Beds ready but doctor shortage prevents use

Tuesday, Dec. 5, 2006 | 7:07 a.m.

CARSON CITY - A 40-bed addition to the state's mental hospital in Las Vegas can't open because the state is short the two psychiatrists it needs to staff it.

As a result, those taken by paramedics and law enforcement to hospital emergency rooms who are then deemed mentally ill will have to stay at those facilities - usually about two days - until a bed opens up at the existing, state-operated 150-bed Rawson-Neal Psychiatric Hospital in Las Vegas.

The bind reflects the shortage of doctors in Nevada and the urgent need to recruit more, including psychiatrists, from out of state and license them.

"We have a crisis," says Carlos Brandenburg, administrator of the state Mental Health and Developmental Services Division.

He says part of the blame lies with the state Board of Medical Examiners, which he says takes too long - sometimes six to nine months - to issue Nevada medical licenses to doctors moving here. The state needs to expedite the licensing procedure, he says.

But Tony Clark, executive director of the board, disagreed with Brandenburg, saying doctors can get special restricted licenses to practice at the state hospital within 90 to 120 days. A restricted license allows a physician to practice psychiatry under the supervision of a licensed psychiatrist at a state institution.

The new Rawson-Neal Psychiatric Hospital in Las Vegas opened in August with a full complement of eight psychiatrists - some of who were borrowed from the staffs of other state facilities. The opening of the 40-bed addition is expected to be approved in the next week by the Nevada State Health Division. But it will remain unused until the psychiatrists can be enlisted to work there.

On average, 71 people are waiting on any given day to be admitted to the state mental hospital.

Dr. David Rosin, medical director for the state Mental Health and Developmental Services Division, says he has eight or nine physicians in the process of being licensed but gave no indication when they would be ready to work.

Dr. K.C.R. Nair, newly hired director of hospital, doesn't need a Nevada medical license in his administrative role, but in July he applied for one nonetheless. He says he was told he may not get his permit until March or April.

The pressure to hire enough doctors for the mental health hospital comes as the state is also preparing to open a community health center in downtown Las Vegas, its fifth in Clark County.

The new center is expected to serve up to 1,500 clients, many of whom may have mental health issues, when it opens in April.

The centers are staffed by 22 psychiatrists, although they are budgeted for 42. The shortfall, officials say, is also blamed on not enough psychiatrists in Nevada and the difficulty of recruiting them from out of state.