Nevada does not have a single board-certified child abuse pediatrician, and University Medical Center in Las Vegas has received no applications for the specialized position it has advertised online since February. That gap leaves prosecutors, child welfare workers, and emergency room doctors across the state without an in-house expert trained to distinguish genuine abuse from accidental injury — a distinction that can mean the difference between a child staying safe or a parent facing years in prison.
Chief Deputy District Attorney Dena Rinetti, who prosecutes cases in which child abuse has led to death or substantial bodily harm, said the absence of a local specialist has made her job far harder. “The absence of a child abuse pediatrician has made things very, very difficult,” Rinetti said, according to the Las Vegas Review-Journal. Rinetti said Nevada needs a child abuse pediatrician and is hopeful that the open UMC position could eventually let someone build a program from the ground up, potentially producing substantial change across the state.
A Niche Specialty Nobody in Nevada Holds
Child abuse pediatrics only became a certified subspecialty in 2006, with the first board exam administered in 2009, according to a Rhode Island Medical Society historical account, making it one of the youngest fields in medicine. Candidates must complete a three-year fellowship after their general pediatric training and pass board examinations to become certified, and there are only about 330 to 400 child abuse pediatricians nationwide, according to experts cited by the Review-Journal. Debra Fox, UMC's chief nursing officer, described it plainly: child abuse pediatrics is a niche specialty with few qualified individuals, the paper reported.
UMC operates Nevada's only Level II Pediatric Trauma Center and the state's only dedicated pediatric burn service, according to background from the Kirk Kerkorian School of Medicine at UNLV, which is why the hospital has become the focal point for recruiting a specialist in Southern Nevada. Terence McAllister, a general pediatrician in Las Vegas and president of the Nevada chapter of the American Academy of Pediatrics, has received training in child abuse pediatrics from Antoinette Laskey, a board-certified child abuse pediatrician and University of Utah professor. Las Vegas has had child abuse pediatricians in the past, but child abuse services in the city are now scattered, lacking the infrastructure that would combine those resources and expertise under one entity or program.
Nevada Patients Sent to Utah, Records Reviewed From Afar
Laskey is not licensed in Nevada and cannot see patients locally, but she still works with Clark County, reviewing some patients' medical records after treatment and providing testimony in certain cases, per the same Review-Journal report. Nevada patients are sometimes sent to Utah for specialists unavailable at home. Laskey said Nevada cases have included missed opportunities involving significant life-threatening or life-altering injuries.
The stakes of a wrong call run in both directions. Correctly diagnosing child abuse could protect a child's life, while incorrectly diagnosing it could lead to a child being separated from parents or caregivers who did nothing wrong — and parents or caregivers could face jail time after an incorrect abuse diagnosis. Rinetti recalled one case in which a pediatrician determined that a suspected foster-parent burn was actually a spider bite, an example she pointed to as evidence of how much can hinge on specialized training that Nevada currently lacks.
The National Shortage Behind the Local Gap
Nevada's struggle to recruit even one specialist reflects a much larger, structural problem. Only 33 ACGME-accredited Child Abuse Pediatrics fellowship programs exist nationwide, according to research published by SAGE Publications, creating a bottleneck that limits how many new board-certified specialists enter the field each year. Fellows must complete three years of specialized training covering multidisciplinary team collaboration, court testimony, forensic pathology, and advanced trauma evaluation, standards set by the Accreditation Council for Graduate Medical Education. Prospective candidates for the UMC role reportedly want a Las Vegas fellowship program established to train others in the subspecialty before they commit to practicing there, and the field itself is described as psychologically difficult work.
Nevada's broader physician shortage compounds the problem. The state ranks 48th among U.S. states for primary care physicians per capita and 49th for general surgeons, according to Association of American Medical Colleges data cited by the Review-Journal. To reach national average physician density, Nevada would need 561 more pediatricians statewide, including 388 in Clark County alone, according to a Nevada Health Workforce analysis published by Las Vegas HEALS.
Caseloads Keep Climbing
The need is not shrinking. Clark County Child Protective Services received 30,569 total referrals and closed 12,661 child abuse and neglect investigations during the 2023-2024 fiscal year, substantiating 3,212 cases, according to data from Prevent Child Abuse Nevada. In calendar year 2023, the county investigated 11,950 allegations of abuse and neglect, a 10% increase in substantiated cases over the prior year, according to Nevada Public Radio — averaging roughly nine substantiated cases a day.
Under Nevada Revised Statutes 200.508, child abuse or neglect resulting in substantial bodily or mental harm is a Category B felony carrying 2 to 20 years in state prison, with penalties reaching up to life imprisonment in cases involving severe harm or the sexual abuse of a child under 14, according to Nevada law. Child abuse pediatricians are trained specifically to evaluate whether injuries were inflicted through abuse and to maintain heightened awareness of biases and cognitive errors that could cloud that judgment. Laskey said child abuse pediatricians work hard to reach the best possible answer based on the information available, striving to strip away extraneous information and rule out abuse where it did not occur. Nationally, child maltreatment results in roughly 1,990 child fatalities each year, a rate of 2.73 deaths per 100,000 children, according to federal data compiled by Child Trends — underscoring what experts say is lost when specialized diagnostic expertise isn't available before it's too late.
