I work in California so may be geographically biased. At both hospitals I work at ACNPs make a lot more than PAs. In fact, PAs make less per hour than most staff nurses (I make 79/hour as an NP). You can view UCSF's pay scale on line (lower than most hospitals). Northern California Kaiser Permanente now has an official policy that you must hire an NP before an equally qualified PA. We do have numerous PAs in the surgical specialties, especially orthopaedics. Few NPs work in the surgical specialties, possibly because there is only one ACNP program in Northern California. Both professions seem to be well respected at my facilities, but NPs a little more so. I think this is because of the quality of UCSF graduates vs the local PA programs, and not the professions in general. Good luck.