Psychiatrists in state prisons earn higher hourly wages than those in Ohio’s psychiatric hospitals, but the hospital contract allows doctors to collect “overtime” wages for hours worked outside the regular workday. The wage is lower than psychiatrists’ regular hourly rate, but boosts pay well past the state and national averages for psychiatrists’ salaries.
A Dayton Daily News analysis of state payroll data shows about half of state hospital psychiatrists’ salaries are derived from this benefit. Nine psychiatrists make at least half their annual pay from “on-duty” work during nights, weekends and holidays.
The data shows that some work on average more than 80 hours a week. But hospital officials say precautions are taken to ensure top care at the state’s six psychiatric hospitals.
State law mandates the hospitals follow standards established by the Joint Commission, an accrediting agency. Those standards include the availability of psychiatrists at all hours.
Department of Mental Health officials say the overtime policy saves money because on-duty hours are paid at a rate lower than psychiatrists’ hourly wages.
After hours work
The state hospitals offer about 5,000 on-duty hours on nights, weekends and holidays that pay a reduced hourly rate outlined in the union contract. The rate for psychiatrists increased from $60 to $65 in January 2013, about 20 percent less than the average hourly rate.
The top-paid psychiatrist in the state in 2012 was Dr. Zinovi Goubar of the Northcoast Behavioral Care near Cleveland. Dr. Goubar earned $335,392 in 2012, with $177,720 from on-duty hours.
Department of Mental Health spokeswoman Trudy Sharp said hours can’t be tallied and divided by wages because oftentimes the doctors don’t use all their vacation and sick time despite working long hours. Dr. Goubar earns $76.33 an hour during regular hours and in 2012 cashed in unused paid time off including 20 hours of personal time.
Still, Dr. Goubar averaged 59 on-duty hours and at least 36 regular hours per week. Sharp noted that working a whole weekend, which Dr. Goubar has done, totals 56 hours of on-duty time.
“He’s known as the go-to guy whenever there’s a shift nobody else can cover,” Sharp said.
Overnight duties include attending to emergencies and admitting new patients. Psychiatrists can sleep and rest when not tending to patients. Dr. Justin Trevino, assistant chief clinical officer at Twin Valley Behavioral Healthcare in Columbus, said plenty of eyes are on doctors’ schedules to make sure they’re not overworked.
“While you’re earning extra money, and that’s the motivation, it’s hard work and you have to be ready to do it and be ready to come in the next day,” Trevino said. “I think people are OK with telling us, I need a day off.”
State prisons do not pay any type of overtime to their psychiatrists, but their higher rates still put most above the state average salary of $170,180 a year. Prison doctors are paid an average of $89 an hour.
The Ohio Department of Rehabilitation and Correction employs 66 physicians, including 25 psychiatrists, to treat the nearly 50,000 state prisoners. The doctors are salaried and not eligible for overtime, said DRC spokeswoman JoEllen Smith.
Psychiatrists are on call for mental health emergencies but are not paid extra for that service, she said.
A national trend
Nationally, state psychiatrists are among the highest paid in the profession, according to the Bureau of Labor Statistics. The national median rate for state psychiatrists was $95.54 an hour in 2011. Only three of the nearly 100 Ohio psychiatrists on the state payroll earn that rate or higher.
“Regrettably, our pay within the Department of Mental Health is the lowest between comparable facilities,” Medical Director Dr. Mark Hurst said.
Hurst said the average contract rate for on-call services is $92.83 an hour — $12.17 higher per hour than the average hourly staff rate — so the arrangement saves money.
“It is not as glamorous as working in a private office and treating employed, respected members of society, but on the other hand it is very rewarding to do,” Hurst said. “Many of our physicians feel a mission to do that work.
Dr. Trevino, who helps hire new psychiatrists, said the lower than average pay often deters applicants. In addition to the opportunity to earn after-hours pay, Trevino said, psychiatrists have great health benefits, are eligible for public pensions and work mostly regular weekday hours.
“Once you leave for the day, we won’t be calling you,” Trevino said. “Doctors like to work a lot. Some may work part-time elsewhere because they know they’re going to get in and end at certain times.”
Trevino said increased admissions have kept psychiatrists busy, even after hours. The hospitals have seen an increase in admissions in recent years and are on track to beat previous years. From July 2010 through June 2011, state hospitals admitted 5,750 patients. From July 2011 through June 2012, state hospitals admitted 6,777 patients.
“Being a taxpayer myself, I think it’s good value for the dollar,” Trevino said. “These folks cause a lot of costs for our community — they’re in the hospitals and the jails a lot.”
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