Mo. doctors get paid while sleeping
Saturday, August 6, 2011
By DAVID A. LIEB
JEFFERSON CITY, Mo. (AP) — As a doctor at one of Missouri’s psychiatric institutions, Hungi Sripal has been paid thousands of dollars while sleeping on the job. His round-the-clock wages helped make Sripal the state’s highest paid employee, earning more than double the governor.
In fact, Sripal is one of 50 state workers who were paid more than Gov. Jay Nixon and the state’s seven Supreme Court judges during the recently concluded budget year, according to figures provided to The Associated Press under an open-records request. Like Sripal, almost all those employees are physicians for the Department of Mental Health. And like Sripal, many got extra pay for working all day and all night — no matter whether they were sleeping or simply relaxing on the job.
The Department of Mental Health defends the wage arrangement as a necessary price to pay to entice skilled professionals to work undesirable hours attending to sometimes unstable patients at institutions that might be more than an hour away from the doctors’ homes in Missouri’s major metropolitan areas.
“I understand that the first glance looks bad, but I do think that we’re actually managing the money pretty well to take care of the patients,” said Jay Englehart, the medical director at the Southeast Missouri Mental Health Center where Sripal works.
Missouri’s legislative budget leaders told the AP they were unaware of the physicians’ special salary arrangements in the Department of Mental Health. The lawmakers raised concerns about both the size of the paychecks — Sripal’s pay was $320,598 last fiscal year — and a potential lack of transparency in how taxpayer dollars are spent. They pledged to question mental health officials about the salaries at future legislative hearings.
“In this time of underemployed professionals because of the national economy, that really does seem to be a lot of money,” said Senate Appropriations Committee Chairman Kurt Schaefer, R-Columbia.
The salaries of state employees have come under heightened scrutiny at the Missouri Capitol during several years of tight budgets. Most state workers have gone without pay raises. And the House Budget Committee, in particular, has attempted to reduce the wages of certain upper level officials in Nixon’s administration. But the budget ax generally has spared those in advanced-degree professions such as the physicians at the Department of Mental Health.
Records obtained by the AP from the state Office of Administration show the state paid more than 68,000 people during the fiscal year that ended June 30, with amounts ranging from as little as a few dollars and cents to Sripal’s six-figure peak. Nixon’s salary of $133,821 ranked 58th among government workers, just behind that of Missouri’s seven Supreme Court judges. Forty-six of the top 50 worked for the Department of Mental Health. The list does not include earnings for employees at state universities, whose paychecks come from the institutions and not directly from the state. If university salaries were included, the $2.35 million salary of University of Missouri football coach Gary Pinkel would dwarf that of both the governor and the Department of Mental health physicians.
Sripal’s salary is listed as $114,014 in the 2009-2010 official state manual. But Missouri’s online financial tracker shows he actually was paid more than $300,000 in both of those years. His total wages ballooned over his base salary because physicians at the Farmington facility get an extra $80 an hour when they serve as the onsite, on-call doctor on nights and weekends. Sripal was paid for more than 2,500 hours of nights and weekends last fiscal year, according to department records.
At times, he responded to patient emergencies. But he also could have passed his time in a room equipped with a refrigerator, microwave, telephone and a place to sleep. Reached at work by the AP, Sripal said he often chooses the extra shifts.
“There are so many other people (in the private sector) who make more than what I make,” Sripal said.
The extra pay Sripal receives on nights and weekends would be fairly typical if he were a psychiatrist. According to the U.S. Bureau of Labor Statistics, psychiatrists in Missouri earn an average of $81 an hour, or $168,680 a year.
But officials at the Mental Health Department said it can be difficult to entice physicians to work in rural communities such as Farmington, which is about an hour southeast of St. Louis. The facility houses approximately 300 people, including about 130 committed because of sexual offenses. About four-fifths of the total population is there under court order.
“Unlike the private sector, when we have a shortage of physicians, we can’t simply opt to close some of these units,” said Mark Stringer, director of the department’s Division of Comprehensive Psychiatric Services.
To fill a vacancy at Farmington, the state currently is paying $200 an hour for a temporary psychiatric worker, Englehart said. Staff physicians take turns sleeping at the facility because the combination of patient needs and the remote location make it impractical for an on-call physician to remain at home in the St. Louis area, he said.
“Yeah, we do have some of the highest paid employees in the state, but that is partly because they’re working many, many hours, and it’s because we provide great service here,” said Englehart, whose total wages of $209,619 ranked 11th among state employees.
The governor’s office declined to make Nixon available for an interview about the salaries at the Department of Mental Health.
Schaefer and House Budget Committee Chairman Ryan Silvey both acknowledged the state’s need to offer attractive salaries to certain professionals but expressed reservations about the wage arrangements at the Department of Mental Health.
“Does it concern me as a conservative that we have government salaries that high? Absolutely,” said Silvey, R-Kansas City. “Is it possibly a necessary evil to provide the services? Possibly.”
Schaefer said he’s aware of plenty of physicians, lawyers, engineers and other professionals who are not working as much as they would prefer, which he said calls into question the department’s justification for paying its physicians extraordinary wages to work after normal business hours.
The two legislators expressed an even greater concern that their budget committees weren’t informed of the department’s extra-pay policy, and that it was not transparent from employees’ base salaries how much they actually are making.
“The fact they’re being reported at $114,000 but they’re really making $320,000 — that’s a concern,” Silvey said.
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