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.

[Scrubmouse RN]

I've heard (correct me if I am wrong) that PAs work under the Physician's license the duties depend on what that physician feels comfortable allowing the PA to do. So if the doctor is only comfortable with letting the PA put on bandaids, then that is all the PA is going to do. As opposed to an NP who does not work under anyone's license and has more autonomy. From what I've heard, both NP and PA do the same thing.

[Neveranurseagain, RN]

In some states, a NP can work independently. In my town (in Arizona), there are several NP that have their own practices, without an MD and can even bill insurance companies and recieive reimbursement without going thru an MD. But a PA has to work in conjunction with an MD and cannot have a independent practice, nor can they bill insurance companies directly.

Another thing to consider is whether or not you will ever relocate to another state. A friend of mine was a PA here, but when she moved to Florida she was told she needed an additional 2 years of training to be a PA. She regretted her decision to be a PA, stating that being a NP is has greater reciprocity.

[VivaRN]

Another angle is if you want to work internationally NP's are way more widely recognized because of the basis in other countries of nursing. For example, Doctors Without Borders (MSF) doesn't take PA's but DOES take all manner of advanced practice nurses.

I work with a few PA's who wish they had known this.

[TheCommuter, BSN, RN]

Physicians (and physician assistants) fall under the medical model of care delivery. Nurses (and nurse practitioners) fall under the nursing model of care delivery. The medical model and the nursing model are two totally different approaches to patient care.

There are specific reasons that many physicians possess biases toward PAs.

[Echo_of_Faith]

I have done a lot of research about furthering my career after LPN school. I've made calls, visited with doctors, NPs, PAs, worked with them at clinicals. I've asked so may questions it's ureal. When it comes down to it remember that it is YOUR decision; however, if you choose to head some advice or maybe tips here they are: responsibilities and scope of practice will vary in each position from state to state, as well as facility to facility. What procedures & tasks do YOU want to do? What resources do you have to find the information you need? What amount of information will be enough for you to make a decision? Also there is this: I got what I believed to be a late start on my schooling (screwed up w/ irresponsibility after high school) the 1st time around. I had (last year) been debating about whether or not to go into NP or PA school. I spoke with the closest school for these programs and decided that based on the time I would be in school for these degrees, I should go ahead with the original dream I've had for many, many years, & go to medical school. I am in LPN school right now, & will be bridging over to get my Bachelor's degree so I can enter MED SCHOOL; I don't know what your dreams & aspirations are but time may be a factor & state laws & facility policies may not be in line with your dream. I would seek out as much information as possible (given you have time) & then make a decision. Don't go off 1 source, but compare/contrast multiple sources. I sincerly hope this helps.

[elkpark]

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.

Yale's program doesn't "still" use the term "physician associate." They used "physician assistant" for many years and changed the name of the program to "physician associate" fairly recently (I don't recall the exact year, but I recall reading about it in the alumni magazine at the time the change was made). To further confuse the issue, note the opening sentence by the "Dean's letter" welcoming people to the PA program website:

"Yale is a wonderful place to begin your career as a physician assistant." (Emphasis mine.)

Dean's Letter, Physicians Associate Program: Yale School of Medicine

Sorry for going off-topic. Just wanted to clarify the comment above.

[GilaRRT]

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.

The approach is different? You diagnose a patient with a problem, then treat it. Seems like medicine to me. In addition, PA's will typically have more in the way of chemistry than their nursing counterparts. I am not talking about survey type chemistry courses either.

With that, I have to disagree with your notion that there is a difference in the fundamental job of the NP or PA. As stated earlier, both have essentially the same job.

[morphed]

Someone tell me if I am wrong with the following logic: As an NP you can do anything that a PA can do but the reverse is not true? I don't know, they both seem like great career choices. I would just go with the one that would allow more room for growth down the road, like an NP would be able to go into nursing education.

[StayLost, BSN, RN]

Someone tell me if I am wrong with the following logic: As an NP you can do anything that a PA can do but the reverse is not true?

The NP can practices autonomously under his/her license when the PA MUST practice under an MD's license. In Arizona (where I went to school) an NP can open their own practice or run a clinic. A PA can not work alone-- the PA must be in partnership with an MD -- hence "Assistant".

[foreverLaur]

Both have their pluses and minuses... one is not better than the other. Ultimately, it depends what your background is and what your ultimate career goal is. For me, PA is more geared towards what I want. For others, NP might be more geared towards what they are looking for.

[tejas-nurse]

Take a look at sample PA and NP curriculums. I do wish that some NP course fluff was taken out in favor of cadaver labs and more hard core science. We got enough of Nightingale and other nurses' theories in our ADN/BSN progs.

[carolinapooh, BSN, RN]

I work in a family practice office right now while I'm still in school, and one of our doctors' mom is an NP, and while he might be biased due to that, he says he'd rather have an NP than a PA because (most of the time) NPs have been RNs for a little while, and they have had so much more in-depth hands-on patient care experience to guide them as an NP, which makes sense to me. I'm sure there are RNs who choose to do PA, so they have more experience than other PAs, but most PA schools require a certain amount of hours working in a patient care field or "voulnteer experience" (at least the ones near me), which might just be as a PCT or MA- which are valuable experiences, but not quite as thorough as what an RN would get.

I'm liking this MD - his mom raised him right!

You're right - I looked into Duke's program at one time and they required 1200 hours of "direct patient care" experience - and volunteering didn't cut it.