I was all set to head towards NP now a dr told me PA. Hmmm

[creativetype2007]

I was all set to head towards NP when I met a pediatric physician at starbucks yesterday who tried to tell me PA is the way to go and that NP's aren't ask knowledgeable and that just threw me for a loop. I just need to hear from people in the field if I should once again consider PA. I love working in hospitals, I would love to treat and see patients (I know I am not going to be the DR), and right now I can go either directions. Thoughts? Thank you in advance.

[Emergency RN]

There's a political reason why Physician's Assistants were given such a name; in cruder parlance, they are solely recognized as only a doctor's "underling" to the point that it's reflected in their professional title.

Years ago, IIRC, the fight with the AMA was brought on when NP's began to fill traditional roles that were normally performed by MD's, except in high need areas where doctors saw little financial reward. So fearful that the American public (and Congress) would create a another class of provider that was in open competition with doctors, they pushed for establishment of a subservient medical worker class. These folks could work like a doctor, but would always not be in a position to ever compete with a doctor.

For a sense of the politics behind this, read here:

Physician assistant name change rubs doctors the wrong way | KevinMD.com

There is also a whole stream of user discussion regarding PA v NP in the "comments" section that follows that article. Either way, good luck with your career, whatever your decision

[alem-tsahai]

Do your research. Shadow both PAs and NPs and you will see for yourself. Most likely you will see how very wrong your physician friend's statement was.

[sirI, MSN, APRN, NP]

To the OP I suggest as others, shadow both professions, keep gathering information, check out what the market will bear in your immediate area.

There's a political reason why Physician's Assistants were given such a name

It's Physician Assistant (w/o the 's').

[SitcomNurse, BSN, MSN, EdD, RN]

im going to run with this theory.... who the heck wants to recertify every couple of years, for areas of practice they dont practice? our pa'a have to exam up every couple of years, and even if they specialize, lets say..geriatrics, or orthopedics, they still have to test for obgyn, child health, community, etc etc....

whats the requirement for np?

im thinking, do md's have to exam up every couple of years? do rn's? heck no!!

i earned it.... i have it.. im not going back every few years to "recertify"!!!!

so, while i may actually be searching for a masters in education, or health care management, i am not not going for something that i will only have for a few years before i need to do it again!

nope.. not doin it.

[geekgolightly, BSN, RN]

The physician has a point guys. This thread is not asking about the typical NP autonomy bloviation, perhaps we can put that to the side for a moment? Comparing typical curricula, the PA in most cases will have much more in the way of "hard" science background and education. As somebody who appreciates this kind of background, I see the physicians point.

I've worked with both and from what I've seen NP's in my current area as well as two previous states wherein I worked seemed much more on the ball than the PA's I have encountered. I still reserve judgment as I don't know why this is so.

[dthfytr, ADN, LPN, RN, EMT-B, EMT-I]

What I hear is that so many docs are going into specialties that there's a big need for primary care providers. Enter the NP, stage right! In any case, good luck.

[GilaRRT]

I've worked with both and from what I've seen NP's in my current area as well as two previous states wherein I worked seemed much more on the ball than the PA's I have encountered. I still reserve judgment as I don't know why this is so.

That is rather anecdotal and does not address my core issue regarding basic science education.

[nursinadream]

Great discussion here. Wonder how its helping the OP?

Deb

[OutlawNurse86, BSN, RN]

I was gonna say something buy MissDaisy pretty much covered it.

I do know of a few NPs around here, they are few and far between but they are smart as heck and their Docs trust them.

[POTR]

There were "proto physician's assistants" back when Nurses were still men. These not-Nurse, feldshers/medico's would have been with the German and later Russian Armies, pre-Florence, 1600's.

Also pre-Florence would have been British Naval 'loblolly boys', followed by US Naval 'Hospital Mates', followed by French 'Officiers de Sante', late 1700's to early1800's.

US Army 'medics' were formed up three decades before Mary Breckinridge established the Frontier Nursing Service in Kentucky.

"Community Health Aides" were introduced to Alaska in 1940 at the same time Dr. Amos Johnson was training Buddy Treadwell (his office assistant) as a proto-PA to help with his rural practice in Garland, NC. This would be the where and how Dr. Eugene Stead, Jr. and the general residents at Duke University were exposed to the current state and worth of the PA model. This may have assisted Dr. Stead in his unenviable position of creating a 'fast-track' 3 year MD program at Emory University, in 1942, to deal with the need for Doctors for WWII.

Mayhaps Dr. Stead sounds familiar, as in 1957, Thelma Ingles, RN began a clinical sabbatical with the good Doctor which led to the development of the first Master Degree program for Nurse Clinicians at Duke University School of Nursing. This program was a success at Duke but ultimately denied accreditation by the NLN.

In 1959 the US Surgeon general made public his claims of a shortage of proper medical care.

In 1961 Dr. Hudson wrote an article for JAMA calling for 'mid-level' providers, the World Health Organization's response was the creation of positions such as Medecin Africain, Dresser, Assistant Medical Officer, and Rural Health Technician.

In 1962 Dr. MacIntosh begins training local firemen at Duke in emergency medicine, later adding former Navy Corpsmen. These para-medicos are termed 'physician's assistants' in their work in cardiac cath lab.

In 1964, Dr. Stead is busy creating a two year test program to create "Physician's Assistants" at Duke, since the Nurse Clinician model was rejected by NLN. At the same time Dr. Richard Smith was busy in the PacNW creating the Med Ex (Medical Extension) Program under direction of the US Surgeon General.

In 1965 Dr. Stead's new curriculum was approved and training started at Duke. Around the same time Dr. Henry Silver and Nurse Educator Loretta Ford establish a Pediatric Nurse Practitioner program at the University of Colorado.

Demand for, and inquiries into, the PA program at Duke are overwhelming.

The original professional association for PA's termed themselves "Physicians' Associates". Progams such as Yale's and U.Minn's still term them as such.

[happy2learn]

The physician has a point guys. This thread is not asking about the typical NP autonomy bloviation, perhaps we can put that to the side for a moment? Comparing typical curricula, the PA in most cases will have much more in the way of "hard" science background and education. As somebody who appreciates this kind of background, I see the physicians point.

I disagree with your point. The PA and the NP have different approaches in regards to patient care. That is the difference.

Also, in comparing a PA and NP program in my area, the only extra "science" course the PA takes is Applied Sectional Anatomy.

I don't think one is above the other or one is more competent than the other. The approach they take is different.

[blondy2061h, MSN, RN]

I chose to go the NP route as they have more autonomy legally, have higher prescribing priveleges in some states (just recently in my state can PAs write for controlled substances, while NPs were doing it all along), and so that I can get experience as an RN first.