Advantages/Disadvantages of NP vs PA

prairienp · Dec 20, 2007

as to the dnp making a difference, i really don't hink it's going to make a difference in the whole scheme of things. unless someone can break the reimbursment bottle neck, not much is going to change. no more money, at least not measureable, no more recognition, no increase in the scope of practice. education is a good thing, and i know that i"ll be doing the doctorate thing sometime in the future, but i'm still out on what it will be in. i'm actually ready all the dnp stuff now, and not just using what i read here. the origional idea/concept is actually pretty good. but like everything in nursing, the reality is open to interpretation someway.
the more i think about this the more i feel this is the way to proceed. with more education in policy dnps may make that difference. with the dnp we are already getting a lot of attention, at least more people have heard of the dnp who never heard of the np before. i have always felt good things happen to good people, i really think nps are good people with good intentions, thus maybe we will have a good outcome.
all i know for sure is that i can't type or spell.

i have to agree with you on this point!

ANPFNPGNP · Jun 1, 2008

I can tell you that the scope of practice for NP's is very limited in Texas. I just completed a post-Master's FNP program at UT (I was already a NP), and my professors told us that the TX BON is really coming down on NP's who are practicing outside their specialty. For instance, we were informed that 17 FNP's had been practicing at Texas Children's Hospital, but they were all fired when the TX BON found out about it. We were specifically told that we were NOT allowed to work in the hospital setting, although we could work in the ER fast-track area.

I checked with the TX BON about this and I was told that I could work in the hospital as an Adult NP, since my program contained an "Acute Care" component that required us to train in the hospital setting. However, I was told that I couldn't work in the ICU. The person I spoke with told me that FNP's were specifically trained to work in primary care and that's it. Another area the TX BON is concerned about is psych. It appears that several FNP's are working for psychiatrists, yet this is outside their scope as well. Supposedly, the BON has had so many complaints/questions about this issue, they are sending a letter to all the APN's in TX within the next few months.

p.s. the scary part is that if there's a malpractice suit filed against a NP practicing outside their scope, their insurance company won't pay the claim! The collaborating physician will then get nailed BIG TIME! BE AFRAID...BE VERY AFRAID! :eek:

djc1981 · Jun 1, 2008

as i see it, the entry level dnp couldn't hurt the profession at all. we'd be on the same educational level that pharmacists and physical therapists are on. sure, the money and scope probably won't change all that much, but i do think there will be more respect there. and we will be dr. (so and so), np. the pa's will be scrambling to come up with a dpa program (if they haven't already started)....its going to drive many of them crazy that we will have higher degrees! they'll be upper midlevels and lower midlevels (jk!) isn't it funny how the entire medical community is like a microcosm of society and class structure?! :devil: :chuckle

core0 · Jun 2, 2008

as i see it, the entry level dnp couldn't hurt the profession at all. we'd be on the same educational level that pharmacists and physical therapists are on. sure, the money and scope probably won't change all that much, but i do think there will be more respect there. and we will be dr. (so and so), np. the pa's will be scrambling to come up with a dpa program (if they haven't already started)....its going to drive many of them crazy that we will have higher degrees! they'll be upper midlevels and lower midlevels (jk!) isn't it funny how the entire medical community is like a microcosm of society and class structure?! :chuckle

yes this just drives the pas crazy. what ever will we do. oh yeah we'll just have to fall back on 40 years of proven clinical competency regardless of the degree given. this is one of the basic differences between the professions. one is based upon clinical competency in relation to a shared academic environment regardless of the degree. the other is based on academic achievement with little shared academic achievements.

for your information there is already a dpas program. it is a post graduate program. the entry requirements are fairly simple. you have to be a member of the us army, you have to have served between 6-10 years with excellent fitness reports, you have to have served one combat tour (currently) and you have to be selected for one of four slots out of 100 applicants. this enables the pa to attend a full time (40-50 hours per week) clinical and didactic course in emergency medicine. original research and publication is expected.

given the number of nps that were disenfranchised by the move to the masters, i'm not sure why you would consider this a good thing. the pa profession has looked at this extensively and found that in the pa world the move to a masters is associated with higher gpa but less prior health care experience. this is also associated with less willingness for the pa to work in rural or underserved areas and decreased ability to provide instruction in rural areas. all of these concerns are increased with a movement to a doctorate.

finally if you want to consider yourself an "upper midlevel" go ahead. i have been a provider for seven years. i have never been midlevel at anything. a patient that sees me can expect the same level of care and competency as any other provider. i have never been "mid" at anything that i do.

david carpenter, pa-c

djc1981 · Jun 2, 2008

david, i certainly wasn't meaning to come off as disrespectful or cheeky. pas and nps are both well trained, educated professionals and i have nothing but respect for both of them. i thought i made it clear that the midlevel thing was a joke ---for future reference "jk" means just kidding. at any rate, apologies for anything that made you prickly.