Now we can join the PA v NP debates!

[bethem]

Australia is considering bringing in PAs. From 2009, UQ is offering a three-year Bachelor degree that will allow graduates to work as a PA. The AMA has (of course) rejected the idea, and the ANF has too.

While the career of PA seems to be one I'd be interested in, I am irritated that we already have a class of midlevel providers (i.e. nurse practitioners) that are not being used appropriately.

I hope it is different in your areas, but in mine, the only NPs around are in Emergency, Women's Health and Nephrology. I know of at least one person who is fully accredited to register as a NP in Critical Care (Intensive Care), but the hospital will not hire her in that capacity.

DOCTORS should have assistants who can order tests, dispense medicines and even make diagnoses, says a new health think tank.

Ummmm... can't NPs do that here anyway? Why on earth do we need to bring in a whole new category of midlevels who can do the same things as the ones we already have?

What do you think?

http://www.smh.com.au/news/national/pas-just-what-the-doctor-ordered/2007/12/15/1197568327142.html

[nyapa, RN]

I figure this is because they are physicians assistants: ie the doctor still has his thumb on the employee. Nurse practitioners are more independent I would imagine, and therefore they are more of a threat.

But if you were paying to see a doctor, then I would want to see a doctor, not a physicians assistant thankyou. With nurse practitioners, you know you are going to see a nurse, with advanced skills.

BTW we are very backward. I have never seen nurse practitioners in the hospitals here. Mind you the remote area nurses may have some sort of authority to order tests etc.

[joannep]

Also, a PA is only qualified to degree level, where an NP is qualified to Masters level, with many years of experience. PA's are going to be cheaper to employ that NP's, I wonder if that is an influencing factor?

[Grace Oz]

HA! Nurses have been doing this for donkey's years anyway! LOL

[ivanh3]

In the states I work with PAs and NPs quite often. I am in my first year of my masters for NP (my wife and I hope to relocate to Australia after I am through). From an "end result" standpoint there is really very little difference in the two professions (at least how they are used in the US). Both are mid level, both require some oversight by a physician. (in the US the amount of oversight varies considerably for NPs from state to state), and both provide basically the same function. The patient would rarely be able to appreciate the difference. In fact most job listings for midlevels here looks something like "NP/PA wanted for....". The pay scale here is almost identical for the two.

To be quite honest, there really is no need for both professions. I honestly think we have PAs here in the states because of the whole female/male dynamic that was much worse between docs and nurses when the various NP/PA programs were being developed. I think that the predominately male physicians profession of the 1960s preferred the idea of a male midlevel which was who the PA profession was marketed to in the beginning. Of course that is a crap notion, but I feel it is true. As women and the nursing profession in general have become more empowered the dynamic is different, and I don't think that those conditions exist to the same extent that they did. However, now we have these two professions that are 95 percent the same. I don't know if that dynamic exist in today's Australia.

To the credit of PAs here, they are moving towards a masters degree (just like NPs weren't always masters degrees here). They have to have a lot sciences as prerequisite courses (more so than do nurses/NPs here in the states) and they do almost triple the amount of clinical hours than do NPs. Of course NPs have backgrounds as RNs and so IMHO, I think it all evens out in the end. If that is the case, then why not just focus on the one midlevel NP position and develop that to its fullest? But then as an RN and future NP I am sure I am biased.

Ivan