PA's are trained to think like doctors; NP's think like nurses. Huge difference in where they are coming from when they approach a situation that needs a resolution.
After 9 years of my husband being treated ineffectively for rheumatoid arthritis and seemingly regarded as an insurance money pinata (prescribed designer drugs that don't work, getting a new ankle brace each year, steroid shots that don't last more than 2 weeks, surgical consults, x-rays and MRI's) we realized that he will probably never be "cured", and since the meds have not put him in any sort of remission, he needs help to maintain the mobility he still has while coping with the pain. The doctors never seemed to address that issue. So we made an appt with our PCP's NP and just today he was finally prescribed a quad cane, PT/OT including aqua therapy, a handicapped parking placard, ordered a DEXA scan to check for osteoperosis d/t 9 years of oral steroids, and she also called all the doctors involved in his care that never communicate (rheumatologist, orthopedist, and pain management "specialist") and got them all on the same page. Some meds were d/c'ed, others added. She accomplished all this on one day. And I knew how she did it: she listened to my husband and me, reviewed all the notes that had been sent over from these doctors in the last year or so, and formulated a care plan in her head. Just like that. I told her right at the start of our meeting: "I'm done with these doctors. He needs someone who thinks like a NURSE who will treat him as a person, not a dx!"