Nurse Practitioner vs Physician Assistant

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jan 5, 2011

*** They can and do. My question is why in the world would anyone want to?

Makes it much easier to get along with the boss!

core0 · Jan 5, 2011

I am leaning heavily towards becoming a nurse practitioner; however, people have suggested becoming a physician assistant. What are some of the advantages of being a nurse practitioner vs being a physician assistant? Is one more marketable than the other? What does the future hold for each one? Does one pay significantly more? Thanks you for your thoughts!

The advantages are going to be location dependent depending on state practice acts and local policies. In general the primary difference is in training (broad medical training vs. training in a specific area of advanced nursing practice). The other difference is in scope of practice which varies depending on the state and local policies.

The marketability is again going to be location dependent. There are some areas that are more NP friendly and some that are more PA friendly. Also there are some specialties such as surgery where PAs have an advantage.

Crystal ball is cloudy try again later.

The average pay for PAs is slightly higher probably because of the number of PAs in surgery. Generally for a given job PAs and NPs are paid the same.

In addition to the PA forum there is also this collection of posts in the NP section here:

Differences (Educative/Clinical) between NP PA - Page 63- Nursing for Nurses

David Carpenter, PA-C

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · Jan 5, 2011

hmm... my pa wrote me a prescription for insulin. and i know the military has a program where the pa and doc are in different cities, and communicate through teleconferencing. go to [color=#0e774a]www.physicianassistantforum.com for unbiased opinions on pa training and practice.

the military system wouldn't make for a useful comparison for the op. my daughter is a combat medic, and they have trouble getting docs and pa's. the military doesn't require a residency program for (at least some) of it's docs, only that they complete medical school. the clinic she runs is promised a pa or doc who is a no-show because they didn't complete their schooling at the last minute (i'm trying to be pc here, she's actually told "they flunked out"). it's also my understanding that the military won't use adn's or np's. if anyone out there has more accurate information, please correct me.

SweetBabyLPN · Jan 5, 2011

hmm... my pa wrote me a prescription for insulin. and i know the military has a program where the pa and doc are in different cities, and communicate through teleconferencing. go to [color=#0e774a]www.physicianassistantforum.com for unbiased opinions on pa training and practice.

again, "where i live. . . ". i'm sure it varies by state.

core0 · Jan 5, 2011

The military system wouldn't make for a useful comparison for the OP. My daughter is a combat medic, and they have trouble getting docs and PA's. The military doesn't require a residency program for (at least some) of it's docs, only that they complete medical school. The clinic she runs is promised a PA or doc who is a no-show because they didn't complete their schooling at the last minute (I'm trying to be PC here, she's actually told "they flunked out"). It's also my understanding that the military won't use ADN's or NP's. If anyone out there has more accurate information, please correct me.

The Military uses PAs, GMOs and residency trained physicians for active duty troops. GMOs are physicians who have completed one year of residency (intern year). Its a complicated situation involving payback for medical school scholarships, the military graduate medical education system and the needs of the military. On the military level they usually fill Battalion or Brigade surgeon positions. The military would prefer that all physicians be BC but they've been trying to do that for 20 years.

To my knowledge the mililary does not use ADNs on active duty. In the past this has been related to the need to have a bachelors degree to be an officer. The military uses CRNAs and CNMs. They have a few NPs but on deployment they tend to be deployed as RNs. NPs don't really fit into the current military medical system and the training doesn't really lend itself to the Battalion surgeon position.

core0 · Jan 5, 2011

Again, "where I live. . . ". I'm sure it varies by state.

I'm curious where this is. I'm reasonably familiar with all the state practice acts and I can't think of one that prohibits injectables. There are two that do not allow schedule IIs and several that have formularies. But again I would be interested in one that does not allow injectables.

babyNP., APRN · Jan 5, 2011

The US Army DOES use NPs...know a few personally, growing up as an army brat :) they were just FNPs though...

JRN72 · Jan 5, 2011

I am leaning PA, because from what I have seen here in WI, I have noticed, as pointed out on an earlier post, that PAs are hired more into the areas I have the most interest in. Also, and flame me if you will, I have found nursing education to be pretentious. I have an ADN and a BS in dietetics, which is an extremely competitive program and gave me all the coursework needed had I been medschool inclined (god how I wish I was focused when I was 20...anyway) with heavy emphasis on hard science courses...as well as all the leadership and management (they just didn't call it "leadership for RDs" and try to call it something special, such as I see with nursing education). They will not force me to get yet another bachelors degree before they deem me qualified to apply. Thus far, I think the PA program more closely meshes with my previous experience, my personal characteristics, and where I want to go. I'm open to changing that opinion, and will certainly be watching carefully as I start my new job on Monday (OR in a large facility), and get a chance to really observe the roles I have future interest in.

PMFB-RN, RN · Jan 5, 2011

This may not be true for every PA program but the ones I've looked at require intensive curriculums that have very little room for anything other than the PA program, for instance one program I'm looked at is 28months long, no summer break, and the program does not allow the students to work during the 28months. NP programs (again, not all) seem to allow more room for flexibility, the program I'm looking at for a FNP has a 2year or 4 year option, and many of the people I know that have attended NP programs have been able to work while in the programs. I myself am looking at NP and PA programs and have been contemplating which route I'd like to take and being able to work while in a Masters' program is a huge factor in which way I go. I also like the autonomy NP's have (dependant on which state one practices); and because I have my BSN I won't need to take any pre-req courses to attend a NP program whereas I would need to take around 3 pre-req courses for a PA program I'm interested in. Lastly, the pre-req's for the PA program have a 10 year limit on them (if taken over 10 years ago the pre-reqs need to be taken again), so if one has been a nurse for over 10 years they would need to take all of the pre-req's over again. (again, this is just for the NP and PA programs I have looked at and there is much variety between requirements for NP and PA programs). Good luck with whatever route you take.

*** You might be interested in the Univerity of North Dakota's program. First year in online didatic. Second is mostly done in your home area with a preceptor.

RN4784 · Jan 5, 2011

i have been considering going back to school for np or pa as well. my understanding of np is that some nurse practitioners work independently of physicians while, in other states, a collaborative agreement with a physician is required for practice, and a pa is a healthcare professional licensed to practice medicine with supervision of a licensed physician. i have been leaning more towards np because in most states np's work independently, and a pa will always have to work under a physician. it seems to me that more people are going to pa school over becoming a licensed physician, so what will happen to pa's when there arent enough physicians to work under?

i think it also depends on if you enjoy more patient centered or medical model care?

np is more patient centered focusing on patients' conditions as well as the effects of illness on the lives of the patients and their families. their priorities are more directed towards prevention, wellness, and patient education including educating patients about their health and encouraging them to make healthy choices.

pa is concerned with preventing, maintaining, and treating human illness and injury by providing a broad range of health care services like conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, and assist in surgery.

ImThatGuy, BSN, RN · Jan 5, 2011

Makes it much easier to get along with the boss!

If they've got the stones to do it then by all means. From having been an avid reader at physicianassistantforums.com it seems that the PA locates and pays a physician to be their collaborator.

Arkansas prohibits this though, but the PAs still dont' require immediate, direct supervision so for the readers they can work independently on a day to day basis.

GM2RN · Jan 5, 2011

NP = Doctorate preparation after the BSN
PA = Associates, bachelors, or master preparation. Yes you can go to a community college and become a PA.
*** Here in Wisconsin PAs & NPs working in the same speciality make the same. However the very high paying specialities, like CV surgery are only open to PAs.
I was debating this myself until the nurse hating nurses revealed their insecurity and low self esteem and mandated the doctorate for NPs. Now PA is clearly the better path for me.

While a doctorate is an option, it is not (yet, and may never be) required for NP. At MSU, for example, you can still get a masters (was just on their site this morning).

I was also looking at job openings in my area for NPs and found one for cardio-vascular surgery for a new NP or PA at a hospital local to me. Also, some places will only hire NPs, so this would seem to vary by area/region.