treejay

I see this posted time and time again... And I will say it again. It isn't true anymore. The large number of direct entry NP programs have made this blanket statement not truthful. It is true for a substantial number of NPs. But most definitely not all. It's important to be accurate and not misleading.

This simply isn't true anymore. It used to be, but with the proliferation of many direct entry programs, it is no longer the case.

How do PAs not get more or better education? Not trying to be antagonistic, but I disagree and would like to understand your viewpoint.

Yeah this is too bad in my opinion, because the NP profession really had a chance to fix some of the problems with current NP programs such as limited clinical hours.

All things being equal, I do believe PA school has a much more rigorous training based in more hard sciences and many more clinical hours. This is virtually undebatable. All NP preceptors I have rotated with have unequivocally agreed. That being said, there will be certain restrictions once you become a PA that you wouldn't have as an NP. I was in a quandry choosing between the two, and I chose PA because of the educational opportunities, and because I want to enter EM which seems to have more jobs for PAs than NPs, at least in regions I'm in. A big part in the decision I believe should come from what field of medicine you want to practice in. If I was sure I wanted Family Practice, NP hands down far and away. Inpatient settings less so (Peds and OB/Gyn being notable exceptions). As many earlier have said much learning will also come from the job.

One more comment about the title NPP vs APC. Non-physician providers defines us what we aren't. Advanced Practice Clinician defines us by what we are. I dunno. To me, it seems the latter is the better term. treejay PA Student

Just a few comments on the notion that APCs have more time. I think it's a myth in many cases. The only reason why an APC would have more time, is if they're seeing fewer patients. And if one isn't working for themselves, the employer will try to get the provider to see as many patients as possible, as quickly as possible. If an APC is seeing the same amount of patients as a physician in a practice, that math just doesn't pencil out. TIME is determined by how many patients/day one sees, not their degree. Time is required for patient education. Not sure why this myth is so perpetuated that APCs "get to spend more time with patients". One area where I do agree with you strongly, is that nursing education is much more consistent with education of patients. Medical educations places ZERO emphasis on that, which as we all know is absurd.

Thanks SkiBumNP. I appreciate it. I will PM you in the near future.

Does Kaiser use PAs in the ED? Also, what hospitals in the bay area use PAs in the ED? PA student considering a path in EM somewhere on the west coast..

How come ?

and when I say most often causes flushing, i have read that most patients who take niacin at therapeutic doses for HLD, get flushing side effects. it's not widely tolerated.

niacin most often causes flushing at therapeutic doses for hyperlipidemia. the vitamin dose it drastically smaller than that used for cholesterol/triglycerides. as far as overmedicating society, definitely. and in no small thanks to the incessant lobbying of the pharmaceutical industry. and holistic NPs to my knowledge, at least schools that offer that focus, ultimately sit for the FNP certification

wrong. why not simply type a few words into google for your quick answer?

I don't know if I agree that it's a real shame. How it's setup by the accrediting agency, PA programs are competency based, not degree based. Graduates of any PA program, associates or master's need to meet the same competencies, and those competencies are stringent. I think this is one of the strengths of the PA education model. With all due respect, and not intended to flame, and as discussed in other threads here, shameful might be the online NP program requiring in the ballpark of 500 clinical hours which may vary widely in quality. Theoretically, and i bet it has been done, not just in theory, one can obtain a BSN (or an accelerated BSN in 12 months if already have another bachelors), work very briefly as an RN if at all, then move on to an online NP program and practice after completion of the 500 hours of clinical hours. Granted, I have never met anyone or know anyone first hand who has done this. But it seems like the system is there to do it if one wanted to. And please understand, I point this out not to compare good vs bad, us vs them. I believe it's a fair critique of NP educational model. There are outstanding NP programs and from what I have read here, there seem to be some poor ones too. Huge variance if you will. I think PA education has a leg up in this issue. The standards for accreditation are stringent, well defined, and enforced. It's been discussed elsewhere in this forum. Just curiously, for my knowledge, who accredits NP schools? And what are the standards? Don't take me wrong. I'm a uniter of the two professions, not a divider. But even with a vision of unification, there will always be room for critique on both sides. "constructive feedback" so to speak

Abe Frohman ?? The sauage king of Chicago ?? :) Couldn't agree more. I'm with your vision. treejay, PA-S2

I don't know a single listing that lists all programs and what degrees are offered. The one core0 provided has all the info, it just takes longer to get at because you'd need to click on each state individually. Take, for example my state of Texas. click on it, and you'll see each PA program in texas and which degree it offers (M, B, or C). In that case, there is one program offering a C, or B which is the program for those in the Army. As for why the motivation for more programs to go for masters degree, i can't say definitively since i haven't read discussions of those decisions, however I'd venture to say it is in sync with all heatlhcare fields who have had degree creep. ask why NPs have chosen to go to DNP. answer is probably the same.

agreed strongly. unfortunately, there is lots of misinformation that ought to be cleared up. but our fields more or less occupy the same niche in healthcare with subtle differences. Therefore uniting to meet common goals will almost always be in our best interest. And on the contrary, those who would oppose our interests would rather have us divided. This would be true for any movement.

I have a hard time imagining not bringing up the pay. After all, that is the very reason you are looking into the job in the first place. why beat around the bush? You are working to make a living. You make a living by earning money. You have to know how much it pays.

very inaccurate. vast majority of PA programs are masters with many prereqs.

Of course. As is mine for PAs and NPs. But what is the outlook overall for all 50 states?

Amazing all the misinformation is out there about this, especially by people posting on this board.

On the contray, PAs have prescriptive authority in 50 states. Many of the states includes schedule II. Some states only schedule 3 and above. What is the state laws for NPs and scheulde IIs?

Not accurate, in 2 ways: 1) NPs do not need a doctorate, nor is there any timeframe which says they will need one. I'm quite surprised regarding the misunderstanding RNs and others here have regarding this topic. It was recommended that by 2015 Master's training programs start to offer DNP. But there is absolutely no requirement. Amazing how people are continually confused by this 2) True, you can enter PA school with any degree, but most enter with a science degree. And here's why. The prerequisite list is very heavy! Heavier than medical school in many cases. Keep in mind, you can also enter medical school with any degree. Here is the prereq list from my PA school: [TABLE] [TR] [TD]Human anatomy*[/TD] [TD=width: 120]4[/TD] [TD=width: 324]Biochemistry[/TD] [/TR] [TR] [TD=width: 188]Human physiology*[/TD] [TD=width: 120]4[/TD] [TD=width: 324]Cellular biology[/TD] [/TR] [TR] [TD=width: 188]Genetics[/TD] [TD=width: 120]3[/TD] [TD=width: 324]Human sexuality[/TD] [/TR] [TR] [TD=width: 188]Psychology[/TD] [TD=width: 120]3[/TD] [TD=width: 324]Immunology[/TD] [/TR] [TR] [TD=width: 188]General chemistry*[/TD] [TD=width: 120]8[/TD] [TD=width: 324]Medical terminology[/TD] [/TR] [TR] [TD=width: 188]Organic chemistry*[/TD] [TD=width: 120]4[/TD] [TD=width: 324]Pharmacology[/TD] [/TR] [TR] [TD=width: 188]Microbiology*[/TD] [TD=width: 120]4[/TD] [TD=width: 324]Spanish[/TD] [/TR] [TR] [TD=width: 188]College algebra or higher[/TD] [TD=width: 120]3[/TD] [TD=width: 324]Statistics[/TD] [/TR] [/TABLE] Let us strive for accuracy when making comments. We would only expect the same when taking care of patients.

I'm sorry friend but you appear to be quite misinformed. A bit surprising too considering you have the healthcare experience you speak of. 1) Very important to compare apples to apples, not apples to oranges. One can get a PA or NP degree with 0 hours of health care experience prior to entering school. Traditionally, in both professions, that is not the case. However, both professions have changed. Traditionally, for NP, one worked as a nurse for some time, then went on to get their NP to practice. Traditionally, for the PA, one worked in fields such as nursing, paradmedic, EMT, respiratory therapist, etc, then went on to get the PA to practice. It originally evolved out of returnings medics in the military with a high skill set but no way to enter the workforce as a civilian utilizing those skills. Of course this is still true for both professions, but less so, and becoming even more and more less so. Take my primary care provider for example, a PA-C. He was a respiratory therapist for 15-20 years, then went back to become a provider. Traditionally, PA schools required a certain number of healthcare experience (HCE) to be considered for admission. Most PA schools still do, although the amount seems to have decreased. UW for example requires 4000 (their average student has 8500ish). The same is true for NP schools. You can now apply to a "direct entry NP program" with no experience as a nurse or in healthcare. Here is a list of some of these schools: http://www.aacn.nche.edu/research-data/GENMAS.pdf So in comparing apples to apples, you would have to compare your 9000+ hours of HCE to a student who has chosen the PA profession with equal to what you have. There are tons of PA students with tons of experience. Additionally, if you are looking at a PA student with no HCE, you would have to look at the same type of NP student, whom are accepted in programs like in the list I posted above. I was one of those students. I has probably about 1500 hours of HCE. I got accepted to both quality PA schools and direct entry NP schools. Both would have taken me about 2.5 years to complete. After very tough deliberation, I chose the PA path because it was best for me. 2) Indeed, the "physician assistant" title that our profession has is misleading, no doubt. Reality is, the majority of PAs don't assist physicians at all. They practice medicine, autonomously, but are affiliated with a physician "supervisor". One notable exception might be in surgery, where a PA much more resembles an assistant in the OR itself. I, and many others, believe in a profession name change to "physician associate". It much more accurately reflects what we actually do, and hopefully eliminate confusion from folks like yourself. 3) Finally, and where you were way off the mark, was to say that the "two roles are in no way interchangeable." On the contrary, MANY if not most job listings are looking for a "PA or an NP". How could this be if the roles aren't interchangeable? It can't. At the end of the day, PAs and NP fill a very similar role in healthcare, with significantly different paths to getting there. NPs, to my envy, have a vastly stronger advocacy and lobby, getting more recognition and legislation in your favour. But I don't believe this comes whatsoever from a better ability or skill set. It believe it has predominately to do with political factors, and also how the profession was set up. Anyone else care to chime in ?

Actually brings up another reason I chose PA. which is I didn't know what specialty I wanted to go into. And since NPs have to choose a specialty from the get go (FNP being the most versatile), I wasn't ready to commit. If I did however, like yourself, know I wanted to go into Psych, PsychNP would hands down have been the answer. I am leading towards interest in Emergency Medicine which I felt the PA profession has a better leg up in terms of education and post-graduate residencies, and possibly actual preference in job hiring, but I think this is more regional, and I don't have hard facts to back that up, just hunch. If I was positive however, that family practice was what I wanted to do, it would have been FNP no doubt. This was a tough decision for me. I respect both professions. And I am more convinced than ever that we should work together to strengthen our role in healthcare and medicine.