PA-C or NP? What would you do? - page 2

I am an ADN, with many years under my belt in nephrology, ICU, ER, and M/S. In my current role, I function quite independently/autonomously and I'm quite good at it clinically. One thing this... Read More

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    From the outside looking in at both I'd go for PA school if given the chance. If that were a more geographically accomodating option I'd do it. Heck, I'd have already done it, but I chose instead to get a second bachelor's degree (BSN/RN). Now I'm more or less stuck going the APN route because I'm tied down now. I also heavily favor the medical model of healthcare.

    Additionally, it's pretty much a given that you can't work and go to PA school although many people work full-time and take an APN role.

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    Just thinking the requirements to get into PA school are a bachelors, with your ADN you are closer to completing a BSN.

    I once had a student nurse (in a BSN program) that did not understand the differences in PA/NP and she stated to me when I explained that in this state as a NP I have independent practice, she stated that that's why she was going to become a PA is that she DID NOT want the independence. Turns out she became an NP. Looks like she now understands the differences and the issue about independent practice.
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    I sincerely appreciate everyone's thoughts.

    I have no fear of "independent practice" as an ANP degree would afford, so that's not an issue. I also don't mind working under/with MD's when those MD's are of a collaborative nature, so the PA route (medical model which is very enticing) doesn't raise a flag either.

    The issue for me specifically at this point, is trying to determine the future markets, where and how NP's vs. PA's will be in most demand, and future scope of practice. Both options coud lead to entirely different outcomes, especially in the context of HCR, market saturation, and political lobbying clout.

    Thanks again.
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    Hello and thanks for starting this thread. I am in a similar situation, as I was recently accepted into an entry level MSN-FNP program and also was accepted to PA school. I have done a lot of research on the whole NP/PA thing and really went back and forth for a while. It really seems like they are 2 different paths to a similar outcome.

    I chose PA because I am not an RN already, so PA school is 2 years versus 3 1/2 for NP. Also, I like the notion of learning under the medical model and PA school is said to be about 75% of Med School. Also, the clinical rotational hours are almost double for a PA vs NP. I wanted more hands on clinical training and thought that I would be better prepared as a diagnostician after attending a rigorous PA program. Also, it seems like ERs and Surgeons tend to hire more PAs, whereas NPs seem to work a lot in primary care (I could be wrong about this, it just seems to be the case in CA...correct me if I'm wrong!).

    I may end up in primary care (and actually that is where I feel most led), but wanted the option to specialize, which seems more viable for a PA vs. NP. This is just my opinion. I am sure there are many excellent and challenging NP programs, and I am sure that NPs do specialize, but it just seems that more is required of a Physician Assistant. Also, I was accepted in to FNP program and I am still not sure of the specializing options for Family Nurse Practitioners. I just thought that I would be mostly doing primary care.

    I understand that NPs do have more autonomy in California, yet it seems that most NPs work under a doctor anyways. I would be curious to know how many NPs actually do work independently. Supposedly the education requirements for NPs are changing in 2015. All new NPs will be required to get their DNP, which may add some clinical hours and obviously...more school!! I think that students who enter the program now or soon will be grandfathered in, which made me think that I should get the NP before they add more and more requirements. Also, I was leaning towards the NP because I though I might have better job prospects. Yet, nearly every job posting I've come across asks for either an NP or a PA. Not to mention that PA school is 50K cheaper in tuition alone. The notion that I could finish my education slightly faster and considerably cheaper, and to have the same job prospects, duties and responsibilities really appealed to me. So as of today, I will be attending PA school in the fall!
    BradS and Zaphod like this.
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    Wow Laguna B. 50k less! That is amazing . Good luck with school in the fall. It will go by so quick
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    Hi! Something to consider....I too looked at PA vs. NP, and as an RN already, it was a wash time and money wise.

    I do a lot of medical mission trips, and travel extensively. If you are interested in any international work, PA's are only recognized in the US and Canada, where NP's are recognized pretty much world wide. An NP can work in Mexico, Australia, Canada, and all over Europe. PA's are an American invention, where NP's and advanced practice nurses and midwives have been around forever in many other countries. In Australia, the lion's share of healthcare providers are NP's and midwives, not doctors.

    I think PA and nurse practitioner are both a great way to go. There will always be struggle for autonomy, as the AMA and doctors as a whole are lobbying very hard against all midlevels, midwives, NP's, PA's, and CRNA's. They are instrumental in creating the limitations outlined in the ACO language, and will continue to try and thwart the progress of PA's and nurse practitioners.

    Go where you will get a great education, in the least amount of time, for the least amount of money. Then, practice where they appreciate you and treat you well.
    ICUman, Lisalis, pacnwRN, and 1 other like this.
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    The clinical education advantage of PA seems to be that they do more hours and more varied rotations, but I did extra clinical hours in my MSN (more than required) and was able to choose a variety of areas - I do not feel my clinical experience was limited. Just make sure you choose a program that gives you some flexibility. I do feel that your experience as an RN really makes a difference to potential NP employers - I am interviewing at the moment and my years of ICU experience as a CCRN mean a lot more to them than my 850 hours of clinical during my MSN.

    Edit to say: RE lobbying power, PAs and NPs need to work together and join forces!! The employment outlook is fantastic for advanced practice providers, and there are enough jobs for both types of APP. We are still being lowballed on pay though - many of my graduating class will start at just about the same or even less as a new grad NP than they were as experienced RNs in senior positions.

    At the end of the day, choose a program that suits your needs, and an education model NP/PA that is most marketable in your area, since that varies.
    Tinabeanrn likes this.
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    Quote from LagunaB
    I understand that NPs do have more autonomy in California, yet it seems that most NPs work under a doctor anyways.
    Well, California isn't really known for NP autonomy. There are restrictive laws, NP's need a Standardized Procedure laid out with a physician prior to starting a practice and two, NP's do not prescribe, we "furnish" and a Furnishing License is required prior to being able to furnish therapies and pharmacologic agents.

    In its true sense, the number of nurse practitioners who own a practice with no physician oversight are low compared to the overall number of NP's:

    The states where true NP independent practice exist are seen in this map in pink:
    LagunaB likes this.
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    This is something I've been thinking about as well. Although there are a lot of factors that will come into play, I intend to apply to grad school, but leaving the VA would be difficult (we have the greatest benefits ever). The community college that I did my RN at offers a PA program with a price tag of $3000. If you have a bachelor's degree, they award you a master's degree from a university in Pennsylvania. Not too shabby. The only downside if you CANNOT work during the program. A cal-state about 2 hours away from where I currently live has an FNP program for about 20k, which is not too shabby either considering there are other local schools that run for 60k+. You can also go part-time if needed.
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    Not to mention, if you go the PA-C route and you want to further your education and become an DO you can go to Lake Erie College of Medicine and do their PA to DO bridge program in three years. I don't know of any physician bridge program for NPs. Correct me if I'm wrong, cause' I learn more when I'm wrong!

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