Why do some practices prefer PAs to NPs?

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It this just a way to increase the likelihood that you will be able to hire a male candidate over a female candidate?

I work in FL and it seems like the NPs and PAs function in their roles very similarly, so why the preference?

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.

This is not true - they bill at 85% like NPs, if billing their own notes. Incident to can bill at 100% just like NPs.

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Specializes in Surgery.

I'm a surgical NP, but when I was looking always applied for 'PA jobs'. Its probably because the want a someone that is able to assist in the OR and a PA is more readily able to do that.

I don't think gender has anything to do with it..

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Specializes in Critical Care and ED.

It depends on the culture of the unit/office in my experience. I worked in a cardiac surgery open-heart ICU and the lead surgeon didn't like nurses and refused to have any NPs on the unit. They only hired PAs. In another ICU I worked in, they only had NPs and the unit was basically run by them.

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Specializes in Rheumatology NP.
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.

Please someone tell me if this is true. This seems absolutely inane to me.

The ONLY reason I can come up with that a PA might get 100% reimbursement when an NP cannot is if they are billing under the physician.

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Please someone tell me if this is true. This seems absolutely inane to me.

The ONLY reason I can come up with that a PA might get 100% reimbursement when an NP cannot is if they are billing under the physician.

I already addressed this earlier in the thread. NPs and PAs are reimbursed the same by CMS - 85%. When billing "incident to", or when the physician sees the patient with the APP, it is 100%, for both NP and PA.

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Specializes in Rheumatology NP.
I already addressed this earlier in the thread. NPs and PAs are reimbursed the same by CMS - 85%. When billing "incident to", or when the physician sees the patient with the APP, it is 100%, for both NP and PA.

Thank you and I saw your earlier comment. I was just disturbed that two others said the opposite and wondered what made them think such a thing.

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Thanks, I was wrong.

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PAs are managed by the State Board of Medicine, NPs by their State Board of Nursing. Depending on the State, physician oversight is either collaborative or supervisory. Physicians may prefer having more control and in that case they will prefer a PA. An NP can practice independently in partnership with a collaborative physician if their State offers collaborative physician oversight. A PA will have difficulty practicing independently as they are under the State Board of Medicine and do not have their own Board managing their practice for the State.

Nursing focuses on the whole person in its educational model. PAs focus more on medical systems as their education is a medical model and not a nursing model. As a result the PA education is more on par with a physician's theoretical education.

Before moving to a State, it is very important to check the Nurse Practice Act for that State and also the opinions of the State Board of Medicine and State Board of Nursing to make sure they are supportive of your practice, be it as a PA or NP.

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Specializes in ER, progressive care.

We essentially do the same thing. The only difference is the training - I feel like NPs only do 1/4 of the required clinical hours compared to the 2,000 hours that PAs typically have to do. I've heard from physicians that PAs are better trained and the knowledge of recent NP students is lacking.

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I've heard from physicians that PAs are better trained and the knowledge of recent NP students is lacking.

It is, I agree.

PA's are making a big push for independence at this time and I hope that they achieve it.

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Specializes in Reproductive & Public Health.
We essentially do the same thing. The only difference is the training - I feel like NPs only do 1/4 of the required clinical hours compared to the 2,000 hours that PAs typically have to do. I've heard from physicians that PAs are better trained and the knowledge of recent NP students is lacking.

It is, I agree.

PA's are making a big push for independence at this time and I hope that they achieve it.

Unfortunately I agree. I'd like to see *significantly* more clinical hours for APRNs in general. I don't think prior nursing experience is enough to make up the deficit.

PAs seem to be few and far between in OBGYN, at least in my area. I work in GYN and our group of clinics is about 40/60% CNM/NP, with just a few PAs. And I've never personally worked with a PA in an obstetric setting, whether out or inpatient. I wonder why that is?

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I'm running into this in a search for a new job in a new area. I'm an NP in a specialty in which I'd like to consider myself experienced. Where I work now, there are NPs and a few PAs.

At any rate, a lot of hiring managers where I'm applying are PAs. Over the years they've hired only PAs for their teams. I don't know if it's because it's what they're comfortable with or it's who's available--probably a combination. Once you get to that point, I feel like it can be an uphill battle. It's silly b/c I do truly think PAs and NPs can work together, although I admit it is hard not to be disheartened when you think of how in a lot of specialties truly how much the nursing model is utilized: symptom management, counseling, time.

Three potential solutions I see:

1) NPs assume leadership roles, remind people we're highly trained, that we can all work together. Advocate.

2) Demonstrate we're highly trained every day. This involves getting the job first.

3) NP schools to quit it with the sub-par programs who take anyone with a pulse.

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