Physician assistant versus Nurse practitioner

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Does anybody know what is the difference between a physician assistant and a nurse practitioner.

They seem to have the same responsibilities and same range of salary.

um, quick thing, PA school and NP school never cross paths, as one poster mentioned, the other thing is that you should be careful with this "NP's have their own license thing" you will never see a hospital based NP working solo, always under supervision, second it's a rare thing to see them solo in the real world. Legislation does seem to be moving in that direction though, so good luck with whatever you decide. and PA's have prescriptive authority in all 50 states.

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um, quick thing, PA school and NP school never cross paths, as one poster mentioned, the other thing is that you should be careful with this "NP's have their own license thing" you will never see a hospital based NP working solo, always under supervision, second it's a rare thing to see them solo in the real world. Legislation does seem to be moving in that direction though, so good luck with whatever you decide. and PA's have prescriptive authority in all 50 states.

You do see hospital based NPs working solo and it isn't such a rare thing any more to see them working solo in the "real world". There are a large number of independently practicing nurse practitioners in a growing number of states. It is great to hear you acknowledge that despite your objections legislative efforts continue to move us forward into the new millenium in healthcare.

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yeah, it's happening, but I don't understand, what do you mean by solo? All the hospitals I've worked in have bylaws requiring physician oversight? They have no MD's around?

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yeah, it's happening, but I don't understand, what do you mean by solo? All the hospitals I've worked in have bylaws requiring physician oversight? They have no MD's around?

What do you mean by solo? Are you equating your experiences at a few hospitals with all US hospitals?

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um, you could answer the question, do you have any idea. I'm asking cuz I want to know, please dispense with the 'tude dude. thanks.:cool:

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um, you could answer the question, do you have any idea. I'm asking cuz I want to know, please dispense with the 'tude dude. thanks.:cool:

You are the one who used the term initially. I was asking how you would define it.

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Sorry, I think I misread your post. By "practicing solo" I mean operating independently of a physician. As in they are admitting/rounding on their own patients, or working in an ICU without an MD cosigning orders. Basically that they don't have any contact with an MD except consults. I think in outpatients NP's do have independent clinics, as in no MD's cosigning charts?

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Sorry, I think I misread your post. By "practicing solo" I mean operating independently of a physician. As in they are admitting/rounding on their own patients, or working in an ICU without an MD cosigning orders. Basically that they don't have any contact with an MD except consults. I think in outpatients NP's do have independent clinics, as in no MD's cosigning charts?

Yup, that's exactly what I meant.

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I would like to know what hospital this is in.

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Specializes in ICU, Telemetry, Cardiac/Renal, Ortho,FNP.

I'm neither NP or PA but have looked into both extensively and decided NP for me for several reasons. I've read and corresponded with both NP's and PA's in private practice. Both "can" open a private practice, depending on the state. I think overall it's more accepted that an NP would versus a PA, especially inner city and rural areas. Both seem to have to do the Physician oversight rule in some manner and most just hire a Physician and pay them a few thousand bucks to review files, etc., and be on call. PA's do work as mini-physicians meaning their emphasis is still on diagnosis and prescription as opposed to patient treatment/management. Some conditions are not to be managed w/o physician oversight (don't know the specifics but have read that). In a nutshell there's not a lot of difference b/t the two although it seems that people understand that PA's will prescribe meds and act in lieu of a physician whereas there seems to be still a little misunderstanding of Nurse Practitioner's scope of practice.

Is one better than the other? In general, IMHO, yes. NP's have to be nurses FIRST and most require at least 1-2 years patient experience before matriculation. One can enter PA school with a BS in anything (as long as you have the pre-req's done) w/o any patient "care" experience. Some will argue that PA students have a req'd number of hours of healthcare experience but many seem to have just observation hours and great attitudes/GPA's. That's all great but again, IMHO NP's are better prepared right out of school. Of course, within a few years of experience in most cases all things equal out.

As to which one a person should choose it probably depends on your background, mindset and previous education. If it's all pre-med education then going into a nursing program will prolong your suffering (believe me!). If your just starting out then go nursing all the way.

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Problem is nursing has nothing to do with medicine. At least not in the sense of treating and diagnosing, which is what you are supposed to be doing as an NP or PA. Also, PA's are taught treatment, I'm not sure how you separate diagnosis/rx from treatment/management? they're the same thing. Plain and simple nursing school will help you treat and diagnose patients about as well as a technical college electrician can claim that his training allows him to work on the space shuttle. I will concede that you, as a nurse, will be more familiar with terminology perhaps once you start, and some of the medicines. But that is all.

Don't be confused, your "medical" training is 100% in NP or PA school as a midlevel. PA's who began as nurses have no advantage over what I just mentioned compared to PA's with no medical experience prior to PA school (most of whom do anyway).

Are you in nursing school right now? can you honestly say that anything you are learning would help you come up with a decent differential diagnosis for even a cough? or belly pain?

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Specializes in ICU, Telemetry, Cardiac/Renal, Ortho,FNP.

Not sure who you're addressing or what your suggesting. We are talking NP or PA not RN vs PA.

Anything an NP would learn in nursing school to differentially diagnose? Uhhh....yeah...Advanced Pathophysiology, Advanced Physical Assessment, Advanced Pharmacotherapeutics and all applicable preceptorships treating real patients with real NP's, MD's and DO's. Like I said there's virtually no difference in the curriculums b/t NP's & PA's. How do I know? There was virtually no difference b/t what I learned in D.C. school vs Medical/DO school in basic sciences, physical examination and diagnostic procedures, pathophysiology, etc., and the curriculum in both PA school mirrored exactly the same coursework I've already taken, same thing in the NP program. Both learn differential diagnosis and please don't over dramatize differentially diagnosing a patient. You can differentially diagnose a patient to death if you don't ever get started with a working diagnosis and get to work.

This tired old argument that nurses don't learn "medicine" I think is just stupid. Your right on comparing RN's to PA's but dead wrong on comparing NP's to PA's. As I said before it only holds true until the typical PA's gets some skin in the game then there really isn't much new under the sun. If they came into school with some real background then fine but the entrance requirements for all the programs I've looked into (a lot) do not require it. It's an alternative pathway into mid-level mainstream medicine.

"Medicine" is the art & science of healing. That's it. It's not some mysterious knowledge vault that only Doctor's have access to. I can tell you right now I've taken every class any M.D./D.O. needed to take to get into med school and while it's "nice" to understand the background chemistry, physics, biochemistry yadda yadda it's really not a game changer. Understanding patients is much more important than understanding chemistry. Nurses are taught to understand patients. Dictating care is much different than directing care and as a DM I can tell you first hand that as a Doctor of any kind you are forced into a role of dictating care and not much treatment/management. Treatment/management is not Dx., treatment and management is the execution of a plan based on the Dx. Being the one who spots the fire is not the same as fighting the fire.

I've learned a great deal in nursing and I understand most of what you're saying but I have had this same ridiculous argument with people before who either want to elevate medicine to an "untouchable" status or demean nursing to an "underling" status. It's all ridiculous b/c medicine encompasses all of it. Nobody is saying a nurse should be a physician but remember in the real world there aren't enough doctors and PA's and NP's are well capable of treating patients. If an NP can deliver your baby I'm sure they can differentially diagnose your belly pain as pregnancy or constipation. I'd bet on the latter. :smokin:

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