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What is the Difference Between a Physician Assistant and a Nurse?

By Shannon Kietzman
Updated Mar 02, 2024
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Differentiating between a physician assistant (PA) and a nurse can be a bit difficult, particularly because there are many different types of nurses. Licensed vocational nurses (LVNs), registered nurses (RNs), and nurse practitioners (NPs) are just three types of nurses all with different educational requirements, licensure guidelines, and job responsibilities. At a very basic level, the difference between a PA and a nurse is this: a physician assistant is trained to diagnose and treat medical illnesses, albeit under the supervision of a physician, while a nurse primarily provides nursing, or bedside, care. A PA therefore generally has more decision making autonomy in a patient's care, than a nurse does.

Nurse Practitioners, however, have an advanced level of education, training, and experience and therefore can have a wider scope of practice than other nurses and PAs. NPs provide both medical and nursing care.

A physician assistant is a licensed health care professional, who's scope of practice is determined by his or her training, experience, and state laws. A PA can generally provide about 75% of the services that a physician can provide but a PA must work under the supervision of a physician. Working under the supervision of a physician does not require that the physician be physically present at all stages of a patient's care. It is possible for a PA to act as the primary care provider in clinics where the physician is only occasionally present. This practice is most common in inner city and rural clinics where the number of physicians is low compared to the patient population. A physician assistant may also make house calls or travel to hospitals and other facilities in order to check on patients and report their progress to the physician.

Like physicians, PAs generally do not perform clerical tasks, as a nurse may sometimes provide. Generally, more complex cases are handled by a physician rather than a PA.

While a physician assistant may diagnose a patient, most nurses, with the exception of nurse practitioners, cannot. Rather, a nurse cares for the patient by following the physician’s orders and reporting any changes in the patient’s physical or emotional health to the physician. Nurse practitioners, however, may operate independently and therefore have even greater autonomy than an assistant.

Like a nurse, a physician assistant is a part of the health care team. He or she may examine the patient, as well as take a medical history, provide treatment, order and interpret laboratory tests and x-rays, and diagnose illnesses. He or she may also treat certain injuries, such as those requiring splinting, suturing, and casting. In most of the United States, a person in this position is also permitted to prescribe medications. Some states permit nurse practitioners to write prescriptions.

In order to become a physician assistant, one must complete a training program and pass a national exam. Most of these PA programs are two year programs. Unlike physicians, PAs do not have to complete internships or residencies. Nurses also have specific educational requirements they must meet, with nurse practitioners having the most amount of education required, namely a masters degree. Once licensed, a physician assistant generally has the potential to earn a higher annual salary than a nurse.

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Discussion Comments
By anon934274 — On Feb 19, 2014

Nurse Practitioners and Physician Assistants are highly trained individuals who have many things in common. The most important is, they are not the doctor. Both professions have "bad eggs". Some even leave you wondering how they got through the programs. The majority are knowledgeable professional which add accessibility to healthcare. PA's however do not have a political loby which spends time and money bashing other professions.

By anon353441 — On Oct 30, 2013

This is a bad post. Most of these are not accurate. MDs and DOs have to evaluate 10 percent of cases and don't ever have to be in the office. They can come in through phone or Skype. Someone needs to do more research.

By anon334093 — On May 09, 2013

I have a B.A. in accounting, owned a hardware store and went straight into a PA program 22 years ago. I have had a great career and never needed pre-PA medical experience. Do you realize,physicians don't need a medical background to apply, get accepted and attend medical school?

I think the concept that PA's have to prove their motivation to become a health care provider is ridiculous, and it is the PA programs that require potential applicants to shadow a PA before applying to a PA program. Do potential physicians shadow doctors?

By anon329220 — On Apr 08, 2013

I am so tired of these PA vs. NP posts. Some people say NPs have a better bedside manner. Some say PAs have a more general and broad-scope education. There is also a frequent statement that "APNs have master's Degrees" and then no one mentions that PAs do also. Seriously, I am so tired of people saying "PA is a two-year program" and leaving it at that. What a ridiculously misleading statement! This implies that the PA program is an Associate's level program? Give me a break! It's a 2 year post-baccalaureate program. Not the same at all as implying that it takes two years of education to become a PA.

Also, people talk about how NPs are better than PAs because "new" NPs are coming into it with "years of health care experience" vs. PAs who just "have a degree but no patient care experience." Again, this is very misleading. Maybe several years ago, when there was less consistency with the level of education required to be a PA, this might have been the case, but times change.

Years ago, one could also become an RN by working at a hospital and learning on the job. This isn't the case anymore, and things changed for PAs too. MOST people going into PA school do have years of patient care. Some are nurses. Others are military field medics with lots of trauma experience and decision-making skills. Some are radiologic technologists or other imaging techs. Some are paramedics. Some are physical therapists.

Find a PA school's website and look at the "prospective students" section. I am sure you will see that the vast majority of schools require a minimum of 2,000 hours of direct patient care, in addition to a BA or BS with a GPA of at least 3.0 (most higher) and a strong background in math and science. Most schools require the GRE, and some require the MCAT. PA schools in the US are very very competitive programs now.

At the University of Iowa, for example, only 25 students are accepted into every new class of PAs. Prospective PA students are required to take the MCAT test and are expected to score as well as the MD applicants. The didactic portion of the PA school actually covers the exact same classes as the first and second year MD classes, and the PA students take the classes with the MD students. How many NP programs require the same?

This is not to disparage nurses or APNs at all. Many of them do have years of nursing experience and most of them are good nurses and intelligent people. However, blanket statements about one profession or the other are simply erroneous, because it all comes down to the individual.

Yes, at this time, NPs do have more professional autonomy than PAs. This does not mean that in every setting, NPs have more responsibility. A lot of people choose to go into one program or the other based upon the type of care they wish to provide. For my husband, who had already had 11 years as a radiologic technologist and CT technologist, and who had already been teaching courses for an x-ray and MA program at a community college, and who already had a Masters in Health Administration, he chose to go into the PA program so that he could work in orthopedic surgery (his true passion). He definitely has the brains to have gone to medical school, but since he didn't decide on this until he was in his 30s and already was married with kids, he liked that the PA route would get him back into a financially secure position in a shorter time and with less accrued debt than MD school and the training that follows it. And yes, PAs do more than "assist" in surgery; many of them close up the cases themselves.

I also have two close friends I've known since high school who decided to become NPs. Both had BAs in courses that weres completely unrelated to health care. After stagnating in office and sales jobs after college, they decided to attend one of the new "fast track" BSN programs that gives people with no nursing background (but a four-year degree in something else) a BSN in one year. Then you can go straight into an NP program. They are both bright people and I am sure will make awesome NPs with time, but neither of them has the "years of health care experience" that others have implied to be inherent with all NPs.

Furthermore, the implication that having a background in something other than nursing makes a PA "less than" is insulting. One of my close friends has a BS from Cal Berkeley in Neuroscience. She's worked in epilepsy research while also working as a paramedic. She's applying to PA schools right now, and I know she'll be awesome at it. She's incredibly bright, and a strong background in science is a good thing when you want to be doing diagnostic work.

I am sure that on a case-by-case basis, you will find many newly-minted NPs with less health care experience than newly-minted PAs. You will find stellar and highly intelligent NPs, and some who are not so bright and don't understand the science behind their care decisions. You will find PAs with the skill of physicians, and you will find some who are not as bright or not as intuitive in total care aspects. It's really a case-by-case thing, not an objective truth about one profession over the other.

More or less, what you should choose depends on your background, where you live, and where you want to work. Want to work for a hospital or a primary care setting or a free clinic or women's clinic? Go NP. Want to do surgery, ortho, etc. and work side-by-side with physicians and be treated as a colleague? Go PA. Want to do Emergency medicine? Either will work. Anecdotes about one good PA and one bad NP, or one good NP and one bad PA, are not enough on which to base your career decisions or your faith in a clinician. Judge each clinician individually.

By anon285328 — On Aug 15, 2012

Nearly all PA schools require you to have a bachelor's degree, plus at least two years of relevant medical experience before they will accept you. In addition, you will need required science coursework. Yes, an English degree is fine, but only if you also took the same chemistry and biology classes that pre-med students took. Nearly all PA schools now provide a Master's Degree in addition to the medical training. This was not always the case, but over the past ten years has become the norm.

It is highly unlikely you will be able to continue working a job, even part-time, while you are in PA school. The 24-27 months programs are extremely rigorous. The first year of classroom work is intense, and the second year of clinical rotations require a minimum of 40 hours per week at the clinical site seeing patients under supervision. Fifty-plus hours per week is more the norm, and there is still a lot of studying to be done when you get home. At the same time, you will probably be doing research and working on your master's thesis.

The difference between Nurse Practitioners and Physician Assistants? On the job, there is very little difference, if any. They are both licensed to practice medicine. This is very different than practicing nursing.

There are some significant differences in training. PA's tend to get more training in surgery, and many opt to specialize in some form of surgery: cardiovascular, neurosurgical, orthopedic, etc. Both PA and NP's practice widely in primary care -- family practice, ob/gyn, and internal medicine. There are hospitals that hire both NP's and PA's into critical care and "hospitalist" medicine. Emergency medicine departments generally hire more PA's than NP's, but that could be changing.

Most state laws allow NP's to practice independently. They are not required to have oversight by a physician. A PA medical license, on the other hand, is always paired in some way to a physician's license. Some see this is a plus, some as a minus.

By anon243052 — On Jan 26, 2012

I am a PA. I've worked in surgery, primary care and emergency medicine. I've worked with both PA's and NP's who have been stellar in their medical knowledge, their ability to work autonomously and in the respect they garner from their MD colleagues. And I have known some in both professions who have not impressed me.

It's silly (or petty) to criticize or praise an entire profession based on the experience of a few individuals. The way I see it is we both fill a void of critical need that is great enough to encompass both professions. One comes from the medical model, the other from a nursing model, but we end up doing the same jobs, making the same salaries.

To prospective students: If you are already a nurse, and know clearly what you want to do (especially if that involves being your own boss), and want to be efficient, go the NP route. If, on the other hand, you are a nurse who prefers to keep your options open or would like a new educational perspective, go PA. PA's can of course be their own bosses too, but our side is generally focused more on partnership. For those just entering college, know that it's absolutely not true that PA schools will accept any degree. The pre-requisites are the same as for medical school. Also, though most PA programs are now Master's degrees, if you're not already a nurse, becoming an NP will still take a little longer due to the requirement that you work as a nurse before going on for your Master's (which provides excellent clinical experience).

PA's get their clinical experience through a heavy focus on clinical rotations and some choose to do residencies afterward, plus they are expected to continue their clinical training with the supervising physicians who hire them.

Either way, they are both great professions with a solid future in health care.

By anon176150 — On May 15, 2011

@Ahng: No, I am not bitter, just responding to the comments of anon48902's 'analysis' of NPs, which for the record sounded extremely disrespectful, condescending and ill-informed coming from a PA and "who has such contempt for professional colleagues should not be in the health care field at all!" (did you miss that part in anon48902's comments?)

Sorry if sharing my typical day came across that way. Because I enjoy it a lot.

I am not bashing PAs. I work with a couple (one with a construction background, one a former LPN/RN) who are nice but I admit, I get 'grumpy' when I am the one picking up the details that they miss.

@"There are PA's across this country doing exactly what you do..." In what part of the country do you see this? MDs prefer the NP role due to independent practice. Nothing personal to PAs (who by the way, how did they get board certification in Critical Care?). My PA peers don't get that training in their programs, and as for "style and grace," my motto is "leave when the work is done," which packs on the OT that I'd rather not, but then spares my PA peers from staying late, who I admit are quick to leave for family reasons, etc. (like I don't have family?). So much for not showing style and grace.

And for the record, my nursing background is what prompts me to stay because it's for patient care. Again, not bashing PAs or MDs, just noticing what is stressed as part of the Medical Model. Oh, and the same PAs and MDs have advised me to follow suit in how they do things (e.g., don't waste time on pesky details--leave it for IM, and leave it for tomorrow's workload -- again, their words not mine. So if you analyze their views, who shows more lack of consideration for their colleagues?)

One of these PAs is so "worried" about me helping in the OR as 'i don't belong' (her unkind words, not mine) even though she didn't realize that I had first assist training... Again, I am not bitter, just fighting for my right to practice.

By anon172746 — On May 04, 2011

This is the biggest load of crap I have read to date regarding the differences between PAs and APNs. The APN is more than capable of making treatment and care related decisions. The APN typically has more education than the PA. It is not required for the PA to have a Masters degree, while it is a requirement for the APP. APNs approach treatment from a holistic perspective while the APN uses the medical model. Lastly, APNs are able to bill for their services, unlike the PA.

By anon159124 — On Mar 10, 2011

OK can someone give me some feedback please as I'm not in the medical field yet but looking into becoming a PA. I'm in the UK and we are currently introducing the PA role into health care here. It is bit of a tester to see if it will work.

My problem is that I really don't understand what the point of a PA is if there are already NPs that could basically do the same job or take a few exams to validate them as a PA. I want to know if there really are differences between the job *role* (I'm not talking about the education, I'm just interested in the actual care and job they perform once graduate).

I like the look of the course and the job in entails afterward but I don't want to go into a pointless profession if there are other professionals (NPs) that already do the same job. Seems meaningless and wrong to me. I don't want to threaten other people's role, especially after they have worked so hard as nurses surely do.

Ideally, I would like there to be a reason (a difference) why the PA's should be introduced here as I would love to do the job. -Rebecca

By anon153625 — On Feb 17, 2011

Interesting comments. I will speak from the NP point of view. While it may be true that PA's get a wide variety of education, they often focus on one in the end - as stated above: ortho, internal medicine, derm, etc. And under a supervising physician. NP's may also be varied - and that would be the FNP. Others specialize in Peds, ob/gyn, geriatric and frail elderly and psych.

Both may also specialize in acute care and work as ER NPs or PASs, or hospitalists. In my state, MP's are able to practice independently, however PA's require a supervising physician.

The most important difference is the way we are educated. NPs are educated on the health model. PAs are educated from a medical model. They are different. So before you decide what you want to do, you should investigate the models and decide which you would like to do. Y

ou should also look at least at the state practice act where you plan to practice and see what type of practice you will have. I know nurses who have gone into one or the other for various reasons. Soon the NP will need a doctorate to practice - so make a choice soon!

By anon131057 — On Nov 30, 2010

For those of you who are either RN'a, PA or NP'a I would love to hear experiences that have made you be a better patient-care provider.

I think it is rather simple to belittle another profession- we all have egos. I respect you all because you know so many things I don't- I am a student trying to become one of these three professions.

What is a day like for you? What makes you happy being in your profession, not for what others around you do, but what makes you say "man, this is something I love about my job"?

By anon123021 — On Oct 30, 2010

Wow-some egotistical comments made about each profession. For those who said PA's are not as caring as NP's because they were not nurses first, think again. I was an RN in the ICU as well as cardiac rehab for years before becoming a PA-C. I did it because I had no desire to take nursing courses over again. I was delighted that the PA program was medically based and not nursing based.

NP's are totally threatened by us because we have more of a generalist education than they do. Many of us know surgery very well and we function many times more independently. I love the NP argument that we have to be supervised more. What a bunch of crap. I have seen some nurses work only a year and then go right in to NP school thinking they're more qualified than a PA who was an RN for 12 years before that. You have got to be kidding.

I just left the retail healthcare setting (Minute Clinic ) because some fat, bullying, NP District Manager couldn't stand the fact that the PA was excellent at her job. When is it ever going to stop?

I have numerous friends who are PA's and we get along just fine. Why? Because we are all here to do a job. I think the nurse practitioners who criticize us (PA's) do ii because you are not happy in your own job situations. Why can't we all just get along?

By anon117411 — On Oct 10, 2010

Anon48902's comment concerning MD/DOs having to complete a second residency to practice in another field is not entirely accurate.

This may depend on the area of the country he/she is from, but I used to work at a hospital whose Director of Emergency Medicine had only completed a residency in physical medicine and rehabilitation (not emergency medicine) and wasn't board certified in either.

Not all states require board certification to practice in a specific specialty (this is why I recommend patients always check the credentials of a doctor they are seeing).

His other misconceptions concerning the "differences" between NPs and PAs have been discussed by others on this board, but have any other readers who work in the medical field ever known a PA that works for multiple doctors (of multiple specialties) at the same time? Even the hospital based PAs I have worked with have all worked within the same specialty even if there are multiple doctors who "supervise" them.

Also all of the PAs I have ever worked with are too busy with patients from one "specialty" to even consider working in two or more specialties. It is possible here that he is referring to surgical assistants or PAs working as a Surgical Assistant for a hospital.

That said, I have worked with surgical assistants/surgical first assistants who assist with numerous types of surgeries and with numerous surgeons (i.e. neurosurgery, orthopedics, etc.); however, there again all PAs I know who work in a surgical specialty practice their full range of PA skills with just that specialty or group of doctors (even if they also first assist).

By anon107986 — On Sep 01, 2010

From a clinical perspective, as a patient, there is very little difference. When I was considering education as a PA-C or a NP (I am a bachelor's prepared RN), I consulted various physicians on their input.

The best advice I received was from an MD that I worked with in shock and trauma. He said, "Why be the bottom of someone else's field, when you can be the top of your own"? Good advice.

By anon107518 — On Aug 30, 2010

A rather lively discussion here.

When I got out of the military as a policeman, I was offered an opportunity by the Army to attend a program in Oklahoma that would make me a PA in two years (the Army was unaware that I was one class from a language and psych degree). I'm not sure if I'd even have received a PA degree.

I went on to complete my language arts degree with a minor in psych and decided, after doing some volunteer work, to become a registered nurse. This required another full four year degree.

I noted somebody said nursing is less rigorous academically, but after getting A's in calculus, taking a number of hard science courses and having to study physiology, pathophysiology, biology, inorganic chemistry and biochem/organic chemistry along with taking some pretty darned rigorous writing courses, in addition to the nursing core clinical courses, I'm not sure I'd agree.

Getting into a master's program to become a nurse practitioner required that I have clinical experience (I had two-plus years before I was accepted), got superb scores on the GRE and was willing to attend another rather rigorous two to three year program that was again, academically rigorous and clinically challenging.

I work with a number of PAs in my practice and all are good, solid clinicians and excellent resources -- and I view myself as much the same for them. Clinically, they require much more supervision from our providing physicians, in order to meet legal criteria than do the NPs.

Up until recently, in our state, if an RN completed a PA program, they were automatically NPs, but now they have to get master's degrees to become NPs. This is because the national boards for NPs now all require master's in order to sit for the exams. And billing requirements for some agencies require national certification as a requirement for NPs to bill.

Keep in mind that both PAs and NPs evolved to fit critical needs in the health care team. The PA is a construct of the physician/medical model arm and the NP is a construct of the nursing/holistic approach arm. There is a lot of overlap between the practices of the physicians, physician's assistants and NPs. And there are areas that each specialize in and do exceptionally well with.

I wouldn't disparage any of the team members. But for me personally, I have great appreciation for the NP and the NP role and that's why I chose this as my career field. It's a great field, with great people who care about people and providing excellent, evidence-based health care, without forgetting that we are caring for people.

By anon105649 — On Aug 21, 2010

NP's are trained using a nursing model while PA's are trained using the medical model.

PA's are like physicians in training and undergo over 4000 hours of didactic and clinical training, compared to NP's which complete on average 1100 hours of didactic/clinical training.

NP's have an RN degree first and advance their career via NP training or some other medical training. I have taught at both schools as I graduated from UC davis with both degrees. PA programs are significantly more involved academically compared to NP. It truly is a softer approach to being a clinician.

As an NP, I have the ability to practice without physician supervision in some states (but not really because I can't prescribe without a physician). Other than education, the difference between the two is merely semantics.

In some settings, the degree doesn't matter such as primary care. PA or NP - you get to do most of the same things, although the approach might be different. However, as a PA, I feel in many other practices, I have a much broader scope of practice. My PA license allows me to have the same scope as my supervising physician, but no more scope than my supervising MD. NP's I have worked with didn't work with the complex patients I was able to work with because of my training.

It's all in what you want. If you have a science background, go PA. If you have a nursing background, go PA or NP. Overall, I give PA the upper hand because of their education and autonomy/flexibility as a practitioner.

The generalist education is so very important. The NP programs I have taught at don't do the clinical rotations that PA programs do. Often the NP students have to find their own. The PA programs have very specific requirements of the programs they select and rigorous objectives for the student, but with experience I just don't know if it matters which you go to if you are properly supervised by the MD/DO. Anyhow, I'm going in circles. Let's put it this way: I would rather work with a newly minted PA than a newly minted NP any day. With experience, it depends on the person.

Only trying to be balanced and loyal to each profession.

By anon94314 — On Jul 08, 2010

I am both a nurse practitioner and a physician assistant. My observations after 30 plus years of practice is that a lot of what these health care providers do is driven by the practice they are in, as well as their own desires and motivations.

I am more surgically oriented than most NPs but I love surgery, urgent care and the ER.I have also worked in internal medicine and family practice. I love all aspects of medicine. Many folks in my position may not.(just like MDs)

I have found that NPs tend to be more experienced before they go into advanced practice since they have already had years of health care experience, usually in a hospital setting. Most states allow NPs to practice in a more independent fashion whereas a PA must always have a collaborative MD relationship.

By ahng — On Jun 28, 2010

Wow, anon 83042. Bitter much? You sure do seem to hate PA's and any health care provider who has such contempt for professional colleagues should not be in the health care field at all!

Oh FYI: There are PA's across this country doing exactly what you do, but with style and grace while being considerate to their colleagues!

By anon84277 — On May 14, 2010

This is ridiculous. all of these comments in response to the article are just bashing on PAs. You are all supposedly stating the differences but in reality, you are doing the same as the article, and that is belittling the profession that is being compared.

One of the key differences is that a PA can receive a BA in any field he/she wants and then proceed to a PA program where as any type of nurse, i.e. NP RN etc. has more of a history in nursing courses.

If someone does want to find more information on the difference between a PA and different Nurses search for a sight that does not belittle other profession, perhaps by looking at the state laws and policies that each profession has to follow.

By anon83042 — On May 09, 2010

To anon48902: i appreciate your input but am baffled by the 'softer side of medicine'.

For the record, I am board certified in trauma/critical care, cardiology as an NP. Do you consider Trauma/Critical Care softer? I work in such a unit, placing central lines and making medical decisions -independently and helping my PA colleagues who don't have a clue about running a code or whose notes are so anemic in substance they finish with the ever winning 'will discuss with my attending'. Geez, make a decision!

You're right about the lack of 'generalized education' for NPs because all of us have already had that at our bachelor's educational level. For my Master's level, I focused on critical care and cardiology. As for my notes, my surgeons, intensivists, etc. thank me daily for my detailed and 'sound reasoning' hence, them being able to sleep at night while I work independently. I don't see my PA colleagues doing that.

Oh, FYI: I do rounds on hospital patients, do leave notes, do present my plan of care. etc. because it is expected of me, like any of the doctors. As for the residents, yeah, I help to train them, too, about how to make decisions.

What is especially gratifying is when they get kudos on morning rounds for 'their' decisions. I would love to 'chat further' but there goes my trauma pager. Let's see -- will I be in the OR like I was last night, assisting? Or perhaps, just doing the usual rounds, admitting, etc. and making those pesky independent decisions without any help from my PA or even MD colleagues? Hmmm.

By anon75799 — On Apr 07, 2010

There seems to be quite a backlash against NPs in this country, which is more than likely physician initiated. You only have to read the physician's (if he is) comments above.

The "algorithms" he mentions are called evidenced based medicine and his patients should be concerned that he is not aware of them. In fact, a recent AMA study found that 42 percent of physicians were not following evidence based practice in treatment of hypertension and post-MI patients. Apparently those are the ones who have the "autonomy" to fly by the seat of their pants in making medical decisions.

People need to take into consideration that each state is different. In states like Georgia and Mississippi for instance the NP role is very restricted legislatively. Maybe he is from one of those states.

In New Mexico and Colorado, however, NPs assess, diagnose, order tests and prescribe medicine independently, just as a physician would. This is why physicians are in an uproar and seek to belittle NP abilities.

Most states are somewhere in between. Legislatively, PAs are pretty much the same from state to state because their scope of practice is controlled by physicians.

Basically, the bottom line is, if you are a patient and you go see a PA or an NP, you won't be able to tell much of a difference, except the NP may have a better "bedside manner."

There are good NPs and PAs and there are bad ones, just like anything else.

By anon65436 — On Feb 13, 2010

As a nurse practitioner, some of these comments are very discouraging. A PA better than an NP? That's not the point of any discussion of the differences between us. The points are that both professions are moving towards a PHD program as being required to practice.

No, you cannot work as a nurse or nurse practitioner if you are a PA and I could not work as a PA, because of different licensing. In my opinion you have a better chance at getting a job anywhere you go being in the nursing field, you are more autonomous.

As far as practicing style - many of us have a basic nursing focus but use more of the "medical model" as we gain more advanced knowledge. We manage at times very complicated patients and with practice can learn many advanced skills. You will find us everywhere.

By anon64495 — On Feb 07, 2010

Nurse Practitioners have master's degrees and can specialize in any field, sometimes receiving that additional training if hired by a physician who specializes.

I know of two NPs who work for specialists, not GPs (general practitioners). One works for a GI group, another works for a surgeon. Although they do not perform procedures, the surgical NP assists during surgery, just the same as many PAWs do.

Both of these NPs see patients in both the office and the hospital setting, and do pre-op work-ups and post-op follow-ups.

A PA, on the other hand, has not had the nursing background that the NPs have had. When they enter their master's programs, they generally enter with four year degrees in fields such as biology, biochemistry, or even pre-med.

Although they receive the training that they need in order to provide good patient care, they do not have the hands-on patient care experience that a NP has had.

Either provider gives excellent patient care and the salaries are comparable. Just a different path. Both types of providers are essential in helping our healthcare system function.

By anon64329 — On Feb 06, 2010

I am not sure I understand the whole PA program. I have looked into it and as long as you have a bachelors degree you can get in. You can have your bachelors in english and you can get in. How can you learn in two years how to diagnose and practice medicine? It takes doctors how long? Twelve years with school, internships, and residency?

At least NPs have a bachelor in something medical related, understand how the body systems work, and understand pharmacology.

By anon57830 — On Dec 27, 2009

I'm a little confused. Do you definitely need your masters degree in order to become a PA nurse?

By anon48902 — On Oct 15, 2009

A PA practices medicine and thus has supervision from a physician. NP's practice nursing, not medicine. They handle the more common problems in the clinic. I employ both. The PA has more autonomy because of their education and the fact that they are supervised by an MD/DO. They do more procedures, assist in surgery, and can practice within the scope of their supervising physician(s).

Another neat thing about PA's is their ability to work in any specialty. They can have multiple supervising physicians and practice in multiple specialties at the same time providing them with a broader scope of practice than any health care provider, *period*!

As a physician, I can't do that, I must complete another residency. Nurse practitioners must go back to school and specialize.

Another problem with NP's is their lack of standardized education and lack of generalist education that is seen in PA and MD/DO education. NP's typically use algorithms to practice where PA's, MD's, DO's have the autonomy to make medical decisions. If you want to practice medicine as a midlevel provider - GO PA. If you want to practice a softer type of healthcare that is less science based, go nursing/NP.

NP's sometimes practice independently because they don't practice medicine. PA's make rounds in hospital, act as house staff at major medical centers, and have the ability to make sustantially more money than NP's in ortho, cardio, gen sur, etc.

I enjoy working with both. The NP's at my practice see the more routine patients and keep the flow of my clinic moving. They also tend to do and have a special interest in women's wellness, which is sometimes nice to have an NP perspective on things. In all truth, RN's are the real warriors in healthcare. We would be lost without them. True nurses are RN's. NP's essentially practice a low level medicine...their notes and diagnosis look like mine. Although I often find their DDX rather unimpressive even with basic presentations. The ones I work with seem to know their limits and consult with each other or come get either the PA or MD.

Unedited and thanks for entertaining my perspective.

By anon28271 — On Mar 13, 2009

Physician assistants are trained in the medical model (as physicians are) - not as NP's (which are trained in the nursing model). The only reason NP's may independently practice (as mentioned in the article) is because state law's mandate PA's work alongside a physician. NP's that I have worked with are trained differently than PA's and in my opinion that training is inferior to that of PAs.

By anon26736 — On Feb 18, 2009

Hi. I have a simple question. What if I finish Physician's assistance program then in the state where I move there is no PA position. Can I be hired as a nurse practitioner or RN with my PA degree? Thank you

By anon24036 — On Jan 06, 2009

Most PA's graduate from a Masters Program's not Associates programs. Check any major university's web sites and see if they offer both programs. If they do, then they will give you more information about the two highly qualified care givers.

By anon23458 — On Dec 25, 2008

To anon11947, Majoring in nursing and working as a nurse will give you patient contact experience, but you don't necessarily have to. If you have a B.S. (I happen to have mine in health services admin), that's typically the requirement. Good luck in your endeavors!

By anon22321 — On Dec 01, 2008

anon17432 You have missed the point! The NP doesn't have "more" education per se , as a NON nurse you are not understanding. The nursing model and the medical model are not one in the same. The NP has both the medical model and the nursing model as their scope of practice, thereby they have a greater scope of care, treating medically and then holistically.

By anon17432 — On Aug 29, 2008

I agree with the above article, however the following statement cannot be further from the truth: "Nurse Practitioners, however, have an advanced level of education, training, and experience and therefore can have a wider scope of practice than other nurses and PAs". Both NPs and PAs hold M.S. degree, NPs from nursing schools, and PAs from PA schools that generally mirror medical school education. NPs are "advance" nurses who practice within a specialty of medicine, that is Adult NP, Psychiatric NP, Family NP, etc.. PAs on the other hand work under the scope of practice of a supervising physician, which may be in primary care, orthopedic surgery, internal medicine, emergency medicine, ob/gyn, dermatology, etc. PAs are trained in all fields of medicine, therefore to say that NPs have more level of education or training than PAs is missing the boat.

By anon11947 — On Apr 26, 2008

I am a High School student who will be a attending a community college soon. I plan to pursue a career as a physician's assistant, however i'm not sure what classes i'm suppose to take. so far i've spoken to a counselor and she has been of no help. i first thought that to become a PA you'd major in nursing but now i'm told that PA is a whole different level major. i am so confused. can someone please help me?

By anon6921 — On Jan 12, 2008

Some spell it "physician's assistant," but that implies a sense of ownership and therefore is not encouraged by those in the PA field.

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