nurse practitioners vs physician assistant

If you are thinking about advancing your healthcare career, you are likely well aware of the many different directions that your career could take. Two very popular paths are becoming a nurse practitioner (NP) or physician assistant (PA). A lot of people don’t know the difference between a physician assistant and a nurse practitioner. You might visit either type of healthcare provider in a physician’s office even though they are not physicians. Many people have primary care providers that are nurse practitioners or physician assistants.

Nurse practitioners and physician assistants are advanced healthcare practitioners who have similar responsibilities, such as diagnosing illness and prescribing medications. However, their training and paths toward certification differ in significant ways. To get a better understanding of both the professions, we have put together this guide explaining the differences between a nurse practitioner and a physician assistant, what each role does, how much you can earn, and more.

What is a nurse practitioner (NP)?

A nurse practitioner is a health care professional who offers a wide range of acute, primary, and specialty care services, either alone or alongside a doctor. As primary care physicians leave the profession faster than they can be replaced, especially in a rural area, nurse practitioners play a larger role as primary care providers. They are also vital to caring in specialized medicine, which has its physician shortages. There is also an overlap in the roles of nurse practitioners and physicians, but nurse practitioners focus on preventing diseases and promoting the health and well-being of the whole person.

What does a nurse practitioner (NP) do?

Nurse practitioners deliver advanced care to a variety of patients in the clinical setting. According to the American Association of Nurse practitioners (AANP), nurse practitioners work “autonomously and in collaboration with healthcare professionals and other individuals, to provide full range of primary, acute and specialty health care services.” The idea of working independently of physicians is a great incentive for some people to move into the nurse practitioner career. The profession rates #2 as the best job in health care and the #3 job overall in the top 100 jobs, according to the U.S News and World report.

Nurse practitioners provide teaching and supportive counseling and refer patients and families as appropriate. They focus on health education, health promotion, and disease prevention. CRNPs also collaborate with others to provide health care services to individuals, families, and communities. Acute care nurse practitioners (ACNP) work in hospitals or acute care clinics. They see patients when they are sick, are admitted to the hospital, have injuries, or have surgical procedures. They treat patients from admission to discharge.

They can order diagnostic and laboratory tests to help diagnose diseases. They may do procedures such as intubation, debriding wounds, and putting casts on injuries. They work as part of a health care team to develop a treatment plan and follow-up care. Nurse practitioners may also specialize in specific practice areas such as orthopedics, pediatrics, oncology, gerontology, and psychiatry. They diagnose and treat diseases related to these specialties and serve as part of a patient’s health care team. The working environments of nurse practitioners include:

• Hospitals, acute care, or ambulatory care settings
• Outpatient settings
• Long term care facilities and nursing homes
• Private homes providing health care services
• Hospice and palliative care services
• Government and community health agencies
• Universities and research agencies
• Healthcare or health industry businesses
• Private practice
• Phone triage centers
• Rural health care facilities
• Nurse managed medical centers

Education and training:

All nurse practitioners complete a Bachelor of Science in Nursing (BSN) program and a Master’s of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) degree. Nurse practitioners then pass a standardized exam to get certification from the specialty nursing board that oversees their practice area. Finally, nurse practitioners must get a license from their state. The requirements vary and may include renewing a license or completing a certain number of continuing education hours each year.

According to the U.S Bureau of Labor Statistics, the need for nurse practitioners is expected to grow by 45% by 2029. This is much faster than the national average of other healthcare-related professionals included registered nurses.

What is a physician assistant (PA)?

Physician assistants are integral members of the health care team in many hospitals and clinical practices. The role of the physician assistant (PA) is to practice medicine under the direction and supervision of a licensed physician. A physician assistant (PA) is a mid-level medical provider who is licensed to provide many of the same clinical services as physicians when working in primary care settings. These services include performing physical exams, diagnosing and treating illness, and prescribing medications.

What does a physician assistant do?

A physician assistant’s role typically includes things like:

• Making rounds (checking on patients)
• Doing patient exams
• Helping doctors in surgery
• Diagnosing illness
• Writing prescriptions
• Creating and managing patient treatment plans
• Offering advice to patients on preventive care and best health practices.

Although Physician assistants alongside a supervising doctor, that doesn’t mean they work under the doctor’s direct supervision. Instead, they are in partnership with the doctor. They are independent clinicians within the scope of state law. Most state laws require physicians to have agreements with physician assistants to define what they can do. Physician assistants work in medical settings include:

• Physician offices
• Hospitals
• Employment service office
• Outpatient care centers
• Urgent care centers
• Surgery centers
• Government and community health agencies
• Universities and research agencies
• Healthcare or health industry businesses
• Phone triage centers and rural health care facilities
• Nurse managed medical centers
• Psychiatric hospital
• Orthopedics and Dermatology
• Pathology and pediatrics
• Critical care and surgery
• Emergency medicine and adolescent medicine

Education and training:

According to the U.S World News and report, working as a physician assistant is the best job you can have in 2021. They ranked physician assistants as #1 in the best health care jobs. An increase in the number of patients with chronic diseases, such as diabetes, is causing an increasing demand for healthcare providers. Physician assistants often provide preventive care and treat the sick. An increase in medical technology and access to healthcare services further strains the healthcare system requiring an increase in advanced practice providers.

A career as a physician assistant starts with a bachelor’s degree from an accredited (approved) college or university with coursework focused on science. Some schools offer a pre-physician assistant degree. From there, students must complete a physician assistant’s program that has accreditation from the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Most physician assistant programs take about 2 years. Students take classes while getting at least 2,000 clinical rotation hours. They then receive a master’s degree in physician assistant studies.

Physician assistants must pass the Physician Assistant National Certifying Examination (PANCE), which is overseen and administered by the National Commission on Certification of Physician Assistants (NCCPA). Afterward, they are free to practice with physician assistant certified (PA- C) credentials. A physician assistant must take 100 continuing education credit hours every 2 years to keep the certification. They must also take a recertification exam every 10 years.

Physician Assistants focus on patients’ education, preventive care, and managing chronic (long-lasting) health issues. A physician assistant’s training means they can treat many kinds of health problems. It may be easier to schedule an appointment with a physician assistant than with a doctor. Physician Assistants also treat a patient for one issue and notice a problem in another area that requires further attention and a referral to a doctor.

Differences between a nurse practitioner and physician assistant:

After getting a better understanding of both the professions, their jobs overview, working environments, and their education and training, we will compare them side by side to look at their differences.

The two most fundamental differences between nurse practitioners and physician assistants are the training they receive and the environments where they work. Nurse practitioners are trained in the advanced practice of nursing, where they focus on a specialized role, such as that of a neonatal nurse practitioner. Physician assistants, on the other hand, are educated in general medicine; their training follows the medical model and covers all foundational aspects of medicine and specialties.

Educational differences:

Both nurse practitioners and physician assistants are required to earn a graduate degree, complete a rigorous schedule of clinical training, and acquire certifications. These differences lie in the type of training and certification requirements.

For a nurse practitioner, you will need to complete the following:

• A full-time Bachelor of Science in Nursing (BSN) program typically takes four years to complete.
• Passing the NCLEX- RN examination is a requirement to practice as a registered nurse (RN) in your state. Once you pass the exam, you will receive your registered nurse license.
• You will either need a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) with a nurse practitioner role specialty, such as Family Nurse Practitioner (FNP). In addition to coursework, NP programs typically include a clinical practicum of at least 500 hours under the supervision of a preceptor.
• You must take a national certification exam through one of the five national certification boards to become licensed as a nurse practitioner.
• For certification renewal, nurse practitioners are required to take 100 hours of continuing education and 1,000 clinical hours every five years.

To become a physician assistant, you will need to complete the following:

• You must graduate from an accredited Physician Assistant program- typically a Master of Science in Physician Assistant studies. You must also complete at least 2,000 hours of supervised clinical practice in various medical and surgical settings before graduation.
• Once you pass the Physician Assistant National Certifying Examination (PANCE), administered by the National Commission on Certification of Physician Assistants (NCCPA), you can receive your state license.
• PAs must complete 100 hours of continuing medical education (CME) every two years. They are required to take a recertification exam every 6 to 10 years.

Work environment differences:

Nurse practitioners and physician assistants work in primary, acute, and specialty care across a wide range of healthcare settings, including medical offices, hospitals, nursing homes, VA facilities, correctional institutions, and community clinics.

Although Physician assistants can serve as primary care providers, they are required to work under the direct supervision of a physician or surgeon. Nurse practitioners must work under the supervision of a physician in 11 states. However, in 24 states and U.S. territories, nurse practitioners can operate their practice with full autonomy.

Specialization differences:

There are also legal distinctions between nurse practitioners and physician assistants. Nurse practitioners can work across a variety of nursing specialties, earning certifications for the specialties that require it. If a nurse practitioner desires to switch specialty certification, such as from neonatal to family nurse practitioner, they need formal education and licensure for that new role. As for physician assistants, once licensed, they can switch specialties without the need for a new certification or additional job training.

Career outlook and salaries:

Employment for both nurse practitioners and physician assistants is projected to grow over the next decade at faster rates than the average for other occupations. The U.S Bureau of Labor Statistics predicts a 45 percent growth for nurse practitioner roles and 31 percent growth for physician assistant roles between 2019 and 2029.

As of 2020, the median salary of a nurse practitioner is $117,670 while the median salary of a physician assistant is $115,390.

NPs and Pas both provide direct patient care at the advanced practice level, including working independently or collaboratively. With so many baby-boomers aging, the need for more graduate-level health care providers is increasing by the day. “Physician assistants and nurse practitioners are most cost-effective in a health care system, and there has been an amazing up swell interest in how to integrate them into hospital systems in more and more ways,” says Jonathan Bowser, director and associate dean of the Physician Assistant program at the University of Colorado Anschutz Medical campus.