Why do some practices prefer PAs to NPs?

DizzyJ DHSc PA-C · Mar 28, 2018

It really just boils down to whoever has the final say of PA vs NP and what their opinion about each profession is. For many specialties, either can fill the role. It just takes one admin with a poor understanding of education or practice laws to exclude one of the professions.

djmatte, ADN, MSN, RN, NP · Mar 28, 2018

I would be hesitant to come to a knee jerk conclusion of a male vs. female preference. Especially with the sheer numbers of women filling the medical ranks these days compared to historical periods. The similarities of training methods of PAs in the medical model make them an easier decision for an MD. Also, when there is no clear likelihood that PAs will be getting (or really pushing for) real independent practice anytime soon they get more subservience than they might with an NP. Many older MDs need to be exposed to other practice models before they are likely to bite. Newer MDs are more accepting of utilization of NPs and i think it will just take more time before the less inclined move out of the profession and their younger colleagues begin to accept roles and encourage use of nurse practitioners.

mep7296 · Mar 28, 2018

It's weird because this practice currently has both on staff, but they have a job posting for PA only. There is also a large ortho practice here that has a strong preference to PAs and most of them are male. 75% of their NPs are women, but of the PAs only 40% of the PAs are women.

djmatte, ADN, MSN, RN, NP · Mar 28, 2018

If they have a mix, I would be more inclined to believe they want to keep the numbers somewhat even.

Oldmahubbard · Mar 28, 2018

Medicare reimbursement is better for PAs.

allnurses Guide · Mar 28, 2018

I've seen situations where NPs are part of the nurse's union at a facility, and PAs are preferred to avoid dealing with the union. I work in a private practice that always hired PAs. The reason for that was there is a PA school nearby, and PA students often did clinicals at this practice, so there was always a pool of prospective employees. The practice owner did not realize that NPs do not require the oversight that PAs do, and has since hired 2 NPs, which has decreased his workload in reviewing charts.

guest769224 · Mar 28, 2018

PA's typically have a stronger, broader education comparatively.

Goldenfox · Mar 29, 2018

May be a combination of reasons, but I generally find it to be about politics. The physicians and Boards of Medicine have total control over PAs, but not as much over the NPs as some of them would like.

Dodongo, APRN, NP · Mar 29, 2018

Go over to the PA forum and they have numerous threads asking why NPs are favored. Ultimately, there are many more NPs practicing than PAs so I don't think we can say PAs are preferred - provably just in surgical specialties, really, because NPs, for some strange reason, don't offer training in the OR.

And Oldmahubbard, PAs and NPs are reimbursed at the same rate? So I'm confused by your comment.

Dodongo, APRN, NP · Mar 29, 2018

I've seen situations where NPs are part of the nurse's union at a facility, and PAs are preferred to avoid dealing with the union. I work in a private practice that always hired PAs. The reason for that was there is a PA school nearby, and PA students often did clinicals at this practice, so there was always a pool of prospective employees. The practice owner did not realize that NPs do not require the oversight that PAs do, and has since hired 2 NPs, which has decreased his workload in reviewing charts.

That's very similar to my hospital system. There is a PA school 1 block away from the "flagship" so they love hiring new grad PAs that they can pay poorly. Whereas the NPs demand more money for being RNs first. But, go downtown where there are NP programs and PA programs, hiring is pretty even - even though NPs with RN experience are given extra compensation for that experience.

DayDreamin ER CRNP · Mar 30, 2018

Medicare reimbursement is better for PAs.

Yep. This is what I was going to say. In most states, a PA is 100% billable.

As always, it comes down to the dollar.