gave way to professional excitement, as Koday learned more about PNWU’s mission and the impact it could have on access to care in rural areas, and he brought the idea to WSDA’s Board of Directors for their consideration. In addition to the overall need for more dental education opportunities in the state, directors saw other advantages of the proposal.
“Having more students providing care in our clinics will be important to the patients we serve,” said Koday of his organization’s interest. “But the larger, long-term access-to-care impact will be felt as these graduates go out and serve in rural communities. PNWU has a strong track record in recruiting and educating students from rural communities who then end up practicing in rural communities.”
The prospect of having more dentists practicing in rural communities also got the attention of Dr. Chris Dorow, another WSDA Board member who participated in the selection process for the school’s first dean.
“I’m a dentist in the small rural town of Othello in eastern Washington, and I have watched private medical and dental clinics that used to surround me close over the past couple of decades, to the point that I’m the last one serving five local communities,” he said. “It’s been incredibly challenging — impossible, really — to recruit dentists to come here if they weren’t home-grown or already have a connection to the area.”
“To get more folks to consider practicing in a rural setting, we need to have a school in a rural area,” Dorow added.
“PNWU is located in an underserved area with high need, and I have great hope that the school will recruit and produce healthcare providers that are not only well-trained, but also have a desire to come back to underserved areas like mine. Private healthcare can’t end with me for the large area I serve,” he said.
Yakima Valley’s Koday echoes that concern for the future of rural health care and the hope that the new dental school can make a difference.
“As the school develops, one of the things that we will have to do is to identify how to connect with private practices in rural and underserved areas,” he said. “Ultimately, we need to be serving more than just the community health role. We need to grow the ability of the private sector to serve these areas. Creating fellowships and residencies in private practices would help build stronger connections. They could make a graduate dentist available to a rural-based, private sector dentist at a fairly low cost.”
“Of course,” Koday noted, “These are 10,000-foot-level ideas, and the dean will
have to figure out how to make all the pieces fit together.”
AN IMPORTANT PARTNER
WSDA was not the only important player PNWU brought to the table early. Last year, Delta Dental of Washington committed an initial grant of $2 million to the school to support the planning for its new Doctorate in Dental Medicine Program.
“We are thrilled to enter this strategic and funding partnership and feel strong alignment with PNWU’s vision for preparing dental students to work in rural and underserved communities across Washington,” said Diane Oakes, Delta Dental’s chief mission officer. “As a purpose-driven organization, we look for opportunities to be a catalyst for the changes needed to ensure all people can enjoy good oral and overall health, with no one left behind.”
In addition to improving access to dental care in underserved areas, there were other important elements of the PNWU approach that appealed to the company, Oakes said.
“PNWU will be the first in the nation to educate dental students in community-based settings full-time for three years. Additionally, PNWU sees the value of increasing diversity within the dental professions to help reduce disparities in oral health for communities across our state.
Each of these components of PNWU’s program will be an excellent learning opportunity,” she added.
AN INTEGRATED APPROACH
Supporters of the new school, including both WSDA and Delta, have also been impressed by another strategic approach that will be a hallmark of the new school: An interprofessional curriculum and clinical training program that integrates medical and dental education and fosters collaboration between students in both areas.
This integration reflects a growing recognition that health care disciplines can learn from each other’s diverse skills and experiences. Story predicts that there will be many opportunities for dental students to engage with the College of Osteopathic Medicine’s faculty and classes, as well as those from other disciplines who are also training on the PNWU campus. He notes that nursing and pharmacy students from Washington State University are already receiving some of their training there.
“Our campus allows these students from multiple disciplines to learn and work together. That’s the way it will be in the real world, and it prepares them to meet the challenges of the communities we serve,” said Story.
Like current PNWU programs, the proposed dental school will combine traditional lectures with extensive clinical training.
WSDA’s Ulmer is a strong supporter of the integrated approach.
“The integration of medicine and dentistry is healthier for students, who develop better skill sets; for patients, who receive improved outcomes; and for communities that get better access to well-rounded dental professionals,” she said. “Students already enrolled in training settings like this are more positive about their experiences and better trained than those in other models at similar stages of their education.”
“I believe that this emphasis on integrated care will help young dentists treat patients more confidently and competently as they focus on the needs of the whole patient,” she added.
Despite this belief, Ulmer recognizes that some practicing dentists who have been trained in more traditional settings may be initially skeptical. But she doesn’t see that skepticism being long-lived.
“Good dentists appreciate good dentists, no matter where they trained. The results will speak for themselves. As the environment around health care shifts to whole body care, these dentists will be well-equipped to handle the changes,” she said.
LOOKING AHEAD
School organizers have already begun sharing their plans with the Commission on Dental Accreditation (CODA), whose approval is required before the first students can be admitted. They recognize that their proposal is unique.
“Our dental school would be one of the smallest in the country. The classroom/clinical mix of our program will be 1:3 rather than 2:2. We’ll focus on rural and underserved communities and our students will be getting their clinical education in FQHCs. We will have strong integration of dental and medical education. Some of those may be taking place elsewhere, but we believe the combination of all of them is truly unique,” Story explained.
That unique nature is one reason for optimism, according to those working on the project. Another is the collaborative relationship that has developed between PNWU and its supporters in the broader dental community, including WSDA.
“We are very grateful for the great support from the dental community, including WSDA and Delta Dental of Washington. Their tremendous collaboration and encouragement have been critical in allowing us to proceed with developing a School of Dental Medicine, and we are counting on their expert guidance and active participation in teaching and mentoring our students,” said Lawler.
“Without the backing of WSDA, Delta Dental of Washington, and the Washington dental community, this opportunity to create a new school of dental medicine would not have been possible.”
That feeling of optimism is shared by WSDA, according to Ulmer.
“We are off to a great start with PNWU and look forward to a long, healthy relationship with them and their students.”
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PANAGAKOS TO SERVE AS FOUNDING DEANThis article originally appeared in the Spring 2022 issue of WSDA News.
