NP vs PA -- a travesty ????

Specialties NP



no one replied to my last thread, no harm done.

I was considering the pursuit of a PA or an NP and have been reviewing the ups and downs.

I have done a little research on incomes for NP's vs. PA's and have discovered one study in 2001 claims "on average" PA's tend to make around 71K a year and NP's average 63K a year. Granted these are averages. What gets me is that any dolt with a BA degree can go and get a PA in almost half the time it takes to get an NP and have half the experience but still actualize a greater salary. Why is this?

The PA degree was initially supposed to allow field medics with a lot of experience in, well battle, to get certification allowing them to take more weight off the physicians hands without having to go to school for 10 years (an exaggeration) to become a physician. Now adays, this is generally not the case. I'm not trashing PA's altogether, however, I know the one at my PCP's office has a BA in French Lit. and I as a nurse can see the type of care being delivered. The NP at my PCP's office pretty much sealed the assumption with an interview.

I have heard other such tales.

How can such quality of care or healthcare experience receive a greater reward.

any thoughts appreciated............................................................

Specializes in Med-Surg.

Ok, I am not an NP or PA...yet :D But I think the difference is probably because NPs are usually women and PAs are usually men. Of course that is my very unreasearched, uneducated, personal thought on the matter. And I am not saying it's RIGHT, or that I think that's how it ought to be.


455 Posts

My view is that the PA programs were created by MD's as way to ease the burden of the MD. PA's work under the supervision of the MD and under the license of the MD who supervises them. The NP in many states can work independently, and work under their own nursing license. In other states, NP's are required to have a collaborative agreement with an MD (as opposed to a supervisory agreement). There are some physicians that view NP's as a threat to their practice, others see NP's as an asset to their practice. But, MD's have a lot of political power, which I believe is why the NP may make less than the PA. Physicians have more control over the PA than the NP.

My ex is a PA with a Bachelors degree. However, there is currently a push to encourage PA's to have a Master's degree, as the PA organizations recognize the differences in educational levels.

Just my thoughts on the issue.



18 Posts

I may be wrong and things are changing (more acute care NPs) but, I think the majority of PAs work in hospital settings, while, traditionaly, the majority of NPs work in primary care. Generaly, acute care is higher paying.


413 Posts

I agree with Ruby, but I would add that many PA's work with surgeons and are able to bill as First Assits, while many NP's do work in Primary Care. However, I do know several NP's that work in the same capacity with surgeons and make a nice $100,000+ salary and know of some PA's that work in Primary Care and make accordingly. So it seems that salary is more commensurate with what you do not necessarily your credentials.


8 Posts

I work in a large ED with both PAs and NPs. The NPs are paid significantly more than the PAs.


7 Posts

I have to disagree with the other's comments. I have done extensive reseach on the PA profession. I myself was trying to choose between NP or PA. I have decided to choose PA. If you do not already have a nursing background I would say go ahead and research as much as you can about both NP and PA. NPs are trained in the nursing model whereas PAs are trained in the medical model. PAs receive the same training, minus the residency, as physicians, condensed into 2 1/2 years. Most PA schools require some patient care experience, i.e. EMT, CMA, Nursing, CNA, etc. It also depends on what state you wish to practice. In most states, PAs practice under their own license, but with a supervising physician to review charts and handle the more complicated cases. NP and PA are both midlevel practitioners with different training. Starting salary for PAs, according to the American Academy of Physician Assistants, is about 60,000 a year. Again that all depends on the area where you will practice. The PA route is mostly for those who have previous clinical experience, as stated above. But mosts PA schools will give you much more clinical experience that NP schools, due to the fact you do the same rotations as physicians. If you want to work in a rural setting then you will have more autonomy in your pactice. As I said, in most states, PA and NP are equal their capabilities in treating patients. The question is do you want to be trained in the nursing model or the medical model?If you are already a nurse, then NP is usually going to be the best option. Another difference between NP and PA is that when one attends a NP school he/she has to pursue a specialty, i.e. FNP, CNM, NNP, ANP, etc. PAs are trained to be versital. You do not have to choose a specialty. You can easly work in family practice or cardiology, depending on what jobs are available and your interest. If you wanted to work in different specialy as a NP you would probably have to go be to school, but as a PA you can slide right in.

Sorry if I offended any NP out there, that was not my intention.

Falconboy, PA school is actually very difficult to get into, as CMAMW stated. I too was debating PA school but chose the nursing route. All the PA schools I was looking at required at least 500 hours of clinical experience, plus all the premed classes like O-chem. So check out your area of the country specifically and see what is more in demand, as well as scope of practice for your state. In Pennsylvania PA's practice with physician supervision, whereas NP's practice with physician collaboration only. Some hospitals in my area will not hire PA's and will only hire NPs. So, if you are debating between the two professions talk to both a PA and NP in your area and decide what is best for you.

Granted Fal

83 Posts

Thanks for all your insight. It's greatly appreciated.

Specializes in Hospice.

My spouse, currently an LPN and attending RN school, has changed his mind and is going to attend PA school..........why? for the reasons stated above of course........he lacks only a few more "core" classes to qualify for the PA program that last only 24 months.....Good for him! I'm not knocking NP's but why should you have a BA to get a BA?


18 Posts

There are several RN to MSN (NP) programs in my state (you don't have to have a bachelors degree). However, NPs must have a MSN, in fact some are considering doctorate preparation (PTs are all going Phd, no wonder they are more highly paid). PAs just have a bachelors. In my neck of the woods, NPs are much more common than PAs. Why not just go to medical school, if you want to just use the medical model and not a more holistic model of care? In addition, NPs seem to be more highly paid, where I am, at any rate.


15 Posts

I dont know much, but I chose to go the NP route because I like the training better and I feel that Nurses are better care givers which if thats what one wants to do, in my experiences as a pt. i liked the NP pt relations better than the MDs(y my primary is a NP). I do know that in the hospitals around here are also phasing out PAs, may be unique to the area? I am biased, I know so Happy chosing! And please remember no matter how much you get paid, its about the pt.

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