Comments on: The Difference Between a Nurse Practitioner (NP) and a Physician Assistant (PA) http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/ Healthcare Job Blog Sun, 22 Aug 2010 03:58:09 -0600 hourly 1 By: Pete http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/comment-page-1/#comment-302 Pete Sun, 22 Aug 2010 03:58:09 +0000 http://blog.sunbeltstaffing.com/?p=142#comment-302 Take this with a grain of salt, because I am neither a PA nor an NP yet, but I have seen both in action as a paramedic and nurse, and offer the following comments. Civilian PAs and NPs are quite similar in many states, in their scope of practice, duties, privileges and responsbilities. Individuals interested in military medicine/healthcare (as I am) should be aware that PAs and NPs are currently assigned quite different missions within the armed forces, owing to the historical nature of nursing and PA. The first PAs came from returning Vietnam-veteran corpsman and medics, whose considerable experience found no exact civilian counterpart. These were trained under the hurry-up medicial training model used in WWII, and PAs were the result. To this day, many medics and corpsmen become PAs. Nurse-practitioners come mostly from nursing, which is historically a female-dominated profession. Fair or not, the army, navy, etc. use PAs very differently than NPs. The former in more-stereotypically male roles nearer to the front, NPs in missions the nurse corps has always received. The services are beginning to change in how they use PAs and NPs, but the old ways do persist. For anyone interested in military medicine, as I am, weigh this factor in your decision-making. No one is mentioning CRNA much in discussing APNs. Nurse-anesthetists do many of the same cases as anesthesia MDs, and at considerably less cost. CRNAs can practice independently in many states, and are very widely used in the military, where many are men. CRNAs are very well-compensated, making well into the six figures, some as high as 170K/year. It is a pre-requisite to have done 2+ years in ICU/ER nursing, before admission to a masters program. Training takes two years. My brother is an MD in anesthesia, and recommended CRNA to me. My interests lie elsewhere, but someone reading this may want to explore this crucial specialty. My investigations show that PAs get a generalist education, and specialize later; APNs are forced to choose a specialty earlier in their training, while still in school. Both approaches have their merits; choose according to your learning style and tastes. Similarly, a semantic point is that PAs are "medical" practioners, while NPs are "nursing" practitioners. Strep throat is strep throat, a fractured femur a fractured femur, no matter what your license says on it, but be aware that these terms and distinctions will follow you around in your professional life. I've seen more PAs assisting in surgery than NPs, but the latter are becoming more common. Some hospitals and docs use PAs only, others NPs only. Both are heavily-used in under-served areas, such as inner-cities and rural areas. Anyone know of a source for comparing PA and NP side-by-side, in terms of duties, scope of practice, income, hours, state regs, etc.? I'm still making up my mind. Also, is there a clear advantage in terms of cost and length of training for one or the other, or financial aid avalable? I'm probably leaning toward the PA route, but not yet decided for certain; there are pros-and-cons to both. Take this with a grain of salt, because I am neither a PA nor an NP yet, but I have seen both in action as a paramedic and nurse, and offer the following comments. Civilian PAs and NPs are quite similar in many states, in their scope of practice, duties, privileges and responsbilities. Individuals interested in military medicine/healthcare (as I am) should be aware that PAs and NPs are currently assigned quite different missions within the armed forces, owing to the historical nature of nursing and PA. The first PAs came from returning Vietnam-veteran corpsman and medics, whose considerable experience found no exact civilian counterpart. These were trained under the hurry-up medicial training model used in WWII, and PAs were the result. To this day, many medics and corpsmen become PAs. Nurse-practitioners come mostly from nursing, which is historically a female-dominated profession. Fair or not, the army, navy, etc. use PAs very differently than NPs. The former in more-stereotypically male roles nearer to the front, NPs in missions the nurse corps has always received. The services are beginning to change in how they use PAs and NPs, but the old ways do persist. For anyone interested in military medicine, as I am, weigh this factor in your decision-making.

No one is mentioning CRNA much in discussing APNs. Nurse-anesthetists do many of the same cases as anesthesia MDs, and at considerably less cost. CRNAs can practice independently in many states, and are very widely used in the military, where many are men. CRNAs are very well-compensated, making well into the six figures, some as high as 170K/year. It is a pre-requisite to have done 2+ years in ICU/ER nursing, before admission to a masters program. Training takes two years. My brother is an MD in anesthesia, and recommended CRNA to me. My interests lie elsewhere, but someone reading this may want to explore this crucial specialty.

My investigations show that PAs get a generalist education, and specialize later; APNs are forced to choose a specialty earlier in their training, while still in school. Both approaches have their merits; choose according to your learning style and tastes. Similarly, a semantic point is that PAs are “medical” practioners, while NPs are “nursing” practitioners. Strep throat is strep throat, a fractured femur a fractured femur, no matter what your license says on it, but be aware that these terms and distinctions will follow you around in your professional life.

I’ve seen more PAs assisting in surgery than NPs, but the latter are becoming more common. Some hospitals and docs use PAs only, others NPs only. Both are heavily-used in under-served areas, such as inner-cities and rural areas.

Anyone know of a source for comparing PA and NP side-by-side, in terms of duties, scope of practice, income, hours, state regs, etc.? I’m still making up my mind. Also, is there a clear advantage in terms of cost and length of training for one or the other, or financial aid avalable?
I’m probably leaning toward the PA route, but not yet decided for certain; there are pros-and-cons to both.

]]> By: Beverly Montalvo NP http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/comment-page-1/#comment-300 Beverly Montalvo NP Mon, 16 Aug 2010 23:09:13 +0000 http://blog.sunbeltstaffing.com/?p=142#comment-300 As noted above, I think it is important to point out that NP's have all of the same medical privileges as you pointed out for the PA. We diagnose, treat, and have prescriptive authority. In fact, in NYS a nurse practitioner is an independent provider, where a PA must work under the direct supervision of a physician. Somehow the term "nurse" in the title of the practitioner seems to allow for the belief that we do not perform these services, when in fact, we not only perform them, but are able to legally and professional perform them without a supervising doctor. We do require a collaborative agreement with a physician, and rightfully so. Isn't collaboration what medicine is all about anyway? So please be sure gentle reader that a you understand: a NP likely has had multiple years of clinical experience prior to entering into an accreditation program, providing him/her with an outstanding knowledge base clinically. We are INDEPENDENT providers. This needs to be pointed out as a distinct difference between an NP and a PA. Every PA I know has an excellent ability to diagnose and treat. I am blessed to work with several that are outstanding, so there should be no concern that the care provided by a PA is less than that of a NP; they simply are required to have supervision and more oversight in their daily delivery of care. As noted above, I think it is important to point out that NP’s have all of the same medical privileges as you pointed out for the PA. We diagnose, treat, and have prescriptive authority. In fact, in NYS a nurse practitioner is an independent provider, where a PA must work under the direct supervision of a physician. Somehow the term “nurse” in the title of the practitioner seems to allow for the belief that we do not perform these services, when in fact, we not only perform them, but are able to legally and professional perform them without a supervising doctor. We do require a collaborative agreement with a physician, and rightfully so. Isn’t collaboration what medicine is all about anyway? So please be sure gentle reader that a you understand: a NP likely has had multiple years of clinical experience prior to entering into an accreditation program, providing him/her with an outstanding knowledge base clinically. We are INDEPENDENT providers. This needs to be pointed out as a distinct difference between an NP and a PA.
Every PA I know has an excellent ability to diagnose and treat. I am blessed to work with several that are outstanding, so there should be no concern that the care provided by a PA is less than that of a NP; they simply are required to have supervision and more oversight in their daily delivery of care.

]]> By: Sherry Crews http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/comment-page-1/#comment-260 Sherry Crews Tue, 20 Apr 2010 16:45:52 +0000 http://blog.sunbeltstaffing.com/?p=142#comment-260 Alisa If you are currently in school for your CNA training and wish to work as a CNA for awhile (to get the coveted healthcare experience), then you do have a bit of time to continue your research. It is possible to go through a PA program within two years or so. Going in that direction would allow you to work sooner than attacking a lengthy nursing program. So, if that's important to you, the PA route would be the best bet. If you have plenty of time (and earning money is not an immediate issue), I suggest the nursing path. However, there is no rule that says you can't do both! Alisa

If you are currently in school for your CNA training and wish to work as a CNA for awhile (to get the coveted healthcare experience), then you do have a bit of time to continue your research. It is possible to go through a PA program within two years or so. Going in that direction would allow you to work sooner than attacking a lengthy nursing program. So, if that’s important to you, the PA route would be the best bet. If you have plenty of time (and earning money is not an immediate issue), I suggest the nursing path. However, there is no rule that says you can’t do both!

]]> By: Alisa http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/comment-page-1/#comment-255 Alisa Wed, 07 Apr 2010 23:15:14 +0000 http://blog.sunbeltstaffing.com/?p=142#comment-255 Sherry- I go to school in Minnesota , but am from Wisconsin and am willing to practice anywhere afterwards. I have always had a passion to work with kids, am very hands on, and thoroughly enjoy the nursing model, however, I am starting to be pushed towards becoming a PA rather than an NP. I plan to get my CNA soon as well as other healthcare experience, but as of now I am at a stand still. I appreciate any advice! Thank you! Alisa Sherry-
I go to school in Minnesota , but am from Wisconsin and am willing to practice anywhere afterwards. I have always had a passion to work with kids, am very hands on, and thoroughly enjoy the nursing model, however, I am starting to be pushed towards becoming a PA rather than an NP. I plan to get my CNA soon as well as other healthcare experience, but as of now I am at a stand still. I appreciate any advice!

Thank you!
Alisa

]]> By: Sherry Crews http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/comment-page-1/#comment-254 Sherry Crews Wed, 07 Apr 2010 19:40:27 +0000 http://blog.sunbeltstaffing.com/?p=142#comment-254 Hi Alisa - You don’t mention what state you are in, so I will address your question in general. (Different states have different criteria.) The main difference is the level of autonomy (and your relationship with the physician with whom you choose to collaborate). NPs are, in general, more autonomous than PAs. PAs work more directly, on a daily basis, with the physician. The actual day to day care is usually the same, with the exception of prescribing privileges...which is different for every state. They both diagnose and treat medical conditions. Just coming out of college, the quickest way to go would be Physician Assistant, since you don’t have (or at least didn’t mention) any previous Nursing experience and there are two-year (approx) programs out there that are quite good. Make sure to choose one that is accredited. The AAPA website (www.aapa.org) can direct you to one in your area. Be aware, too, that many programs will require some previous healthcare experience (i.e. EMT, Medical Assistant, etc.). Good luck with your decision! You sound like a wonderful candidate… no matter which path you choose! -Sherry Crews Hi Alisa –
You don’t mention what state you are in, so I will address your question in general. (Different states have different criteria.) The main difference is the level of autonomy (and your relationship with the physician with whom you choose to collaborate). NPs are, in general, more autonomous than PAs. PAs work more directly, on a daily basis, with the physician. The actual day to day care is usually the same, with the exception of prescribing privileges…which is different for every state. They both diagnose and treat medical conditions. Just coming out of college, the quickest way to go would be Physician Assistant, since you don’t have (or at least didn’t mention) any previous Nursing experience and there are two-year (approx) programs out there that are quite good. Make sure to choose one that is accredited. The AAPA website (www.aapa.org) can direct you to one in your area. Be aware, too, that many programs will require some previous healthcare experience (i.e. EMT, Medical Assistant, etc.). Good luck with your decision! You sound like a wonderful candidate… no matter which path you choose!
-Sherry Crews

]]> By: Alisa http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/comment-page-1/#comment-253 Alisa Wed, 31 Mar 2010 02:16:15 +0000 http://blog.sunbeltstaffing.com/?p=142#comment-253 I am a senior in college majoring in Nutritional Science and trying to decide whether to go onto become a PA or NP. I can't decide and am going nuts! I am a people person, a leader, and agree more with the nursing model as I enjoy work more directly with the actually person as a whole, however, PA seems quite appealing too! HELP! I am a senior in college majoring in Nutritional Science and trying to decide whether to go onto become a PA or NP. I can’t decide and am going nuts! I am a people person, a leader, and agree more with the nursing model as I enjoy work more directly with the actually person as a whole, however, PA seems quite appealing too! HELP!

]]> By: Jacob http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/comment-page-1/#comment-245 Jacob Fri, 12 Mar 2010 18:16:00 +0000 http://blog.sunbeltstaffing.com/?p=142#comment-245 Hope this will give you some additional information on your decision. Hope this will give you some additional information on your decision.

]]> By: Katie http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/comment-page-1/#comment-211 Katie Thu, 04 Feb 2010 15:58:57 +0000 http://blog.sunbeltstaffing.com/?p=142#comment-211 I just wanted to clarify a few points from Scott Best's comment. The majority of states do require a collaborative agreement with a physician, but this is usually a few charts reviewed quarterly. There are many states where NPs can practice independently without any physician involvement (although there are states--usually in the South--where NPs are supervised just like PAs). Often times in rural areas NPs are the only health care providers around, and they frequently have their own clinics. I don't know what the "written protocols" he is talking about. NPs use evidence based medicine just like physicians to make medical decisions (including diagnosis, prescriptions, and any other diagnostic tests). NPs all have nursing background, and therefore usually have years of nursing experience (I worked 8 years in an ICU) as well as a better understanding of the patient experience. As only 2% of graduating MDs are going into primary care, NPs are estimated to be the majority of primary care providers in the near future. I just wanted to clarify a few points from Scott Best’s comment. The majority of states do require a collaborative agreement with a physician, but this is usually a few charts reviewed quarterly. There are many states where NPs can practice independently without any physician involvement (although there are states–usually in the South–where NPs are supervised just like PAs). Often times in rural areas NPs are the only health care providers around, and they frequently have their own clinics. I don’t know what the “written protocols” he is talking about. NPs use evidence based medicine just like physicians to make medical decisions (including diagnosis, prescriptions, and any other diagnostic tests). NPs all have nursing background, and therefore usually have years of nursing experience (I worked 8 years in an ICU) as well as a better understanding of the patient experience. As only 2% of graduating MDs are going into primary care, NPs are estimated to be the majority of primary care providers in the near future.

]]> By: future NP http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/comment-page-1/#comment-208 future NP Fri, 29 Jan 2010 00:41:25 +0000 http://blog.sunbeltstaffing.com/?p=142#comment-208 Yes, NP's are highly educated medical practitioners who can diagnose, treat, read labs and initiate treatment. NP's also at the same time do disease prevention and management. The education of an NP starts from being an RN to BSN and then to master's level. And it's true, NP's collaborate but for special situations that we acnnot handle. NP's can run their own clinic and offers high qaulity care to sick patients. NP's can write prescritions without a physician, they have their own DEA number and furnishing number. PA's cannot practice without a doctor. If I were to choose. NP had extensive training both in nuring and medicine. Yes, NP’s are highly educated medical practitioners who can diagnose, treat, read labs and initiate treatment. NP’s also at the same time do disease prevention and management. The education of an NP starts from being an RN to BSN and then to master’s level. And it’s true, NP’s collaborate but for special situations that we acnnot handle. NP’s can run their own clinic and offers high qaulity care to sick patients. NP’s can write prescritions without a physician, they have their own DEA number and furnishing number. PA’s cannot practice without a doctor. If I were to choose. NP had extensive training both in nuring and medicine.

]]> By: Lennywatson http://blog.sunbeltstaffing.com/advanced-practice/the-difference-between-a-nurse-practitioner-np-and-a-physician-assistant-pa/comment-page-1/#comment-205 Lennywatson Sat, 09 Jan 2010 04:30:31 +0000 http://blog.sunbeltstaffing.com/?p=142#comment-205 I'm curious about the pay rate / work hours info. The information (and sequence and phrasing) appear very similar to that from a Berkeley article of a couple of years ago. Assuming (without judging) that this was the primary source, I'm wondering if PAs in fact tend to work less hours than NPs. The exact phrasing in the Berkeley article is: "Median Salary of Sample of 23,850 NPs Nationwide (2004): $73,620 annually, working 36+ hours a week" and "Median [PA] National Salary (2006): $69,517 annually, working 32 hours a week" So is the median work week info cross-verified, or is this just general rate/hour info without claim of actual median weekly work hours? I’m curious about the pay rate / work hours info.
The information (and sequence and phrasing) appear very similar to that from a Berkeley article of a couple of years ago.
Assuming (without judging) that this was the primary source, I’m wondering if PAs in fact tend to work less hours than NPs. The exact phrasing in the Berkeley article is:
“Median Salary of Sample of 23,850 NPs Nationwide (2004):
$73,620 annually, working 36+ hours a week”
and
“Median [PA] National Salary (2006):
$69,517 annually, working 32 hours a week”

So is the median work week info cross-verified, or is this just general rate/hour info without claim of actual median weekly work hours?

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