The Doctor of Medical Science, also known as the DMS or DMSc degree, is the latest doctoral program designed for experienced PAs. There are several reasons to pursue the DMS/DMSc but one of the first questions every candidate asks is: What is the salary of a Doctor of Medical Science?
How PA Salary is Determined
The 2019 AAPA salary report showed that the mean PA base salary rose to $106,000 in 2018. The AAPA report did not include the incentive or productivity pay, however. The median pay among PAs paid based on productivity metrics was $150,000. And therein lies the biggest challenge to higher pay for those with the DMSc degree…
Love it or hate it, fee-for-service medicine presently dominates clinician reimbursement. The AMA advises CMS (Medicare) who assigns a score to thousands of medical procedures, including office visits. This score attempts to determine the cost, effort, and resources involved in delivering a specific service. This score is known as an RVU or Relative Value Unit.
The Mysterious RVU
Once services are given an RVU score, Medicare sets a basic fee schedule. This fee schedule is used as a starting point for most private insurers who set their payments anywhere from 20-80% above that of Medicare.
When a clinician performs a service, the payer reimburses the practice for the work done by the clinician but also for the expense the practice generates in providing the service, including professional liability. Those clinicians whose pay is tied to RVUs should mostly be concerned with the work RVU, or wRVU, as this is the portion that specifically refers to the time and effort of the individual. RVUs are an excellent system for clinician reimbursement because it values clinician work independent of payment or collections.
What is the Doctor of Medical Science Salary?
Whether a clinician is aware of how their compensation involves RVUs or not–the fact remains that the more RVUs they generate, the more income they bring in. And unless the clinician is paid entirely on a salary, more income for the clinic usually means more income for the practitioner. So, to answer the question of how the Doctor of Medical Science will affect PA salary, one must ask how the DMSc degree will affect productivity and billing.
Anecdotally, some PAs have reported that they were able to negotiate a raise upon completion of their DMSc degree. An informal social media survey among doctoral PAs showed that raises of 10-20% were not uncommon. Medscape’s 2021 PA Salary Survey indicated that PAs with doctoral degrees outearned their colleagues with an average salary of $138,000 a year. PAs with bachelor’s and Master’s degrees brought in $135,000 and $124,000, respectively. Here, PAs with a Master’s degree were believed to earn less due to being younger with less work experience and being female.
One possible reason for the bump in pay is that PAs and NPs are generally paid a much smaller portion of the revenue they generate relative to physicians which leaves more room for negotiation. For example, Becker’s reports that the average general practice doctor took home about 50% of every dollar they generated while specialist docs net just over 70%. PAs? About 35%. There is room for a raise, folks! And becoming a “doctor” is a pretty compelling reason.
Salaries for Doctors of Medical Science are most likely to reflexively increase when working in a Federal system such as the VA or the military. The backbone of the U.S. government’s pay system is the General Schedule (GS). There are 15 levels (GS1-15) and 10 steps within a level. Levels are more education-oriented while steps are heavily based on longevity. A Master’s degree qualifies you for reimbursement at the GS-9 level while a doctorate is required for GS-11. The difference in pay for a GS-9 and a GS-11 is approximately $10,000 a year. Ironically, this is about 10% over the 2018 median base salary for PAs of $106,000.
DMSc Degree = Increased Opporunity
So a Doctor of Medical Science degree certainly can increase one’s salary, but doctoral PAs often speak of expanded career opportunities. Major universities require a doctoral degree in order to get tenured. MSLs (Medical Science Liaisons) and those in the private sector and government leaders often hold doctorates. Some doctoral PAs have moved into research or administration as well. Medscape’s 2021 Salary Survey indicated that only 2% of PAs had a doctoral degree.
PAs in Administration
PAs in Administration, Management, and Supervision (PAAMS) is a group of PAs that currently serve in administrative positions. A 2015 survey found that about half of respondents had no previous leadership training.
Sheri A. Shebairo, MBA, PA-C serves as the director of PA services in the Department of Surgery at the Memorial Sloan Kettering Cancer Center (MSKCC) in Manhattan. As director of PA services, PA Shebairo devotes much of her time to compliance. She manages a staff of approximately 60 people.
PA Shebario does not hold a doctorate but feels the advanced degrees are becoming the norm for health leaders.
An article on PA Shebairo published on AAPA.org quotes her as saying “that the best leaders aren’t always the ones with the most education or the longest list of accolades, but rather, they are those who know how to effectively engage a group and understand the core principles of leadership, which involves bringing out the best in their staff and finding ways to emphasize their talents.“
MSLs are known by many names: Medical Advisor, Clinical Liaison, and Field Medical Director. The most common name for this position is: Medical Science Liaison.
Like PAs, MSLs came about in the 1960s. The position was created to give physicians a knowledgeable contact within a pharmaceutical company. Unlike sales reps who are armed with a particular narrative, MSLs were to be independent and objective scientific voices with extensive knowledge of a particular product or area of medicine.
Historically, Medical Science Liaisons had no required degree. It was not uncommon to have nurses and sales reps graduate into an MSL position. Today, most MSLs in the US are PharmDs (40%). 37% of MSLs have a PhD, 11% hold Master’s degrees, and only about 5% are physicians.
So, how much does an MSL make? According to a 2019 survey by the Medical Science Liaison Society, the average salary for US-based MSLs was just over $167,000. The average around the globe is much lower, however. Canadian MSLs have an annual salary of about $70,000 USD while those in Australia and the UK bring in $67,000 USD and $100,00 USD respectively.
So, while it is possible for a PA with the DMS/DMSc degree to outearn a PA with a Master’s or Bachelor’s, it certainly isn’t guaranteed. But a 10-20% raise is certainly within reason, especially given the value a productive PA can bring to an organization. Could a Doctor of Medical Science work more efficiently and with greater skill and confidence and thereby increase their RVUs? That depends on the program!