Any Np wished they went to PA school?

djc1981 · Jun 24, 2008

Why would they want to be assistants when they're already practitioners? I kid...I kid. From what I see in job ads/hospital openings...nearly all of them ask for either/or. Midlevels are often looked at as interchangeable. Unless you just have to be assisting in surgery (and you could do this as a RN with a first assist cert -- hospitals here use RNFA's consistently), the differences seem like splitting hairs at times.

ANPFNPGNP · Jun 24, 2008

I know this can be offensive but was wondering if any NP who works with PA find that they have more medical background or more well rounded on dx and diagnosis? Any info would be helpful

I've worked with lots of PA's and I've been very impressed with their knowledge of orthopedics. I work PRN in urgent care and one of the PA's saves all the "primary care" questions for me (I fill in for him some evenings). I call him with questions that are ortho related. Also, PA's get far more training in all the "hands on" stuff than we do (suturing, setting fractures, surgery, etc). However, I feel that I can run rings around the PA's in internal medicine.

Regarding the title to your thread, there is no way I would even consider being a PA. That would be considered a step down where I live. PA's can't even open their own practices and the Board of Medicine has their thumb on them. They will never be able to gain 100% independence from doctors. I understand there are some insurance companies that won't even pay for a PA to see a patient without their SP on site. Also, NP's can bill Medicare directly and PA's can't.

On the other side, PA's can work in any field they want without having to get additional education. Another one thing I don't like is the fact that so many PA's don't even have a college education. It just amazes me that PA's can practice with just a certificate, Associate's or Bachelor's degree. I think it's great that NP's are mandated to have a MS degree. If you're out there doing what we do, the more education the better!

Trauma Columnist · Jun 24, 2008

I work in a large nephrology practice with 3 PAs, 3 FNPs, and me. We all do the same job. So...at least for me here in the cornfield, whether I was a PA or NP wouldn't make any difference in the job I do.

christvs, DNP, RN, NP · Jun 25, 2008

It's not that I wouldn't want to be a PA, rather it's more that I am proud of my background as an RN and all the knowledge and experience that brings to my NP position. :)

JDCitizen · Jun 29, 2008

I know this can be offensive but was wondering if any NP who works with PA find that they have more medical background or more well rounded on dx and diagnosis? Any info would be helpful

Grass is greener on which side of the fence

Some of this may depend on what state you are in (as in what or how much you get to do under your degree/certification). NP/PA we confuse the crap out of our patients. My role as a FNP I am still a nurse all the way to my core: I was a nurse before I went into the program and I was a nurse when I graduated. Now I am a nurse that can look at it, diagnose it and treat it...

As a direct answer to your question I thought about it briefly while I was in school but none since...

I have worked with NP's and PA's over the years some good some not so good...

RN28MD · Jun 29, 2008

I appreciate your responses. I actually spoke with a PA who actually told me that he wished he did NP. I asked why and he said they have more autonomy and don't always have to feel that a doctor is telling them what to do. Another thing he said to me was that Doctors feel intiminated with NP and not so much with PA.

Amazing!

djc1981 · Jun 29, 2008

I appreciate your responses. I actually spoke with a PA who actually told me that he wished he did NP. I asked why and he said they have more autonomy and don't always have to feel that a doctor is telling them what to do. Another thing he said to me was that Doctors feel intiminated with NP and not so much with PA.
Amazing!

Oh, I can believe it. They are literally soiling their britches over at studentdoc site over the DNP.

Joan Z · Jun 29, 2008

I would agree that functionally there aren't a lot of differences between NPs and PAs. For myself I think I would have enjoyed school more if it had been modeled along the PA lines--as in specific rotations (peds, ortho, OB, surgery etc) rather than what seemed more like a "catch as catch can" philosophy. I also really missed not getting the hands-on technique stuff; I realize we can pick this up BUT for all the money I would have liked it in the program. This might have been more related to the particular program I was with but talking to other NPs who went through other programs it seems to be fairly common. I did talk to the people running the program with these concerns, haven't gotten any feedback yet!

caldje · Jun 30, 2008

Regarding the title to your thread, there is no way I would even consider being a PA. That would be considered a step down where I live. PA's can't even open their own practices and the Board of Medicine has their thumb on them. They will never be able to gain 100% independence from doctors. I understand there are some insurance companies that won't even pay for a PA to see a patient without their SP on site. Also, NP's can bill Medicare directly and PA's can't.

I would just like to make a point about this paragraph.

While you obviously feel very (maybe overly) confident about your medicine skills. You yourself mention in your paragraph after this "if you are going to be doing what we are doing the more education the better."

Keeping this in mind, I find the above quoted paragraph strangely contradicting your philosophy on the need for the "most education" to "do what we do."

PAs PROUDLY submit to the strict regulation by board of medicine (the gold standard for regulation of those who diagnose and treat illnesses) and even more so PROUDLY support that the practice of medicine (meaning diagnosis and treatment of illnesses) should be overseen and directed by those with the most training/education/experience.. meaning physicians. This TEAM based practice is very important and regulatory oversight by physicians is what is best for the patient... even if it is at the sacrifice of our bank accounts.

I very sincerely submit that maybe being 100% independent, being able to bill medicare independently, and disregarding those with the most education to do our job is not what everyone aspires to. Quality patient care requires team based practice and physician involvement at some level.. even if it means indirect oversight. Its what is best fpr the patient even if its not best for my porsche payment.

ECMOismygame · Jul 2, 2008

I've worked with lots of PA's and I've been very impressed with their knowledge of orthopedics. I work PRN in urgent care and one of the PA's saves all the "primary care" questions for me (I fill in for him some evenings). I call him with questions that are ortho related. Also, PA's get far more training in all the "hands on" stuff than we do (suturing, setting fractures, surgery, etc). However, I feel that I can run rings around the PA's in internal medicine.
Regarding the title to your thread, there is no way I would even consider being a PA. That would be considered a step down where I live. PA's can't even open their own practices and the Board of Medicine has their thumb on them. They will never be able to gain 100% independence from doctors. I understand there are some insurance companies that won't even pay for a PA to see a patient without their SP on site. Also, NP's can bill Medicare directly and PA's can't.
On the other side, PA's can work in any field they want without having to get additional education. Another one thing I don't like is the fact that so many PA's don't even have a college education. It just amazes me that PA's can practice with just a certificate, Associate's or Bachelor's degree. I think it's great that NP's are mandated to have a MS degree. If you're out there doing what we do, the more education the better!

PA practice is COMPETENCY based, not degree based.

core0 · Jul 3, 2008

Snip
On the other side, PA's can work in any field they want without having to get additional education. Another one thing I don't like is the fact that so many PA's don't even have a college education. It just amazes me that PA's can practice with just a certificate, Associate's or Bachelor's degree. I think it's great that NP's are mandated to have a MS degree. If you're out there doing what we do, the more education the better!

As long as we're piling on. Remember that those 10-12,000 NPs that do not have college degrees are completely without skill or knowledge despite more than 40 years of practice in some cases;).

David Carpenter, PA-C