PA vs NP, what really is the difference?

career seeker · May 5, 2004

I think that the regulations may vary betwwen states. In alaska a PA must work under a Doctor (although the doc does not need to be in the office). I worked in a federally-funded rural clinic where the doc would come up once a month and see the more complicated cases and do a chart review. Other than that, the PA's did everything (aside form signing off on DNR's). They could prescibe meds, including controlled narcotics.

I now work for a PNP. she does not report to a physician and does own her practice.

From what I know, the NP is a liscenced provider and and a PA is a certified provider. As for the holistic approach, I would have to agreee with the poster who siad that it depends on the provider. The PA's that I worked with were some ofthe most patient centered providers I have ever worked with. And the NP seems to have $$$ as her top priority.

I am aslo looking into these two professions and the one thing that draws me more towards the Np is the fact that PA's are not really recognized in other countries. My husband and I intend to travel after I graduate and if I am to work oversees, I will not be a bel to do it as a PA

psychomachia · May 5, 2004

From what I know, the NP is a liscenced provider and and a PA is a certified provider.

PAs are licensed in 43 states - from http://www.aapa.org/gandp/license.html

Standardization of Regulatory Terms: Licensure for Physician Assistants

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State laws that regulate physician assistant practice currently use three terms for the credential awarded by the state: licensure, certification, and registration. The category of licensure is the most appropriate.

A key recommendation from the Pew Health Professions Commission Taskforce on Health Care Workforce Regulation is that states should "use standardized and understandable language for health professions regulation and its functions to clearly describe them for consumers, provider organizations, businesses, and the professions."[1] The Taskforce specifically recommends that states use the term "licensure" for public or state regulation of health professions. An additional recommendation is that the term "certification" be reserved for voluntary private sector programs that attest to the competency of individual health professionals. Physician assistants are certified by the National Commission on Certification of Physician Assistants. Reserving "certified" to NCCPA certification and using "licensure" for the credential awarded by the state promotes clarity.

Licensure is the most rigorous method of regulation. In a licensed profession no individual may practice without permission granted by the state. Generally such permission is conditioned on the meeting of certain criteria, which may include registration, passage of an examination, and possession of certain educational and experience qualifications . This type of rigorous regulation of PA practice is already in place in every state, even though it may not be called licensure. Nearly all other health professionals are licensed by states. Licensing physician assistants holds the profession to rigorous standards and creates credential parity.

Many categories of health law refer to "licensed providers." These laws usually intend to include providers who have a specific state authorized scope of practice. Registration or certification as the state credential for PAs can create conflict with laws which fully intend to include physician assistants.

Managed care and third party payers also frequently refer to licensed providers. This may be in reference to reimbursable services, or providers who may order specified tests or therapies. Lack of licensure can create obstacles to PA utilization and reimbursement for services provided by PAs in managed care arrangements.

Discussions of the evolving roles of health care workers commonly use the term "unlicensed assistive personnel." This term usually describes medical assistants, nurses aides, and others not specifically credentialed by the state. Lack of licensure for PAs in specific states has led to instances where PAs were confused with UAPs. Licensure for the profession will avoid this potential problem.

Licensure does not imply nor create independent practice for physician assistants. The states that issue licenses to physician assistants also require PA licensees to practice with physician supervision. This is consistent with the profession's definition. Physician assistants are committed to practicing with supervision by licensed physicians. Although changing to licensure may be sought to assist with reimbursement issues, PAs do not seek direct reimbursement. The policy of the AAPA is that reimbursement for services provided by physician assistants should be made to the practice.

The American Academy of Physician Assistants recommends licensure for physician assistants. Currently PAs are licensed in 43 jurisdictions, certified in five, and registered in three.

References

1. Finocchio LJ, Dower CM, McMahon T, Gragnola CM and the Taskforce on Health Care Workforce Regulation. Reforming Health Care Workforce Regulation: Policy Considerations for the 21st Century. San Francisco, CA: Pew Health Professions Commission, December 1995.

Kabin · May 5, 2004

What?! LOL I have not "suggested" anything....

Anytime you make a generalization about an article, you're suggesting your own interpretation to its intent. :rotfl:

PA's do not "always" work under the supervision of a physician, that is simply not true first of all.

There are general statements that can be correctly made, but once again, your suggested interpretation is off-base. Direct quote from the AAPA.ORG website: "Physician assistants are committed to practicing with supervision by licensed physicians." :uhoh21:

I agree they are both mid-level health care providers and it all depends on what sand box you want to practice in.

orrnlori, RN · May 5, 2004

I also believe that PA's have to re-test or re-certify every 6 years and NP's don't. If that's true, it would be a big deciding factor for me if I was looking at both.