Nevadan at Work: UNLV dental school dean displays turnaround artistry

It falls to many college deans to go before off-campus groups and seek support, especially when budgets are tight.

But Dr. Karen West may be the only one who has gone before the Turnaround Management Association, which focuses on reviving struggling businesses.

Upon becoming dean of the University of Nevada, Las Vegas School of Dental Medicine in 2007, she walked into both trouble and an academic department that shares many traits with for-profit entities.

When she moved into her office across the street from University Medical Center of Southern Nevada, she was the fifth permanent or interim dean in the school's five-year existence. Numerous people had opposed the school's creation, and they renewed their fight against it after the initial promises that it would be financially self-sufficient proved overblown. Several students received diplomas despite being involved in a cheating scandal, provoking further outrage. An ambitious orthodontics program was wobbling with too many students and too little funding after a major corporate sponsor went bankrupt.

With a few years of continuity under West, the debate has subsided. The school now covers about three-fourths of its annual budget -- $21.8 million out of nearly $30 million -- with tuition, fees, research grants and payments from the 60,000 patients treated there every year. West wants to keep state support around the current level to hold down student costs while building reserves to cover expenses such as new drills and chairs.

Meanwhile, she continues to grapple with issues such as how to price services to patients and costs to students, which now run at $178,000 for a four-year program, to maximize revenue without getting ahead of the market.

Question: Why did you want to walk into the problems the school faced in 2007?

Answer: When I interviewed for the position here, believe it or not, that was the first time I had ever been to Las Vegas in my life. So I wasn't aware of the way the school was looked at. All I knew was that it was a new school, which attracted me because you can do so much with a new school. It's like a blank slate and there are a lot of opportunities. But I was only tangentially aware of the problems.

Question: Was there some point when you started to get buyer's remorse?

Answer: Probably a few times I second-guessed myself. Should I have done this? I ran into things here that I never ran into in Kentucky (her home state and previous professional address). It's a different environment of living here, whole different social environment. Kentucky is the South; things are kind of slow there. Here, things move at a very fast pace and you have to make decisions and you can't look back. You move forward.

I thought to myself, "I know I can do this, but is it what I really want to do?" After a couple of years we made changes and things kind of fell into place. I said, "I like this place." It was different for me to move here. I like the desert, I love the weather, but I miss my green trees.

Question: Why did you stick it out?

Answer: Because I'm not a quitter. If I had left here before things were straightened out, in my opinion, I would have felt like I was a failure. And I don't deal well with that. I knew I could make a difference. The school had some tremendous potential and it just needed some TLC and some good oversight and management.

Question: To some extent, you were thrown into crisis management. What was your background for that?

Answer: As an academic dean at the University of Kentucky, I was always the bad cop. That's what academic deans do. They're the ones that sometimes have to tell students that they flunked out. So I was used to doing that sort of thing.

I had quite a bit of leadership training through different programs in health care.

Question: Did you have to learn a lot on the fly?

Answer: Yes, but I found out that I liked it. ... There were so many opportunities to build the school, to expand. I didn't know how much I was going to have to do, but I came because of that. It's so much easier to make a difference at a school that hasn't got a lot of old, established rules.

In Kentucky, for instance, there is the Kentucky way of doing things. Here, we didn't yet have the UNLV way of doing things and that's what we have been able to build, I think.

Question: What is the UNLV way of doing things?

Answer: We like to say that the hallmark of our school is our service. We have service to the community and probably have one of the largest programs in the country for what we provide in service. Our philosophy is that here at the school you are going to learn leadership training, you are going to learn to give back to the community and you are going to have a quality education.

Question: It seems as if you are more of a CEO than a typical dean.

Answer: Most dental school deans have to be business managers because we have clinic operations, even more so than a medical school. Usually, in a medical school, they work in a hospital. Here, we have the entire enterprise.

Question: The school's level of self support is now about 75 percent. When the school was set up, the announced target was total self-support. Is that still the case?

Answer: It will take a long time to get totally self-supporting because we are a new school. Most schools that have a large and self-supporting income have an alumni base. We're not there yet. Once we get up there, I think we can gradually increase the amount. But it's going to take us a while.

If we tried to do that right now, we would basically increase our tuition out of the marketplace.

Question: Do you have to act as chief marketing officer in setting price?

Answer: Oh, yes. There are still a lot of students that want to go to dental school. We had 2,300 applicants for 80 spots last year. We have plenty to choose from.

But at the same time, we don't want to make it so expensive that our students can't pay back their loans when they get out. That's my worry. So I try to balance that, what they can pay and what we need as a school to continue.

Question: How do you think the school is doing now?

Answer; I think we are going great. Our graduates are our best marketing tools because they are doing very well right now. Over half of our students go into graduate programs. That's very difficult, to get into graduate programs. We have program directors at other places tell us that our students are very well prepared. The community is accepting of us. We're involved with organized dentistry.

Question: What's on the to-do list?

Answer: We want to build more graduate programs. We have an orthodontic, a pediatric dentistry and a general practice residency program.

One of the things that happens when students go off to graduate school (elsewhere) is that they generally stay there. We want our students, our graduates, to stay within state instead of going to California or somewhere because we don't have a program here.

Quite honestly, dental schools don't make money on their undergraduate programs. They make it on the graduate programs. So on predoctoral clinics, we just want to break even. That's another reason I want graduate programs.

Contact reporter Tim O'Reiley at
toreiley@reviewjournal.com or 702-387-5290.