What is the difference between pa and nurse practitioner

Considering a career as an nurse practitioner or physician assistant? Here are the similarities and differences between the two occupations.

What’s the difference between a Nurse Practitioner and Physician Assistant?

The most commonly asked question among students interested in pursuing a health care career is "What’s the difference between a Nurse Practitioner (NP) and Physician Assistant (PA)?" A career in the health care field can be extremely rewarding, but getting there requires several years of classes, training and learning. This kind of commitment means you need to be aware of your options.

Here are three differences to consider:

1. Both fields pursue (different) higher education and examinations

When nurses advance from a bachelor's to a master's or doctoral degree and complete an exam, they receive a nurse practitioner certification. Physician assistants also need to complete their master's degree and follow their own certification process, the Physician Assistant National Certification Exam (PANCE).

Both parties need to retest every few years in order to maintain their certification:

• Nurse practitioners need to re-certify every five years, but can also re-certify by meeting the clinical practice and continuing education (CE) requirements. In most states, that's 1,000 clinical hours and 75 continuing education hours.
• Physician assistants need to re-certify every 10 years and have 100 continuing medical education credits.

2. Most physician assistants practice medicine autonomously

In most states, upon completion of their education and certification process, physician assistants work with a physician under a collaborative agreement, but their day-to-day work usually does not require any direct MD oversight. Physician assistants often operate independent PA-led clinics, and their physician interaction is usually limited to a few monthly on-site visits.

While about half of the states now grant nurse practitioners freedom to practice and prescribe independently without having any collaborative agreement with an MD, many states still require nurse practitioners to maintain collaborative agreements with physicians and are not considered independent practitioners.

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3. Nurse practitioners are more patient-centered; Physician assistants are more disease-centered

Nurse practitioners tend to have a long-term approach to working with patients. This is increasingly important when you look at the role of chronic disease in America. Nearly half of all Americans suffer from some form of chronic disease, and two thirds of all death is caused by chronic disease such as cancer or diabetes. Nurse practitioners work with patients to form long-term health plans and provide health education and counseling to those at risk.

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Physician assistants typically are more disease-centered. They work with physicians to identify problems with patients and brainstorm treatments and eventual cures. Their goal is to work with physicians to get patients as healthy as can be and back on their feet.

Despite these differences, both career fields complete

• patient assessments,
• prescribe treatment and
• perform diagnostic tests to determine the health of their patients.

While their education and legal practice operations may be different, the type of candidates that both fields attract is incredibly similar. Nurse practitioners and physician assistants pursue their careers because they want to help people and have a passion for comforting patients and making them as healthy as possible.

Discover the nursing career path that’s right for you with this handy infographic:

What is the difference between a Nurse Practitioner and a Physician Assistant?

Professionals who seek challenging and well-paying healthcare careers may find themselves torn between two comparable disciplines: nurse practitioner and physician assistant. Both nurse practitioners and physician assistants are independently licensed providers. They are not doctors, but they take on some roles traditionally taken on by doctors, including making diagnoses and prescribing medication. They are valuable partly because of their role within an increasingly expensive medical system; their services are more cost-effective than those of physicians.

NPs and PAs sometimes compete for the same positions. Some specialized positions, though, go to one or the other. Even when they perform similar functions, nurse practitioners and physician assistants draw from different traditions; they are educated in separate schools or departments. Students may make their program choices based on their healthcare philosophy, their interest in particular specialized roles, and their previous healthcare experience.

The PA tradition draws more from a medical model. The NP model of course draws from the nursing tradition, one that has traditionally included a whole person and wellness approach. A students’ choice of disciplines will depend partly on his or her philosophies, but it is important to realize that there is also a school-specific component. There is a lot that an individual school can choose to offer. A course in homelessness, open to physician assistant students? In Washington State, it’s been done.

Another factor to take into account? Where one lives! It is more likely that a nurse practitioner will be allowed a greater level of autonomy in his other practice. The scope of practice, though, varies by state. Prospective students may want to consider practice perimeters in their own state before making a decision.

Differences in Role and Scope

People who are interested in certain specialized practice areas are more likely to find their niche as physician assistants. More than 25% of physician assistants have a surgical specialty. There are many duties from the pre-operative to post-operative stage. Actually carrying out surgery would be rare, though American Association of Surgical Physician Assistants lists some very minor outpatient procedures as possibly within the realm of the physician assistant.

Practitioners interested in fields such as maternal or neonatal care may be interested in becoming advanced practitioner registered nurses. Nurse midwives are not typically classified as nurse practitioners but practice at a similar level; some APRNs seek dual credentialing in nurse midwifery and women’s health nurse practitioner roles. (A critical role like neonatal nurse practitioner, though, would require previous related experience.)

It is actually the physician assistant not the advanced practice registered nurse who has the more generalist advanced education. Nurse practitioners are educated to serve specific populations, though the population can be as broad as family primary care. Nurse practitioner certification examinations reflect a particular population. Physician assistants get a somewhat broader education in their graduate programs. They take a generalist examination for licensing purpose.

Differences in Breadth and Depth of Clinical Training

A person training as a physician assistant can expect 2,000 hours of clinical training as part of his or her educational program. Rotations will take place in a number of very varied units – clinical training turns out well-rounded practitioners.

A person on the path to becoming a nurse practitioner can expect to do university-supervised clinical work at different stages: when training for initial RN licensing and when pursuing advanced licensing. In many cases, a licensed RN who is training for advanced practice will complete only 600 hours of additional clinical experiences. Clinical experiences will need to be sufficiently varied to prepare the person for his or her chose population focus, whether it is as broad as family practice (the most common) or as narrow as neonatal.

A nurse practitioner who seeks to change specialties can expect additional formal training requirements and an additional certification exam. This is not the case with physician assistants. The PA discipline has traditionally been thought of as one where a person can change specialties relatively easy. However, in a world of increasing healthcare knowledge and complexity, doctors often do want PAs who have already proven themselves within a particular specialty.

NP education, on the other hand, often takes place at the doctoral level. It’s not yet universal.

First Steps: Program Acceptance

Would-be physician assistants and nurse practitioners complete many of the same prerequisites (Nurse Practitioner prerequisites). Both need a sound foundation in natural sciences. Some schools have identical prerequisites for the two tracks. There can, however, be significant differences. PA programs may be more science-heavy. Some are very specific about the expected chemistry coursework; expectations are not identical from program to program. PA programs sometimes place less emphasis on other related coursework. Some require coursework in nutrition, but this is not the norm. A PA program may or may not have a psychology requirement.

A majority of physician assistant programs require previous healthcare experience. Physician assistant students typically enter school with three or four years of experience, though the formal requirement will likely be lower. Experience can take different forms: EMT or CNA as well as nursing.

Nurse practitioner offers a relatively straightforward career path for professional nurses. Many programs want experience and licensure while some will admit bachelor’s level non-RNs and allow them to earn their professional nursing credential en route to advanced coursework. NPs have, on average, more healthcare experience at the time they begin practice than PAs do – but this isn’t a mandate.

Further Reading:

• Online Family Nurse Practitioner Programs
• Nurse Practitioner Programs: Knowing the Details and Options

Professional Issues

Both disciplines have professional organizations that are working for policy that allows practitioners to practice to the full extent of their training. In the case of nurse practitioners, this typically means independent practice. The American Association of Physician Assistants (AAPA ), on the other hand, is working toward optimal team practice.

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