The Difference Between a Nurse Practitioner (NP) and a Physician Assistant (PA)

As many patients know, people rarely see a medical doctor for routine physical examinations anymore. They are far more likely to have an appointment with a Nurse Practitioner (NP) or Physician Assistant (PA) who works in the practice. Many people are unaware of what each title actually means. I’m embarrassed to admit that I didn’t know the difference for a very long time. What is the difference between a Nurse Practitioner and a Physician Assistant?

Nurse Practitioners

A Nurse Practitioner is a registered nurse (RN) who also has a Master’s degree and clinical experience. The NP may work independently or as a member of a health care team. He or she helps to educate patients, with a focus on health maintenance, counseling, and disease prevention. A nurse practitioner must choose a particular specialty during his or her training. This training allows him or her to empower patients and ensure better patient outcomes, and may involve the patient’s family in their treatment plan. A Nurse Practitioner has a collaborative relationship with physicians.

Nurse Practitioners have a median 36-hour work week, with a median salary of $73,000 annually. They may work in a variety of settings and specialties, including family medicine, neonatal, pediatrics, geriatrics, obstetrics and gynecology, acute care, occupational health, or as Certified Nurse Midwives and Certified Registered Nurse Anesthetists.

Nurse Practitioner
Physician Assistants

A Physician Assistant is a licensed health professional who has passed the national certificated exam that is administered by the National Commission on Certification of Physician Assistants. He or she does not choose a specialty, but must complete a clinical rotation through various specialties without regard to post-graduation career path. The PA works under the supervision of a physician to provide preventative, diagnostic, and therapeutic health care services. He or she helps take medical histories, examine patients, treat patients, order and interpret lab tests, order and interpret x-rays, make diagnoses, and provide treatment for minor injuries. In most states, a PA also has prescribing privileges. A Physician Assistant may also participate in managerial or supervisory duties.

Physician Assistants have a median 32-hour work week, with a median salary of $69,000. They may work in a variety of settings and specialties, including family medicine, pediatrics, obstetrics and gynecology, internal medicine, emergency medicine, orthopedics, general surgery, thoracic surgery, and geriatrics. Those who specialize in surgery are involved in preoperative and postoperative care; they may also work as assistants during major surgery.

Nurse Practitioner or Physician Assistant?

Both Nurse Practitioners and Physician Assistants can play important roles in health care practices. Patients are in good hands, whether they are treated by a PA or NP. Prospective students should consider becoming a Nurse Practitioner if they favor the nursing model or a Physician Assistant if they favor the medical model.

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74 responses to “The Difference Between a Nurse Practitioner (NP) and a Physician Assistant (PA)”

  1. Future NP says:

    You failed to point out that NPs are also licensed health care professionals that sit for National Boards as well depending on their speciality: Adult, Family, or Pediatrics.

    In addition, NPs do focus on health promotion and disease prevention, but they are also vital to diagnosing, interpreting lab results, and some read x-rays as well depending on the practice. There is a lot of the “medical” side that NPs perform, but yes, they embrace the nursing model which is what makes nurses nurses.

  2. tmmcrnp says:

    also it was not brought up that Np’s have prescriptive authority as well and depending on the state, such as in Pennsylvania, we can prescribe schedule II-V narcotics with the appropriate DEA #.

  3. Angela Stevens says:

    Future NP and tmmcrnp,

    Thanks to both of you for your insight and feedback.

  4. M. Carson says:

    PAs have a supervisory agreement with their supervisory physician. PAs have 100% of their patient charts reviewed within 24 hours. While NPs have a collaborative agreement with their physician practice which determines the percentage of their charts that must be reviewed. It is my understanding the percentages differ from practice to practice.

    I have worked directly with a NP in an occupational medicine practice. Both of us performed the exact same tasks, ordering/interpreting labs, X-Rays, etc…

    • Miss d says:

      Anp, will have a lot more experience throughout there career than a two year PA..! That has been forgotten, they also do the exact same job as a junior doctor would if not more at times.! Advanced Nurse Practitioner should be forever acknowledged and not forgotten how long there services have been within the health boards. Two year course can not compare!

  5. William Miranda says:

    This pertains to M. Carson:

    As of July 1, 2009, Florida legislation passed a law no longer requiring cosignatures on all charts in an outpatient setting for physician assistants.

    Just for clarification.

  6. Amy Carter says:

    I am trying to decide which school I should go to. P.A. or N.P. I have been a tech in the hospital for 8 years now. I love patient care I do believe I don’t want to be a bedside nurse. I am very interested in the sciences and how everything in the body syncronizes. I am also interested in knowing if there are travel assignment possibilities for either. Can anyone lend some advice please?
    Thank you very much!

  7. jeff blasswick says:

    What exactly are the limitations for a NP vs a PA. NP can practice independant from a physician whereas a PA cannot. But what exactly are the advantages and disadvantages of each. I have my BSN and trying to decide which route to take?

  8. Sherry Crews says:

    Deciding factors as to whether one should pursue a degree as a Nurse Practitioner or a Physician Assistant is primarily dependent upon the State in which you will be working. In many cases, the pay is relatively equal, as are the duties and level of responsibility. Another question would be what the MDs in any given area prefer. For many, the preference is the NP because of the independence factor, while other Physicians have exactly the opposite opinion – they would rather employ a professional that extends their clinical reach, but within defined paramaters.

  9. Marlow says:

    Actually, Physician Assistants can choose specialties.

  10. Scott Best says:

    The concept on the “independent” NP is fairly misunderstood. NP’s are “independent” in that their nursing license is issued by the sate nursing board…however the “collaborative practice” arrangement that permits these RN’s to perform medical acts as NPs is a defacto supervisory arrangement with a physician or physician practice. Only in rare circumstances would one find an NP practicing medicine (often referred to as advanced practice nursing) without some definite connection to a physician’s license. Similarly, PA’s funstion under a supervisory or practice agreement. It is common for PA’s to practice under the “general” supervision of a physician…that is without the physician present…also there are many instances where PA’s are not required to have co-signatures for charts, and in my own state the only requirement is that the PA must meet with the supervising physician once every 6 months. NPs in my state are required to have “written protocols” whereas PA’s are not.

    PAs do specialize and in fact, about 50% do. They also have the flexibility to cross over into various specialties because their medical education is broader than that of the NP. According to salary surveys I have read for both disciplines, PAs earn a higher median salary than NPs (from their own organizations). Also, PA’s have prescriptive ability in all, rather than “most” states. The real point to the layperson should simply be that both providers are well-educated, properly licensed, and in the same clinical setting perform essentially the same job with an equal degree of capability.

    I am not demeaning the article, which did present good information, but it does seem a bit slanted towards an NP view of NPs vs. PAs and not a true comparison of the two different disciplines.

  11. Lennywatson says:

    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”
    “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?

  12. future NP says:

    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.

  13. Katie says:

    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.

  14. Jacob says:

    Hope this will give you some additional information on your decision.

  15. Alisa says:

    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!

  16. Sherry Crews says:

    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 ( 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

  17. Alisa says:

    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!

  18. Sherry Crews says:


    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!

  19. Beverly Montalvo NP says:

    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.

  20. Pete says:

    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.

  21. Juliana says:


    I found your comparison on the differences between a Nurse Practitioner and Physician Assistant very informative. I’d like to read further. Do you have an information source or reference on the material?
    Thank you.

  22. Swampy says:

    Don’t forget to mention that by 2015 those going to be NP’s will have to get their DNP and not just MSN

  23. janet says:

    our surgi center wants to hire a PA. As a registered nurse in Penna, can i take orders from a PA?

  24. BSN2PA says:

    The whole “collaboration” and “supervision” terminology is all semantics. It’s funny how the percentages of PAs and NPs that own their own clinics is the same at 2 percent. And yes, technically an NP can be “independent” of a physician, but he or she will be extremely limited in the services he or she can provide. The fact is PAs receive far greater didactic and clinical education. An NP has 500 and 700 didactic and clinical hours, respectively, while a PA has 1000 and over 2000. And being a nurse before being an NP does not mean you’re better suited for diagnosis or therapeutic treatment. Nurses do neither of those two things. I’m a nurse who is becoming a PA because I know PAs are better trained. Right out of school a PA is better. After a few years working an NP and PA are comparable.

  25. Joe Kelly says:

    Dear Friends,
    I have a friend who is a PA, but who would like to obtain certification as a NP. This is due because in the third world country where she lives, the ministry of health does not recognize PA’s, but does recognize NP’s. Any suggestions? Thanks.

  26. Rene says:

    I am a freshman at a community college in maryland and right now I plan on becoming an RN, then transfering to a 4-year school and receiving my BSN. So basically Im trying to become a nurse practitioner, but then I heard about a Physician Assitant. I sorta know the difference between the two. But I still cant decide. I am a people person, I want to help and diagnose patients. I jus want a high and rewarding position in the medical field. Can someone help me to decide PLEASE.

  27. Sherry says:

    As pointed out by BSN2PA “collaboration” and “supervision” probabaly are just semantics. I however do feel they are not paying their nursing background due justice…..I too have a BSN and currently work in a rural healthcare clinic as an APN. While working as an RN were there not times that something was wrong with your patient and you knew what was causing their problem and you had to call the doctor and explain to them what you saw, felt, or knew was their “diagnosis”? If you never had that type of patient encounter then I can see how you could make a statement referring that having a background as a RN does not make you better suited to diagnose and treat. No RNs can not do those things but the knowledge gained from the experience should not be undermind. The amount of clinical hours per APN course varies but 1000 hours does seem to be around the standard… compared to the PA program that may be around 1500 to 2000 hours. Here I must state that anyone with any type of Bachelors degree with NO medical knowledge can become a PA. Now…….without bias I feel that no matter which program someone elects to persue……it comes down to how much time and effort they put in to their studies as well as their clinicals that will determine how good/great of a provider they will become no matter what type of background they have.

  28. Rachelle says:

    I have been an RN for the past 3.5 years in Indiana and am looking into going back to school. I am trying to decide between being an NP or a PA. I feel that I have a good grasp on medical conditions due to my experience and am leaning towards PA school. It seems more intense and more expensive than becoming an NP. Any advice?

  29. Shannon says:

    I was an LPN for years, got my ADN, in BSN school, and planning on NP school when I graduate.
    I decided this when I was a new LPN grad 8 years ago and every week gets me closer to my goal!
    My cousin is planning on going to PA school, mainly because RN school is so hard to get into.

  30. Sherry Crews says:


    Putting the expense aside, as well as difficulty getting in (and through) any particular course of study, the bottom line is how independent do you wish to function? If autonomy is of utmost importance to you (i.e. running your own clinic), then NP is the route I suggest you take. If you prefer being under the guidance of an MD on a consistant basis, then welcome to PA school!

  31. MG, RN, BSN says:

    With all due Respect to NP’s: I am a licensed RN and was considering becoming an NP, in fact, it was my plan all along when I was going to nursing school because I talked to a number of NPs and PAs and they informed me that “NP’s and PA’s essentially did the same job.” Some of these licensed professionals could not even tell me exactly what the difference was, so I decided that nursing was the way to go, given that I would be in the hospital sooner, just in case I didn’t end up enjoying my future job. Well, my twin brother is getting his PA degree, and he and some very close friends of mine, have told me that the NP’s they have encountered have not been adequately prepared for practicing medicine. A trusted physician even spoke earnestly concerning the fact that well NP students came to his clinic to learn 2X per week, PA students came 5 days a week. He said, with no disdain, that NPs take too much time taking classes relating to “Florence Nightingale” and “caring.” This upset me a great deal, given what my plans for the future were, however, I must emphasize that the doctor did not say this to an NP or to be mean or arrogant, but it was out of kindness that he was honest with myself. An NP student in fact, reportedly was extremely upset and dissapointed because he was going to NP school, and when he was in the clinic, he was realizing that he did not have the skills he needed. I meant an RN getting her NP license at a hospital where I was working and she informed that the first two classes she was taking, were, “Theory of Caring,” And “Ethics of Caring.” While caring is very important in healthcare, and a holisitc view of the patient’s well-being is vital, I do not believe that a person who already has a BSN, needs another class on how to “care” for patients. Myself, I can, and do, care deeply for my patients, and would do so regardless of if someone was teaching me “how to care.” Certainly these “caring classes” are not vital to a graduate level program. If you are an RN and don’t know how to care, you will never learn how and you should leave medicine.
    I write this comment only to try and help those who might read it. I have the utmost respect for nurses, as I am myself one of them. While MD’s give orders and have a larger amount of medical knowledge, Nurses hold the hospital together. I salute those people who are attempting to advance their abilities to care for others by getting their NP, but I would HIGHLY recommend that if you are an RN looking to advance their degree that you choose the PA route.

  32. Ciela Smith says:

    Thanks to the many people who spoke up in an effort to clarify this subject and present a more balanced view of the pros and cons of each practice. I can attest to the fact, having taught midlevel students of both groups, that PA’s tend to get a much more “medical” education, while NP’s get a more “nursing” oriented one. That point was well taken. PA’s get roughly 75% of a medical school education, while NP’s get advanced nursing training with some emphasis on recognizing and diagnosing disease. Both groups display a greater concern for patient comfort and concerns than many MD’s are taught, or perhaps feel they have time for, however.
    I practiced in Maryland in a practice that generally used its NP’s to staff the school based health clinics. In office practice, we found they tended to perform “PE’s”, referring the complex problems for a future visit to either the MD’s or PA’s in the practice. PA’s were sometimes turned away from jobs, especially in pediatrics, as being “overqualified”. This highlights the fact that PA’s receive a greater degree of technical training in procedures and surgical, including minor surgical, skills and therefore are qualified to specialize in fields other than family practice and general pediatrics.
    It is a frightening prospect that NP’s would be considered adequately prepared to conduct an “independent” practice (though they do precisely this in several states). One of the strengths of the PA profession is that it defines itself as a dependent one, always associating PA’s with MD’s, however loose an association may be permitted by state law. It has always mystified me that some physicians consider PA’s more of a potential threat while seeing none in NP’s who, after all, are the ones who grant themselves the right to practice independently.
    Prescriptive practice also varies across the country, although, I believe, at this point, with some variations, it is nearly universal to both groups. NP’s led the way, chronologically, because their “privilege” sprang from the nursing lobby which was eager to grant it (whether or not pharmacists were eager to fill those prescriptions) rather than the medical one which was more circumspect about sharing this function.

  33. Ciela Smith says:

    Also to Rachelle, and in response to the remark made by Ms Crews,
    “If you prefer being under the guidance of an MD on a consistant (sic) basis, then welcome to PA school!”

    One of the things to be alert to when looking for a job as a midlevel provider is the degree of autonomy granted by a particular situation. There are NP’s, as I stated, who work only in school clinics. There are PA’s who are nothing but “yes men” (or women). Either may find him/herself in a position where they are expected to see a patient, run to the MD with a report, get advice on what to do next, run back and do it and then return again to have any Rx either written or approved.
    This is an extremely wasteful and inappropriate use of a midlevel practitioner and one, I hope, which has gone the way of the horse and buggy.
    PA’s are EQUALLY likely to find themselves working in a practice where they see their own patients, make their own diagnoses and plans and write their own prescriptions. The comfort of working with other professionals… and the reason an independent NP practice is so scary… is the availability of other, respected, minds nearby with which to consult. I know in our practice, MD’s consulted PA’s quite as frequently, in their areas of expertise, as PA’s did MD’s!
    In other words, choose your path by the quality of the education you think you will receive: not by any “we’re better than they are” advice you may be given. Hours, incidentally, are as variable as salary and responsibility: it will be your job to hammer out an arrangement that satisfies your needs.

  34. Constance says:

    Either it has changed drastically in last few years or your numbers are wrong but I don’t know any NP’s that make more than a PA.

  35. drgerardevadassou says:

    what are you trying to say , sorry i cannot understand oh being in some western country can say what all you want i am not against some western guy , i am an indian and if i was weak in studies i can be a nurse just blaber thats what u know i wasted my time jesus

  36. MWO, RN says:

    I believe that, despite the extensiveness of the PA schooling versus the schooling for NPs, NPs obviously work independently without concern and have done so for awhile now. Any persons worry over the difference in schooling should be justified or relieved by the groups abilities in practice, not just assuming because one is different from the other that one is better. This is Evidence-Based Practice.

  37. rufus says:

    You all need to sit down write the MCAT and try to get into medical school……

  38. Disturbing...... says:

    I am sorry but I would really like to know where the author of this article received their information. There are so many fallacies and misleading information in this obviously not well thought out, and unresearched article it makes my stomach turn. I personally do not know any PA’s that work a 32 hour work week. As a cardiothoracic surgery PA we work a median 50-60hr work week with the addition of call hours……yes, call. As a matter of fact the didactic training as well as the clinical internships that a PA must endure is far more intense and demanding than that of a nurse practitioner. By the way, you can’t go to physician assistant school part-time……unlike NP’s. Physician assistant’s are trained under a medical model with courses and internships mentored by physicians…..not nurses or nurse practitioners. Nurse Practitioner’s are still trained under a nursing model and nursing theory with some medicine incorporated. PA’s must also take a national board exam and for recertification must pass a board exam every six years (np’s never have to take their boards again after initial certification). In addition, PA’s must complete 100 hours of CME every two years to stay certified….. 50 of them being category I credits. Category I CME are approved by the American Medical Association which are what physicians are required to complete as well. NP’s are not required to complete CME, but rather CEU’s which are nursing credits, approved by the ANA (American Nursing Association). It is true that some NP’s may make more than PA’s but truthfully their salary profile is quite similar. PA’s have a slight edge if they are surgical because of the higher reimbursement involved with surgical procedures. This article was really upsetting to me as it does not give a factual and realistic comparison between np’s and pa’s. I would not advise anyone to use this site as a reference to better understand the differences between the professions, as well as their roles.

  39. Ryan LPN says:

    This has been very helpful (article as well as comments) but I am confused. I saw a PA today for the first time and was interested in their schooling. The article says there are 2 year programs and you don’t need medical background? Does that mean I could just jump into PA school as an LPN? I live in NC and there are schools that offer the program but I live too far from them, so I was looking up online programs. I am also about to start an LPN-BSN online program but if I can just go to PA school then I’ll do that, but I was a little confused on how this works? I feel like that’s not right.

  40. Mary says:

    As a student who just applied to 10 PA programs throughout the country using CASPA and supplemental Apps, I know the PA application requirements. Yes, your Major of your Bachelors does not technically need to be science-related, but you need to have taken a large amount of prerequisite courses that many students do not take if they were “English” majors or some other non-science major. Also, I am a kinesiology Major with minors in Chem and Bio, and I’ve had to explain why I am this major numerous times to the few schools that I have spoken to, but this is not my main point. Prerequisite courses vary by school but usually include Chemistry 1 & 2, Organic chemistry 1 &2, Biochemistry, Genetics or Cell Biology, Microbiology, Stats or Biostats, A&P 1 & 2, Psychology, non specific upper level biologies, and then basic English courses and humanities. On top of this many schools require around 2000 patient care hours with direct patient experience, (RN, EMT-b, -i, or -p, CNA, PT, PTA, LPN, etc) Some programs require 1000, some require 4000, & others dont have a minimum, but these are more uncommon. Generally you must take the GREs, or in lieu or that the MCATs, and then submit it in a lovely CASPA package, and wait for interviews in fall and winter for a summer or next fall program. Also, many programs are soo demanding that you are not allowed to work a job whilst in school.

    That would be how you get into a PA program.
    the PA application process isnt given justice by described as “Here I must state that anyone with any type of Bachelors degree with NO medical knowledge can become a PA”

  41. Laila says:

    I just have one question, I want to become a PA and I pretty much know a lot about the field, but I was wondering if PAs can practice in any state other than the one they were licensed in? I read somewhere that you have to stay in the state you took your exams and received your license in, is it true?
    Thanks you!

  42. jasminne says:

    I was interested in becoming a PA about 2 years ago while starting college my advisor had brought it to my attention and I’ve done some research but I am I guess discouraged because I don’t do well in science or math classes. I always wanted to be in the health field since I was a little. I am a nursing assistant and have been for a year now. I live in pennsylvania and both PA & NP’s are well recognized and high demand. My question would be can I major in communications and still apply to PA graduate program? as seen above previously, you need the major science prereq’s.

  43. Blake says:

    After being in this buisness for a while i may have a differing position on this issue. The mistake that i feel we are making is in the area of over generalization. i have personally worked with every demographic mentioned in the article and in the discussion. some PA’s are better than some NP’s and some NP’s are better than some PA’s. take the ego out of this discussion this is not a distance urination contest, (if you get my drift). As an FNP that worked years in a level 1 trauma unit prior to NP school i was better prepared for the education that others who didnt have as much prior training. the truth is that no person, not MD, PA, or NP is prepared just out of school to jump right into practice (regardless of their experience or degree) without help and supervision. if you think you are going to do that you are over confident and unsafe. In my humble opinion, choose what you want to do based on the amount of time it takes you to complete your goals. If you already have a BSN, be a practitioner, if you have another degree be a PA. it will take you at least 7 years to become an NP for the most part if you start today, there may be a faster route as a PA but im not sure. really to me the other arguments are of no consequence. Neither is better or worse, we are here to care for the people who trust us with their health care not to fortify our egos by declaring which is best. Remember, our highest callings are to do no harm and to be a servant to those who come to us for help. remember this and you will be sucessful in whatever you do! ok now im off my soapbox.

  44. Steph says:

    You could major in communications if you wanted to, as long as your prerequisites are taken care of. Just be prepared to tell the admissions people how that will help you in medicine. Also, be sure to have great grades and rock the GRE. Some PA schools are nearly as competitive as medical schools.

  45. Linda says:

    If you’re talking about income, the median income for PA’s is 89,40 and for NP’s is 90,121. PA usually start out 10K higher than NP’s but money wise it ends up being the same. It’s really about what and how you want to practice. NP’s will be the new general practice doctors. PA’s are more likely to assist Dr’s in cardiology, oncology or some other speciality. NP’s have specialities to but they tend to be more in the line of women’s health, pediatics and family practice. Most people that opt for NP I think do so because they want to be able to practice on there own and being nurses to begin with feel more connected to with their patients. It is true PA’s can take a test and be admitted without a medical background. A friend recieved 1000 hrs clinical credit toward admission for being a massage therapist. But the escelerated PA 2 yr program was rigiorous. A nurse that has completed a four year program and graduate school has a lot to offer. They have years of clinicals and patient experience. You can’t do either of these without working hard and being smart. NP’s can practice on there own. PA’s have to work under a doctor. It’s what’s best for you.

  46. Sean H says:

    A very brief “side-by-side” view of federal laws governing compliance for PAs and APNs, now together known as Non-Physician Providers (NPPs), can be seen here:
    See the PDF “Medicare information…”
    Even here the list is not quite complete, but relatively simple and correct.
    It will reveal they are equivalent from a billing standoint as far as the governement is concerned. Where the gov’t goes, often private insurance will follow.
    Regarding differences from a PA perspective:
    1) Education – Yes APN’s need a nursing degree, then a master’s degree and with further degree inflation, a doctoral degree. Yes they have a national board and specialize earlier. There are very few PA schools that still offer a certificate or even BS any longer. >80% are now Master’s programs requiring a BS first. Does not have to be science, but surely helps and you will need the grades, prerequisites and prior medical experience. I was a military EMT. A classmate of mine was a band major with years of experience as a CNA, go figure. Degree inflation in time will likely require a doctoral as well, as PTs have moved there too. There is a national board with every 6 year recert. PA education is focused mainly as a generalist for primary care setting, but does follow a medical block-training model with courses taught by MD’s or PA’s. Some lectures are the same lecture provided to medical students, only condensed. I’m sure NP training is rigorous. Only look at the website for various schools and you can see coursework for either. I would not discount a nursing backround, but experience and maturity on both parts helps. PAs historically are older and do have prior medical experience of some sort.
    2) Work – all will take time to be proficient and feel secure enough to act independent. As stated, it would be dangerous if you though otherwise. I cannot speak to how independently NPs act in the outpatient setting. In the inpatient setting, PAs and NPs are often indistinguishable. They work side by side in pulmonary, cardiac, ICU and ER settings, among others. It is rare to see NPs in the OR, though. All charts are being cosigned by supervision/collaborating docs, regardless of state laws, as far as I can tell, and I’ve worked in two states. This is because hospital credentialing and privileging requirements mandate this due to our litigious society. And with electronic records, it is automatic that charts are cosigned. Neither NPs nor PAs need scripts cosigned by their doctor. In the outpatient setting, I know PAs that are functionally independent. The doc is not coming in to see patients with them. They may cosign charts, but it is a percentage and usually only if prescriptions were provided. It varies state by state and doc to doc, and laws change for all as both professions seek more “autonomy.” In a primary care setting, be it family medicine or emergency medicine, oversight will likely not be great. There are varying degress of oversight in the hospital. I have yet to see an APN function independently in the hospital.
    3) Specialty- This will vary as stated numerous times. APNs tend to focus on women’s/children’s/family practices. But I see them in many specialties around the hospital. They are rare to see in the OR, but some do. Not to say they haven’t worked as an OR nurse. I have seen some going to surgical assist courses to compensate. CRNAs of course are OR oriented by training.
    PAs work in women’s/ped’s/family practices. I have seen them in every specialty in the hospital I can think of, including morgue. They are utilized well in the OR, with didactic and surgical rotations as part of their training. I cannot speak to APN OR training.

    4)Licensing – For PAs, you are not limited to your state. If you wish to change, you need to apply for a license for that state. You do not need to retake the national board, unless the state has a board exam, and some do. I imagine APNs have at a minimum to reapply for a license as well.

    5) Compensation – Pay for both will likely vary greatly by specialty. Last APAA census data showed mean salary for PAs at 90K. I know PAs that have made >150K, depends on call schedule and this would be a surgery specialty. CRNAs are making this, and have an excellent lifestyle. New grad in primary care, there is census data for all of these, but among PAs/APNs is likely not too dissimilar and is at the lower end of the pay scale. Higher for experience and production pay.

    6) Travel – many foreign gov’ts do not recognize PAs or APNs, so for NGOs, PAs have a difficult time and APNs function in a RN capacity, from what I’ve seen/read. I’m sure exceptions exist. US gov’t organizations do, and both can work oversees as a US gov’t employee. For PAs, they do legally work in Canada, UK and Australia, Guam/Phillipines. There may be others. APNs likely have some legal status in other countires too.

    7)Demographic – Both are majority women and white at this point, variants among specialty.

    8)Which to decide – Both are respected fields, both should be proud and both are in demand. As stated, look at your state. Some are more bent toward APNs and some PAs. Laws are more and more making them quite indistinguishable Specialties look to both in many applications, or if you apply when they seek one, they will likely consider you if the experience is there. As I said, reimbursement is the same. I think both are great and have equal respect for my APN collegues. If I could do it over again…I might look into a CRNA. It means more schooling/money, but I personally think the return is worth the investment.

    Surely missed some things, but you get the idea.

    Good luck.

  47. Tman says:

    A few question, Would you want to see someone trained by nurses in the nursing model or someone trained by MDs? Wouldn’t you want to see someone that has gone through training side by side with residents, fellows, and med students? Would you want to see someone who does not have to take a national board exam to make sure they are competent? Would you want to see someone who does not have to take their board exam every 6 years? The Answer is Clear. PERIOD. SEE YOUR PA….

  48. rebecca says:

    ‘ Don’t forget to mention that by 2015 those going to be NP’s will have to get their DNP and not just MSN’

    This is a FAQ from the AACN website:

    16) Does implementation of the DNP mean advanced practice nurses will no longer be permitted to practice without a doctorate?

    No, nurses with master’s degrees will continue to practice in their current capacities. Recommendations are included in the Roadmap Task Force report on how to facilitate rapid transition to the DNP for master’s-level nurses seeking this credential.

  49. Scott says:

    I hate to be a jerk but I see an abdundance of comments related to pay. If you folks are overly concerned with that then the healthcare industry is not for you. I work with both PA’s and NP’s and the overwhelming complaint is about money and hours when compared to their physician counterparts. I’ve worked in family medicine, urgent care and ER. These were all physician driven practices and believe me when I tell you the doc’s are just happy to have the help. Most now days couldn’t give a rat’s ass what you are as long as you don’t kill somebody or piss off the staff. For those of you just coming out of college with a science related degree or nursing please volunteer somewhere for a year or so in the third world. You will have a completely different outlook when you return. If you still want to be a NP or PA after that GO FOR IT! You’ll be a much better clinician….

  50. Oksana says:

    Very interesting points made by the proponents of both professions. I am an Adult NP, certified by AANP. As an RN I was able to specialize in the areas of nurisng/medicine I was mostly interested in: med-surg, oncology, wound/ostomy care. My clinical experiences during both Master’s and post-Master’s education gave me an opportunity to become clinically solid and practice with healthy confidence after graduation as an NP (BTW, I’ve had over 2000 clinical hours combined by the end of NP education – it’s required to be certified). My preceptors were both MDs and NPs – they were all fantastic! As in any profession, you must have the drive and the ambition to become the best, and to continue to grow. Medical field is highly competetive; if you want to be a practitioner that can truly collaborate with an MD – you need the ambition. That said, the surgeon I currently work with, specifically was looking for an NP, “because of the nursing background and the educational background”. Other than surgical mandatory module, the NP education is not really that different didactically from the PAs’. I see the benefit of a “Nightingale factor” though – nursing tought me to see the whole person, not just a system/organ – the PERSON, family included. Believe me, it makes a measurable difference. Nursing takes the WHO definition of “health” in hand and goes to work 😉
    As far as the practical side of things. There is no significant difference in the salary or the hours – depends on the setting. as an NP w/hospital privileges, I can admit and discharge patients; PAs cannot.
    there are 2 certifying bodies for NPs; each has somewhat different requirements: mandatory CMEs +/- professional development (teaching, etc.), OR you can get re-certified every 5 years.
    Master’s degree is not mandatory for entry into practice for PAs, unlike for NPs. However, both professions are facing the potential higher requirements for entry into practice.
    I think, both professions are great, and can be a good fit for a specific individual.

  51. Oksana says:

    one more point:
    On a federal level, Medicare allows PAs to get their own NPIs, however, their practice act stipulates that payment for PA services “shall be made to his or her employer….” This is because PAs are “supervised” by physicians, versus the collaborative agreement that NPs have with physicians.
    With Nurse-Midwives becoming independent practitioners and not requiring collaborative agreements anymore, it is possible that the entire NP profession will acquire the same independence soon. Independent practice, anybody? What is your American Dream?

  52. dan says:

    I have read the entire thread. There is a level of truth in most of the comments posted. A quick glance at the comments and you can quickly pick up on the bias view. The facts are the facts. And I will point them out. I have an association with both groups and well informed about intent, practice parameters for both. First thing to understand, the nursing board is independent, it is as easy for the board to declare medical independence as it is for it to declare nurse practioners as rockets scientist. The meaning of this there is no check and balance with respect the credential they pass out. And although some PAs have private practice via hiring a physician part time to collaborate with, the fact is on paper NPs are the independent practioner of the two under the law… In the real world, all hospital treat mid-level care practioners equally, that is regardless of the groups the doctor is the final check off.. As for education, facts are the facts… the didactics associated with diagnosis and treatment it is clear, PAs has much more class room and clinical rotation time. Just for a quick illustration, the guidelines for NP education dictates 700 clinical hours which may be done sparingly, 700 clinical hours amounts to ~ about little than 3months of rotation. Looking at PA training, each rotation is about 2months long. The real, true on average coming right out of school a PA will be better informed then a NP but that edge quickly disappear within the first two years of working… Intent, both groups want to be independent, which is concerning as a healthcare consumer. One comment said, they will be the new primary care providers, really? Truth is neither profession rise to the level of training and education necessary to be completely independent. Whether PAs change the name to physician associates, or whether NPs, add another credential to the same thing they’ve been doing (DNP), none of it can make up for the standard set for medical practice. The good, both are highly skilled profession with a lot to offer the medical community. My suggestion dont do either if you believe its a short cut to acting like a doctor. In the end, when push come to shove, there will be signs notifying patient to specify whether you want to be treated by a medical doctor, MD, a nurse practioner, who practice medicine in a nursing model, or Physician assistant… It goes that route you will be looking for a job. Ironic enough PAs and NPs I have talked to, refuse to see anyone other than a the medical doctor do you think the rest of the public will feel differently..? Im a pharmacist so it doesnt matter to me. What i see, is that, NPs are ever trying to be viewed like doctors, and you think its a good move, but it will end up biting you in the future when push come to shove… If you want to be a doctor go do it, if you want to be a mid level care do it.. , but whatever you do stay in your lane. We all in healthcare, so no need for PAs n NPs to bicker about 1st, 2nd, or 3rd place… The ultimate choice rest with the patient. If you’re a patient what would you choose.

  53. Blake says:

    Dan, respectfully, im not sure where you get your information. my clinical requirement from my NP program was 1000 hrs. You are also not mentioning the 4 years of nursing school and clinical training before i ever stepped into NP school. Not mentioning other training gained in nursing pracitice such as “CEN, ACLS, TNCC, ATLS, PALS,ITLS, BLS, PEPP,and last but not least CCRN”, all achieved prior to advanced practice training and actually used in pt care situations. My graduate program also required at least 1 year of critical care experience prior to admission and was a 3 year program. 7 years of school and 1 year of critical care minimum, and you say that a buisness degree and 2 years of school is better training? your comments appear to be enclusive at times but are clearly inflammatory in nature. PA’s are well trained and i love working side by side with them and the MD, i choose not to degrade any of them. however…..i think that this discussion may be better served by those of us who acutally touch patients. i would never attempt to determine how well a pharmacist counts pills because i am not a pharmacist.

  54. Lauren says:

    I am curious as to where everyone is getting there facts. Firstly, PAs make more in some areas, but generally the pay is the same. The major exception is the west coast, particularly California where there is a strong nurse’s union. The NP in Ca is licensed under the state nursing board and far exceeds the salaries of the PA in Ca (est. $30K more). Second, the PA has a biology degree or something similar usually, then they get their masters (est. 3 year program). This is does not mean they come with healthcare experience. They receive all of their training in school or after in a fellowship. NPs should (however, not always) have several years experience in an acute care setting. Some programs take NPs with less experience, which I don’t agree with. Typically, most NPs have had several years HEALTHCARE experience. What more needs to be said? Everything you learn in healthcare, you learn on the job and anyone who says different is lying to themselves. And as far as the curriculum goes, at the end of the day, both PAs and NPs sit for boards. Do you think that the boards are easier for NPs?!?!

  55. Kevin says:

    Well said Blake!!!! and Dan YOUR INFORMATION is WAY OFF!!!!!!

    do NPs if you like to deal and actually touch and be there for patients
    -PA if you want to do more diagnosing and stuff
    -salary is VERY similar changes state to stay of course
    -big plus is NPs you can practice independently, if you want to own your own practice some day go that route.
    -other then that idk what to tell people

  56. Alex says:

    I’m currently in school perusing my ADN then plan on taking an accelerated transition course for my BSN while already working as an RN. I know that’s not where I want to stop. I’ve wanted to be a physician but quite honestly, I don’t want to be nearing 40 barely starting to practice medicine. I’m ok with the decision I’ve made to be a non-physician health worker.

    I’ve read every thread on here and am still torn whether to go for PA or NP! I feel as though having a BSN going to PA school will have its advantages as I would have nursing courses under my belt AND the rigorous training for PA. I have looked at the curriculums, salaries, and tuitions for both. Having researched this, I noticed everything was higher and harder for PAs than NPs. I currently live in AL but intend on moving to FL after finishing all my schooling. Having said that, is there any more insight someone might have? Especially in the state of FL?

  57. JayeTee Redd says:

    Which has the higher or more advanced medical training, the NP or PA and how many years of medical training is required for each?

  58. Chris Gunderson says:

    It’s funny how most articles that talk about the differences between NP’s and PA’s tend to offer the same stuff that you can find pretty much anywhere else on the Internet. If you really want to know the biggest things that separate a NP from a PA are: 1. PA’s are required by law to have a relationship with a physician. This relationship is paramount to successfully taking care of patients. A lot people see this as a master/servant type relationship; however, this is quit the contrary. The relationship that a PA has with their supervising physician allows them to grow and develop skills beyond the basic skill set that a PA initially graduates with allowing them to become a more functional and collegial member of the health care team. This is what is meant by the phrase “independence gained through dependence”. With this being said, I know many PA’s that own their own clinic’s that have partnered with a physician to provide supervision/mentoring. 2. PA’s are trained in the medical model where as NP’s are trained in the nursing model. This allows physicians and PA’s to share a common knowledge so that they can communicate with one another more effectively. Good communication is paramount to providing excellent patient care. It provides a core philosophy that is shared by both physicians and PA’s – putting the patient first, practicing evidence based medicine, practicing to the standards of care for their respective communities, and on-going learning. 3. All accredited PA programs have specific national standards that every program (regardless of which state you are from) must meet. Those standards mirror those of their supervising physicians. For example, physicians and PA’s are required to recertify every 10 years and maintain a minimum of 50 CME’s per year. The Board of Medicine in every state governs PA’s and physicians. NP programs vary wildly from state to state in regards to there core requirements and clinical hours. Once a NP you are only required to take you licensing board once in your entire life and in some states you do not have to take your boards to practice at all. Hence, this is why you see some NP’s with the credentials ARNP v. FNP-C after their name. If you want to practice as a PA you have to be certified. In some states NP’s (even though they are practicing medicine) are governed by their respective Boards of Nursing. 4. Personally, one of the most disturbing differences that I see that separates NP’s from PA’s that is sadly perpetuated by many physicians, legislatures, and lay people is the NP profession touting themselves as not just independent practitioners, but as equal in par with physicians in training and education. And, yes I am talking about the Doctor Nurse program that Columbia University and the various Nurse Associations have so dubiously promoted. Personally, I think that there is nothing more tragic in our health care system as a person who has 2-3 years of extra education touting themselves as an equivalent practitioner as physicians. I find it laughable that even with the extra clinical training that a NP gets from their Doctor Nurse program that they still run short of the amount of clinical hours a PA gets during their training. It is sad to see a group of people within such an honorable profession blindly place their own ambitions and desires above that of their patients over some sort of headstrong glory hunger, just so they can call themselves doctors without actually going to medical school. It just goes to show what you can get away with when you have large sums of money and huge PAC’s in Washington. Yet, on the other side, their is a part of me that is some-what sadden by physicians total lack of abstinence to start a bridge program for NP’s and PA’s to get through medical school in a reduced amount of time, especially when their is a huge lack of primary care providers within this country.

  59. mike says:

    Blake.. awesome post. Im glad I stumbled upon this site.. Every NP and PA I have met could careless about this argument.. It seems like the only people who care are the ones that are trying to figure out which one they want to pursue. I will say this.. NP,PA, or MD.. titles mean nothing.. it always comes down to the individual.. You can talk about training and experience all you want.. but if the doc, PA, or NP doesnt give a shit.. then none of it matters. What good is 2000 hrs for PAs when they have never experienced a code and are pumping on someones chest trying to get them back like most nurses.. And what good is all that nursing when your simply sick of it and semi burned out.. and all the PAs and NPs can tell you what good is that med school when doctors stop caring cuz all they can think about is the hot nurses or tee time.. no.. none of it matters.. all programs have sufficient training and we know this because all professions have put out excellent practitioners.. but in the end.. the only thing that matters is the individual.. so when you step into a doctors office and see an “i could care less” face.. maybe then you can request an NP or PA.. side note.. I am RN and have seen great NPs and PAs and have seen idiot NPs and PAs.. the percentage is the same for MDs. Im not gonna sit here and say PAs are bad cuz lack of experience.. because most study their asses off in school and take full advantage of their clinical hours.. alot of NPs have great experience from hospitals and some have poor backgrounds.. so its a toss up.. just stop worrying about who is smarter and pick a program or if your a pt see the first person available..

  60. Aaron says:

    I’ve been reading all these comments that seem to be NP is better and have more privileges and stuff. Here’s the thing, I am going to PA school I have a bachelors degree in medical sciences from a highly recognized university and my older sister is in a NP program here in the same state. While a lot of you keep saying PA’s cannot practice without the supervision of a MD and a nurse practitioner can is true in a sense. PA’s are considered the right hand man of a Doctor and yes they are under the supervision of a doctor but they are the right hand man of a doctor the MD and PA collaborate together in the speciality they are in. PA’s can open their own clinics in the same scope of practice as the doctor they have been working with and the doctor does not have to be present and PA’s can diagnose and treat illnesses and perform many tests without the dr being present. PA’s in certain specialities can make upwards of 130,000$ a year with experience according to a recent salary survey. Pa’s practice under the medical part of medicine and NP’s the nursing part. I had to take organic chemistry and physics at my school to be able to apply to their PA program and then graduate level courses like immunology, infectious diseases, biochemistry that I chose to take because it has been very helpful in my Pa studies. I don’t like how this article and comments are basically saying NP’s are better blah blah. Does it matter that much? PA’s make a higher salary than NP’s especially if they specialize in urgent care and surgeries. I appreciate anyone who is a NP or PA because they are providing care for sick people and helping out MD’s. we should respect both careers.

  61. WelchNP says:

    I have been an NP for 8 years and have never seen, until now a 36 hour work week. I have been specialized in neurosurgery, first OR assist as well as orthopeadics. I have worked rehab medicine and now vascular surgery. We can do anything and more that a PA can and for the record our training is everybit as demanding as “PA school” if not more so! They go from a 4 year school with a major in biology or some science to the PA program whereas the NP has sometimes as many as 2 prior degrees in nursing prior to the Masters in Nursing or Doctorate that PA’s can’t even obtain. The biggest difference between the 2 paths, and this is from personal experience is that the NP is more rounded in patient care and the PA tends to have the “I’m a mini doctor” syndrome that you just don’t find with NP’s. Another thing is salary, for the most part it is the same, but I will say I know of NO NP or PA making grater that $150k a year but I do make more than the 3 PA’s that are in the same practice as me and they work in the hospital/OR and have to take call and all of the misery that goes with it, I don’t and I run my independent clinic in the office BECASUSE the doc’s know I can practice more independently than the PA’s!! The future of healthcare will tell the true tell!! Just watch OBAMA care and you will see the NP’s take over!

  62. Ginger says:

    In what states can PA’s have a “collaborating physician” agreement similar to that of an NP?
    Thinking about going back to school for NP, but already have a rad assoc and healthcare ad bachelors. NP would be my first pick, but schooling would be a lot longer. However, I’d like to be able to work independently once experienced.
    What’s your opinion?

  63. G Walker says:

    I have read all the threads in this blog (curious myself as to the difference between a PA and a NP). I myself am not in the medical field in any capacity, but rather I am a recipient of the health care delivered by these healthcare professionals that you are discussing. It is the same argument I heard for years concerning the MD vs the DO. It is not the letters behind the healthcare professional’s name that concern me. It is rather the competency and dedication of the professional that ensures me that I am getting the best care available. I am 66 years old and I can assure you that there are incompetent people in every profession. Over the years I have encountered PA’s, NP’s, MD’s, and DO’s, both men and women, who I would trust with my life, as well as some who I considered to be “Quacks”. Some like Fords, and some like Chevrolets, but both serve the same purpose. If you are struggling as a student as to which career to pursue, my advice is to just pick one and go for it. Education is NEVER a waste of time, and remember that you get out of a career what you put in it, so just do it.

  64. Lienio Desouza says:

    I am a NP my brother is PA i make more money than him and I am independent and his is not. I have more shool and more knolledege

  65. wendell miles says:

    LD, I am glad your concern is that you make more money than your brother but, based on your comment, it would appear you need to go back to undergrad and concentrate on your grammar and English abilities. Personally, I find a comment of this nature to be both condescending and hypocritical, unless of course you are being cynical. Then it would just be in bad taste.

    Some of the information posted above by PA and NP providers are spot on while others are nothing more than wild assumptions and completely false allegations promoted by professional jealousy “I am better/smarter than you are”.

    My input to those who are considering the attendance to a graduate level program for the purpose of becoming a clinical provider I would provide this suggestion, if you are a nurse, enjoy the nursing profession, and wish to pursue a clinical mid level position based on the nursing paradigm, then attend a NP program. If you have clinical experience or not, wish to pursue a clinical mid level position based on the medical/surgical model, and wish to work in collaboration with a physician or surgeon, then attend PA school. I can assure you, as a mid level professional, there will be a time when you will be confronted with a clinical problem that exceeds your education, training, and experience and having a clinical partner that works in collaboration with your abilities will be quite satisfying without any occupational jealousy. Best of luck to all that are preparing to enter the world of medicine and surgery.

  66. Judy Thiessen says:

    I have to refer many of the readers to the AANP website for correct practice authority answers. Many states allow complete independent practice authority for NP’S while others have very specific and different requirements. The latest legislation laws pertaining to these questions are posted on this website.
    As an RN with over 25 years of practice, I will soon graduate as a Family Nurse Practioner, and I am already enrolled to continue to receive my Doctorate of Nursing Practice with a concentration on Psychiatric care. This will not only allow prescriptive authority but will allow me to focus on counseling, diagnosis and treatment of Psychiatric diseases and disorders in addition to medical prescriptive authority. Every NP must pass a national certification and an additional national certification for psychiatric NP’S. All this is in addition to a doctorate degree which is very rigorous and prepares NP’S to be agents of change in our health care system.

    The difference in an NP and PA has more to do with focus. The focus of an NP is care, while the medical focus is cure. I have worked with a few PA S who are skilled, compassionate and patient focused but in my many years of practice in ICU, ER, Occupational, community, and primary care as well as Clinical Administrator. NP’S get my vote hands down for improving patient outcomes!

  67. Anonymous says:

    She is a horrible NP, she is very ignorant and makes mistakes constantly. She told me “EVERYONE makes mistakes”. Now lets review that remark; Everyone makes mistakes? You put your trust and life in her hands. Yes everyone makes mistakes, but for your doctor to make mistakes is a no-no. From a professional POV lets use an example. You go see a doctor, and he/she makes a “mistake” and misdiagnoses you, or miss-reads your medical records. So your dying because of the “mistake”. And her/his response is “EVERYONE makes mistakes”. Now to a true professional, that’s being blatantly ignorant/and or lazy. Doctors are probably the one profession where mistakes shouldn’t happen. Would you put your life in the hands of a NP to evaluate you, or your loved one? No I’m not making this up, it’s not slander either, if she’s a true NP she would admit to this, if not, may God be with you. Because doctors aren’t suppose to make mistakes, unless your just not doing your job and living up to “do no harm”.

  68. John-Obajinmi says:

    Good day.
    I have a degree in engineering.
    (1) Pls what educational background must I have to be a physician. Am I qualified to enrol for PAs ?

    (2) How many year will it take me to run for PAs study?

    (3)What other requirements are neede d by national Commission on Certification of Physician Assistants?

  69. Nancy Price says:

    Just a patient here. Sorry I won’t see a NP or
    PA. Become doctor. Yes the new health care reform
    Is putting unqualified people into
    Practice. Cheaper for them. PCP should always be
    Physcians. Not playing doctor because
    You can’t get into medical school.
    Dr’s gods, hell no.
    But the education and experience

  70. Jake says:

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  71. Sue says:

    If you would like autonomy and the highest paying salary in the non MD medical profession is to become a CRNA. Pay is higher than some MD practices.

  72. Lashauna Petrus says:

    Physician Assistants and Nurse Practitioners actually make about the same. One may or may not make more than the other depending on their skill level. For instance, a Physician Assistant specializing in surgery will make an average of $80k-100k more than a Nurse Practitioner. There are plenty of PA’s that I know that make even $220k specializing in surgery. And about that, a Physician Assistant has a number of schools to choose from where they provide “specialty’ courses/programs. So, it’s not just in their clinicals. Please correct that info in your blog. Thx!

  73. anon says:

    It’s so sad to see all of the outdated information on this page, both in the (admittedly old) article and in the comments. NPs and PAs are both fantastic health care professionals. BOTH should have health care experience prior to entering their graduate program. Unfortunately, there are now “direct entry” NP programs that do not require any experience as an RN first, just as there are a few PA programs that no longer require health care experience. Most PAs and NPs tend to agree that these programs are not ideal and we support continued pre-grad-school health care requirements. NPs CANNOT practice independently in every state. They can in some, yes. PAs DO NOT need a physician to “supervise” their every move, co-sign every chart, or even be physically present. In both cases, scope of practice varies by state. In some states, NPs have better practice laws and in other states, PAs do. Either way, we provide the same quality-level care.

    As for the patients who refuse to see anyone except an MD, that is fine. That’s your prerogative. Consider, however, that multiple studies have now shown that PAs and NPs provide equal care to physicians in all primary care settings and in some cases even lead to better patient outcomes because of our ability to spend more time with patients. Additionally, if you’ve ever been to Europe and seen a physician for any reason, you may not have realized that the training of MDs in European countries is equal to that of PAs and NPs in the United States. IE: maybe it’s not that we’re “undertrained” but that we are unnecessarily “over-training” physicians to the point of severe burn-out, patient-errors, and even suicide (check the suicide rates of residents – it’ll alarm you.) The fact is that NO ONE can know everything when it comes to health care because it is constantly changing. To believe that putting someone through a grueling experience of US med school and residency and then they’ll automatically know everything, is downright dangerous. True healthcare providers understand that the learning never stops.

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