PA's make more $$ than NP's?!

Kate2RN · Aug 11, 2011

here is my perception on why the difference in pay for pa's and np's. the pa's title has "physician" in it, and although nurses are respected at some level, they are still thought of as being less educated than doctors. i believe we all realize that the education is the basic level of training, and with passing a professional licensing exam we enter the profession. it is the years of knowledge and hands of experience that makes us all valuable to the profession. yes, the type of education one receives helps train you to think differently. for example, the nursing focus is on the nursing process and preventative health care, whereas, doctors focus on diagnosis and treatment.

i would like to point out some differences in the program entry for nurses vs. doctors which is highly misunderstood. nursing programs usually requires prerequisite college courses in general biology, general chemistry, a&p, algebra, statistics, 1-sociology and 1-english, with an entrance exam given by the institution. medical school requires a bachelor's degree that included the same courses listed above, plus taking the mcat exam. medical school puts great emphasis on high mcat scores and gpa's > 3.5 because there are an overwhelming number of applicants.

medical school applicants are recommended but not required to take additional courses in biology & chemistry such as cell or molecular biology, biochemistry, organic chemistry, and calculus, and physics. please note: one can have an undergrad degree in anything with the courses listed under nursing prerequisites to enter medical school. most people do not understand this. see harvard's medical school admissions requirements:

http://hms.harvard.edu/admissions/default.asp?page=requirements

presently, i work for a doctor licensed in the u.s. who completed school and training abroad, and was later licensed in the states. this doctor could not pass physics, some chemistry, or calculus; and therefore, he never took these courses. his undergrad degree was in psychology. in addition let me mention. my daughter has a double major in biology & chemistry (gpa 3.0), and her classmate who went to medical school didn't take courses that she did because as he stated, "it would ruin my gpa and i'd not get into medical school." courses my daughter took that the med student did not included 2-biochemistry, 2 - physical chemistry, calculus ii.

so we would rather have students get high gpa's than to challenge themselves and learn more? there seems to be some serious flaws with the whole system!!! those who make the most and control the system have most convinced they are the best and brightest and this is not always the truth. in addition, we are convinced that students in other countries are further ahead. are they? it is more about perseverance. do more foreigners go on for higher degrees? why? they definitely don't incur the debt that americans do.

solution: i believe there needs to be a different gpa scale for students majoring in physical and life sciences, and math. for example, my daughter's courses in biochemistry and physical chemistry were 3 credits each for class, and 1 credit each for lab. the lab grade was separate from the class grade. there is no way a 3 credit course in anything else....i've taken such as.....english, communications, business, accounting, sociology, psychology, history, or religion equates to what she learned. if you don't believe me ask all the med students who avoid these classes!!!

bottom line: we need to look more at the educational course work that make up these programs, and one's level of experience, and put less emphasis on gpa's, and initials after one's name. if the educational evaluation scale was weighted differently we would get the brightest students. more students would challenge themselves and more would major in the physical and life sciences. they wouldn't have a choice because now they'd have to compete with the best of the best!!!

the pay scales definitively need a revamping also. there is a serious problem when you pay new grads (nursing) more than experienced nurses!!! and why are np's earning

Trauma NP/PA · Aug 11, 2011

I have both certifications. I worked in Trauma ever since I got out of school, first job as a Trauma PA and the second job as a Trauma NP. They pretty much pay the same. The job function is quite similar too. The only thing with my first job was I could go into the OR with a PA, but not as an NP if I don't have a surgical cert. That's why I worked as a PA. The second hospital I worked at allowed both PA and NP to operate, so I choose to use my NP.

Overall, the pay is pretty much the same. If you prefer working in surgery, I would suggest getting the PA.

79Tango · Aug 12, 2011

NP & PAs' get almost the exact same pay rate in our Clinic and ER. As a hiring manager we are more concerned with having a current DEA, ACLS & clean license then if the person is an NP or PA.

OB-nurse2013, BSN, RN · Aug 13, 2011

here is my perception on why the difference in pay for pa's and np's. the pa's title has "physician" in it, and although nurses are respected at some level, they are still thought of as being less educated than doctors. i believe we all realize that the education is the basic level of training, and with passing a professional licensing exam we enter the profession. it is the years of knowledge and hands of experience that makes us all valuable to the profession. yes, the type of education one receives helps train you to think differently. for example, the nursing focus is on the nursing process and preventative health care, whereas, doctors focus on diagnosis and treatment.
i would like to point out some differences in the program entry for nurses vs. doctors which is highly misunderstood. nursing programs usually requires prerequisite college courses in general biology, general chemistry, a&p, algebra, statistics, 1-sociology and 1-english, with an entrance exam given by the institution. medical school requires a bachelor's degree that included the same courses listed above, plus taking the mcat exam. medical school puts great emphasis on high mcat scores and gpa's > 3.5 because there are an overwhelming number of applicants.
medical school applicants are recommended but not required to take additional courses in biology & chemistry such as cell or molecular biology, biochemistry, organic chemistry, and calculus, and physics. please note: one can have an undergrad degree in anything with the courses listed under nursing prerequisites to enter medical school. most people do not understand this. see harvard's medical school admissions requirements:
http://hms.harvard.edu/admissions/default.asp?page=requirements
presently, i work for a doctor licensed in the u.s. who completed school and training abroad, and was later licensed in the states. this doctor could not pass physics, some chemistry, or calculus; and therefore, he never took these courses. his undergrad degree was in psychology. in addition let me mention. my daughter has a double major in biology & chemistry (gpa 3.0), and her classmate who went to medical school didn't take courses that she did because as he stated, "it would ruin my gpa and i'd not get into medical school." courses my daughter took that the med student did not included 2-biochemistry, 2 - physical chemistry, calculus ii.
so we would rather have students get high gpa's than to challenge themselves and learn more? there seems to be some serious flaws with the whole system!!! those who make the most and control the system have most convinced they are the best and brightest and this is not always the truth. in addition, we are convinced that students in other countries are further ahead. are they? it is more about perseverance. do more foreigners go on for higher degrees? why? they definitely don't incur the debt that americans do.
solution: i believe there needs to be a different gpa scale for students majoring in physical and life sciences, and math. for example, my daughter's courses in biochemistry and physical chemistry were 3 credits each for class, and 1 credit each for lab. the lab grade was separate from the class grade. there is no way a 3 credit course in anything else....i've taken such as.....english, communications, business, accounting, sociology, psychology, history, or religion equates to what she learned. if you don't believe me ask all the med students who avoid these classes!!!
bottom line: we need to look more at the educational course work that make up these programs, and one's level of experience, and put less emphasis on gpa's, and initials after one's name. if the educational evaluation scale was weighted differently we would get the brightest students. more students would challenge themselves and more would major in the physical and life sciences. they wouldn't have a choice because now they'd have to compete with the best of the best!!!
the pay scales definitively need a revamping also. there is a serious problem when you pay new grads (nursing) more than experienced nurses!!! and why are np's earning

i have to reply to your post. i'm sorry but many things you wrote are not accurate. for instance, pre-requisite classes for nursing school vary greatly. if one is a bsn student then at almost every university by me does require upper level sciences, general chemistry, and organic chemistry. my specific school requires upper level micro., and pathophysiology before entering nursing school. now i am in no way comparing nursing school to medical school but pre-req's for nursig obviously vary so it's hard to generalize. i was very perplexed though when i read what you wrote about med students being that i know quite a bit about gen. medical school requirements for the med schools in my state since my cousin is one and a close friend. you are right you can "major" in anything but every medical school still has courses that required almost always including physics, organic chemistry and the other "hard" classes. even the harvard link that you provided doesn't support what you're saying because if you read it clearly states you can major in anything as long as you also take the required course they list including biology, chemistry, physics, organic chemistry and advanced calculus. everyone has to take them and do well in them to maintain a high gpa.

79Tango · Aug 13, 2011

I have an "Alibi" to my post. In addition to DEA, ACLS & Clean license we care about having a Master's Degree! I learned this the hard way when we hired a PA from Florida. She was a PA-C with ER experience and all the required certifications etc. The problem was she had an Associate's degree in Physician Assistant studies and our credentialing department said NO.

linearthinker, DNP, RN · Aug 14, 2011

The clinic I just interviewed at last week has a payscale that accounts for years of experience (and they count RN experience), degree level, and some certifications. It is the same scale for PAs and NPs.

I am a new grad NP, but I was a RN for almost 25 years. They are counting that experience, oddly enough. So if they hire me as a new grad NP and another midlevel who is a new grad PA, but who wasn't a nurse for 20+ years before going to PA school, I would make considerably more than that PA even though we would both be new grads at the same job, in the same clinic. I don't have a number, they just explained the system they use to determine pay. I am also a DNP student, and my pay would go up 15% when I finish, which is nice since no one else I have interviewed with had any system for formal recognition of the degree.

My husband pointed out what a disadvantage this is for me. If you were going to hire a brand new grad, would you hire the one that costs more b/c of RN experience? Probably not. So I might not get this job just b/c I hvae too much experience of a kind that only costs them money and doesn't change the fact that I am a NEW grad who doesn't know squat, lol. Too bad too, b/c I think I would have taken this one.

TakeBack · Aug 15, 2011

I have an "Alibi" to my post. In addition to DEA, ACLS & Clean license we care about having a Master's Degree! I learned this the hard way when we hired a PA from Florida. She was a PA-C with ER experience and all the required certifications etc. The problem was she had an Associate's degree in Physician Assistant studies and our credentialing department said NO.

Unfortunate discrimination. Expect nothing less from HR policy!

TakeBack · Aug 15, 2011

As was mentioned before, the PRIMARY reason why overall national average salaries are higher for PAs is b/c of the greater portion of PAs in higher paying specialites/surgery.

There is regional variability but when you compare apples to apples, salaries for PA vs NP are usually pretty close.

linearthinker, DNP, RN · Aug 15, 2011

Unfortunate discrimination. Expect nothing less from HR policy!

I look at job postings daily, and every ad I have seen states for both PAs and NPs, "masters degree from an accredited school required." If I were a NP or a PA that had been grandfathered in, I'd mind my Ps and Qs in my present position b/c if you lose it, I think getting a new one w/o a MS would be very difficult in most places.

My NP has an ADN and about 35 years of experience. I think she is the cat's pajamas, but I suspect if we were competing now for the same job, I might get it b/c I have a degree and she doesn't. I think 20 years from now, the same thing could happen with DNP vs MSN. Am I a better hire b/c I have a MSN and my NP does not? Oh he// no, not by a looooong shot, lol. But there is no denying that in the modern world, I have the advantage. I don't think that is discrimination, so much as an evolution of minimum expectations.

TakeBack · Aug 16, 2011

I look at job postings daily, and every ad I have seen states for both PAs and NPs, "masters degree from an accredited school required." If I were a NP or a PA that had been grandfathered in, I'd mind my Ps and Qs in my present position b/c if you lose it, I think getting a new one w/o a MS would be very difficult in most places.
My NP has an ADN and about 35 years of experience. I think she is the cat's pajamas, but I suspect if we were competing now for the same job, I might get it b/c I have a degree and she doesn't. I think 20 years from now, the same thing could happen with DNP vs MSN. Am I a better hire b/c I have a MSN and my NP does not? Oh he// no, not by a looooong shot, lol. But there is no denying that in the modern world, I have the advantage. I don't think that is discrimination, so much as an evolution of minimum expectations.

The bigger issue is what are we doing to the applicant pool by creating a situation, as you describe it, that favors inflated inexperience over the converse.

linearthinker, DNP, RN · Aug 17, 2011

I was merely commenting upon why it does not amount to "discrimination" when an employer opts for more education over less. Of course they are going to miss some strong candidates, that goes without saying. Any ADN prepared RN will tell you that. In making a choice, something will always be lost. TPTB have decided to choose education over experience in some cases. That is their choice to make, and a possibility I'd be cognizant of. NPs/PAs with tons of experience still lacking the degree of choice (whatever it is today, lol) can always go back and get that degree and maintain their competitive edge. I can get the degree, but there is no substitute for the experience, and I just can't go invest 2-3 years and be awarded 20 years experience, lol. They still have the advantage, if they choose to take it. I don't think the employers or rest of us can be blamed if they choose not to.

TakeBack · Aug 17, 2011

It's not discrimination in the legal sense, of course. But when you step back to the HR mindset- which equivocates degree with competence- it will undoubtedly filter out highly qualified candidates who deliver gold standard care (the reason we all got into this for the first place, right?)

Degree creep is an unavoidable reality. NPs are all masters. There are maybe 4-5 PA programs that don't offer masters at my last count. PA will eventually be mandatory masters. I got mine post bacc for your reasons as well.

I just hope that no one on this forum is deceived into thinking that the masters, for the PA/NP level of education and training, makes a better provider. There are legions of non masters PAs/NPs out there to prove the contrary.