Just a note on the NP vs PA debate... - page 3

I did not want to fuel this debate. In fact, I hadn't realized there was this much NP-PA hostility until I found this board. Honestly, I think it a trivial debate in the grand scheme of things....... Read More

  1. by   lalaxton
    Quote from Kabin
    Interesting thread as I've been internally debating the PA/NP path for a few days now. I received a PA flyer from MidWestern University and it states that PAs need to sit for a recertification exam every 6 years. I have yet to hear anything similar for NPs.
    Kabin,
    To maintain certification NP's must either rewrite the certification exam or show significant amount of CME's with other activities such as precepting students, teaching a class etc. The complete requirements can be found at ANCC or AANP. Certification needs to be renewed every 5 years.
  2. by   Kabin
    Thanks for clearing that up.

    I checked out the AANP website and it describes recertification with the two options: 1) take a recertification test, 2) 1000 hours of clinical experience and 75 continuing education hours. So option 1 may be needed for those NPs that let cliinical experience lapse. Whereas PAs need to recertify regardless every 6 years as well as do 50 hours/year or so of CMEs.
  3. by   Alnamvet
    Quote from jackal
    pa's are assistants, they always have been, and always will be...they assist doctors with all the scut work

    my my, such arrogence and anger towards the pa's! maybe if they are just for "scut work" and are merely "assistants", then can you tell me why they receive much more education and training? namely, on average the pa will complete nearly 2200 hours of clinical vs. the np's barely sufficient 300-700 hours? why do pa's do 5-12 weeks of rotations vs. np's only completing a pathetic 40 hours?

    as far as "anyone" getting a pa, more and more programs demand a master's degree in order to practice, something not seen in the np training. oh! and the majority of pa schools of medicine require 500 hours of direct helath care experience before admission where the nursing schools do not require any direct care experience.

    maybe you should actually learn a little bit about what you're railing against. it's obvious you're uniformed but it's admirable that you are so proud of your little profession. it's always been my experience that it is those who yell the most who are the least competent.
    so much mis/disinformation has been provided by your post, it is obvious who needs to do his research; after 30+ years in the business of healthcare, i think i know of what i speak...do yourself a favor, and leave this discussion to the pros who are in the business, and really know what the programs are out their, who qualifies, what the requirements are, the degrees, if any, offered, and what each state has legislated regarding the scope of practice for mid-level providers. there is a load of info out their, and so far, only ~1% of whats been posted in this thread is accurate...i am sorry to say that you get a 0% (zero) for your effort :stone
  4. by   bobbiesal
    Quote from Kabin
    Interesting thread as I've been internally debating the PA/NP path for a few days now. I received a PA flyer from MidWestern University and it states that PAs need to sit for a recertification exam every 6 years. I have yet to hear anything similar for NPs.
    As a Pediatric NP, I have to take a recertification exam every year! Now...I could choose to opt out with practice hours or CEU, however, we are on a 6 year cycle, and out of that 6 years, at least 2 of the years must be exams. So, now you've heard.

    I'm thinking that neither field knows enough about the other to throw stones. I considered going to PA school prior to going to graduate school, actually took all the prepratory classes to do so. (1 extra year of chemistry, 4 extra cedits of microbiology) However, when it came down to it, the university I attended strongly discouraged nurses from applying to their program. Fact is, they would have to "unteach" the nursing perspective & try to instill the medical way of thinking - a difficult prospect for an instructor...

    Is there a difference in practice? Absolutely. NPs are hands down better at teaching, and better at seeing the bigger picture. The teaching part comes from what we are taught in every program from LPN on up, the bigger picture is what nursing is all about. And altho some PA programs offer graduate degrees, most are very minimal on research.

    I am, however, very encouraged that NPs & PAs are working together to forma a new organization to tackle the legislative issues that continue to threaten autonomy. And as far as practicing autonomously, that comes from experience, not from degree....
  5. by   RNPATL
    There was a question posted earlier as to why many NP are not in independent practice. This was a question that I was also curious about. Perhaps some of the NP's on this thread can give their perspective. I talked with several of the NP's at work and there common response was due to reimbursement. One of the NP's said that rural clinics see many Medicaid patients and the resimbursement from Mediciad is very low. Apparently Medicare is either not reimbursing for NP services or the reimbursement is pretty poor. I know that there are many HMO's that reimburse for NP as a Primary Care Provider, but would like to know if any of the NP's here are in independent practice and if not, why.

    This will also help me as I move toward my graduate degree and finish my FNP.

    Thanks.
  6. by   HU_nurse
    I too was interested in this. I want to obtain a PNP degree and open up a small private practice clinic in Southern California. So what's the deal with this reimbursment issue?
  7. by   Kabin
    I've heard NPs sometimes get paid at 80% of the doc's rate. If this is the point, it doesn't seem to be a show stopper.
  8. by   RP2001PAC
    youre absolutely correct Nurse Practitioner do not need to retest in order to keep their certification. If you pass once you are golden.
  9. by   RP2001PAC
    You are slightly mistaken in your representation. IF you are not a Physician Assistant yourself I think that you should stop providing false representation of what a Physician Assistant actually does. I have a great amount of autonomy. I see my own patients in a clinic and the physician works the other end of the hall. Sometimes we dont even cross paths in a day. I know my limitations. I am NOT a physician and likewise nurses are NOT physicians either. You portray PA's to be incompetant little assistants who follow the doc around all day long picking up after him. You could not be further from the truth if you live near my area...I invite you to spend a day with me in the office. I am highly respected by my patients, and colleagues alike (yes including my nurses and supervising physician) On top of that I make EXCELLENT money (40/hour + profit sharing, have EXCELLENT benefits and great working hours (7:30-3:00 M thru F) No Call. great working environment. I dont know where your misconstrued ideas are generated from. Either way I am not going to add anymore fuel to your fire. This message is for those out there reading the rubbish that you write.
  10. by   cgfnp
    Quote from RNPATL
    There was a question posted earlier as to why many NP are not in independent practice. This was a question that I was also curious about. Perhaps some of the NP's on this thread can give their perspective. I talked with several of the NP's at work and there common response was due to reimbursement. One of the NP's said that rural clinics see many Medicaid patients and the resimbursement from Mediciad is very low. Apparently Medicare is either not reimbursing for NP services or the reimbursement is pretty poor. I know that there are many HMO's that reimburse for NP as a Primary Care Provider, but would like to know if any of the NP's here are in independent practice and if not, why.

    This will also help me as I move toward my graduate degree and finish my FNP.

    Thanks.
    Depends on the state as far as independent practice. You can make it happen just about anywhere just have to make the paperwork right for the laws. Medicare reimburses 85% of the physician rate if the doc isn't on site. Everything else is same. (and HMO reimbursement is rediculous no matter what you are)
  11. by   RNPATL
    Quote from cgfnp
    Depends on the state as far as independent practice. You can make it happen just about anywhere just have to make the paperwork right for the laws. Medicare reimburses 85% of the physician rate if the doc isn't on site. Everything else is same. (and HMO reimbursement is rediculous no matter what you are)
    Thank you.
  12. by   PA-C in Texas
    Quote from RP2001PAC
    You are slightly mistaken in your representation. IF you are not a Physician Assistant yourself I think that you should stop providing false representation of what a Physician Assistant actually does. I have a great amount of autonomy. I see my own patients in a clinic and the physician works the other end of the hall. Sometimes we dont even cross paths in a day. I know my limitations. I am NOT a physician and likewise nurses are NOT physicians either. You portray PA's to be incompetant little assistants who follow the doc around all day long picking up after him. You could not be further from the truth if you live near my area...I invite you to spend a day with me in the office. I am highly respected by my patients, and colleagues alike (yes including my nurses and supervising physician) On top of that I make EXCELLENT money (40/hour + profit sharing, have EXCELLENT benefits and great working hours (7:30-3:00 M thru F) No Call. great working environment. I dont know where your misconstrued ideas are generated from. Either way I am not going to add anymore fuel to your fire. This message is for those out there reading the rubbish that you write.
    I have corrected some of the errors espoused by a few of my NP colleagues numerous times in this forum, but it appears that they choose to still choke them up because they suggest a superiority of NP's to PA's.

    I would just add that I don't even SEE a physician except for when a patient's personal physician comes to the ED, or my supervising physician makes his visits to fulfill the supervisory requirements.

    In Texas, the last remnant BPAS program just got the axe. PA school is generally longer than NP school, and it resembles the format of medical school moreso than it does other graduate degrees (including MSN degrees). Students are admitted yearly into a class that has a fixed schedule (no part-timing here). Here's the way it went for my masters program: The first year consists of basic bio-science classes, some of which are the same classes that medical students take. The second year is more clinically focused. The third year consisted of eight six-week rotations in various specialties. We had enormous clinical experience in the field before we were actually allowed to go and practice. We didn't have summers off and they didn't offer night classes.

    If I ever get compared to a nurse's assistant again I am going to scream.
  13. by   RNPATL
    Quote from PA-C in Texas
    I have corrected some of the errors espoused by a few of my NP colleagues numerous times in this forum, but it appears that they choose to still choke them up because they suggest a superiority of NP's to PA's.

    I would just add that I don't even SEE a physician except for when a patient's personal physician comes to the ED, or my supervising physician makes his visits to fulfill the supervisory requirements.

    In Texas, the last remnant BPAS program just got the axe. PA school is generally longer than NP school, and it resembles the format of medical school moreso than it does other graduate degrees (including MSN degrees). Students are admitted yearly into a class that has a fixed schedule (no part-timing here). Here's the way it went for my masters program: The first year consists of basic bio-science classes, some of which are the same classes that medical students take. The second year is more clinically focused. The third year consisted of eight six-week rotations in various specialties. We had enormous clinical experience in the field before we were actually allowed to go and practice. We didn't have summers off and they didn't offer night classes.

    If I ever get compared to a nurse's assistant again I am going to scream.
    Let me ask if you are equating evening and part time classes to being less rigorous or easier simply because there is some reasonable flexibility built into an NP's education? Let us please remember that before an individual can be accepted into an NP program, they must have at least 2 years of experience as an RN. In addition to this, you can compare your program all you would like, a NP is not in the profession of Medicine. We are in the profession of Nursing. Our role is different than that of the PA. Further more, NP practice off their own license.

    I work with many PA's and many NP .... both very competent and both having their place in the health care field today. To compare both is simply not relevent as the programs of education are different as well as their roles. While I can see there are some functions that are similiar .... I am going to become an FNP because I love nursing and the methods nurses employ to care for patients. If I wanted to be a PA, I would take that route. As far as independence is concerned, according to my State's nurse practice act .... the NP has many independent functions and does not have to rely on the licensure of a physician to practice. I know for my own practice once I graduate, I will surely recognize my limitations and have plenty of good working relationships with physicians.

    I have never subscribed to the mindset that it is "ok" to beat down another profession because they have some of the same functions, simply because their education is different. We have to remember, when a PA graduates from college, they start their career as entry level. When a NP graduates, they start their career as entry level. The experience one gains by working and using skills learned is what truly defines competence. So, I think we should really look at competence based on practice and experience rather than entry-level issues.

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