America has been dealing with a physician shortage for the past decade, and by 2032, it’s projected to become even worse. Therefore, nurse practitioners (NPs) and physician assistants (PAs) have become an increasingly important part of American healthcare in recent years. Both of these jobs are ideal for someone who wants to work directly with patients in an advanced healthcare role without the additional responsibilities that physicians face.

NPs and PAs are both required to earn an advanced degree before working with patients. They share many job duties, and often work in the same facilities, including:

  • Hospitals
  • Clinics
  • Rehab facilities
  • Nursing homes
  • Independent practices

Although their roles overlap in many ways, NPs and PAs are more different than you might think. They have major differences in autonomy and scope of practice, as well as the care model they follow.

What is a nurse practitioner?

Like all nurses, nurse practitioners follow a patient-centered model. Their main focuses are disease prevention and health education, and they embrace a patient-centered approach. They aim to improve the overall health and wellness of the patient, and they’re sometimes known to take a holistic approach.

Usually, nurse practitioners will be trained to work with a specific population such as children or the elderly. This allows them to become familiar with unique concerns that other practitioners may overlook

Some of their main responsibilities include:

  • Educating patients on specific health concerns
  • Counseling patients on chronic issues
  • Monitoring and recording vital signs
  • Observing and reporting side effects of medication

Although nurse practitioners have full practice authority in 20 states, they often work closely with doctors to care for their patients, especially with more complex issues. Since their methodologies are patient-centered, they may need input from other specialists when it comes to diagnosing complex diseases.

What is a physician assistant?

 While nurses follow a patient-centered model of care, physician assistants abide by a disease-centered model. They’re more interested in the biological side of healthcare, as well as the pathological. Since their training is centered around identifying pathogens and diseases, they may have an easier time identifying complex conditions than a nurse practitioner.

Their main responsibilities include:

  • Performing physicals
  • Ordering and interpreting lab tests
  • Prescribing medication
  • Referring patients to specialists
  • Diagnosing illnesses
  • Giving vaccines
  • Compiling reports

Unlike nurse practitioners, most states require PAs to have an overseeing physician in order to practice. They aren’t permitted to start their own independent practices, so they have less autonomy than NPs. Many PAs choose a specialty such as orthopedics or cardiology and work closely with doctors to diagnose and treat patients.

What is the difference between a nurse practitioner and a physician’s assistant?

 Although NPs and PAs both work beneath doctors to diagnose and treat illnesses, the two fields have some major differences. Therefore, it’s important to consider which path would be best for your unique career goals before choosing a degree program.

  • Salary: According to the BLS, the average physician assistant earned $108,610 in 2018. In contrast, the average nurse practitioner earned $113,930 per year. Although ~$5,000 per year may not seem like a major difference, over the course of your entire career this could end up amounting to quite a bit. Therefore, nurse practitioners have a significant salary advantage over physician assistants.
  • Scope of Practice: While NPs have full practice authority in nearly half of the US, PAs are always required by law to work under a registered physician. Additionally, PAs face stricter prescription requirement than NPs: For example, their ability to prescribe controlled substances is limited in Kentucky. Therefore, NPs have a broader scope of practice than PAs in many parts of the U.S.
  • Examinations: While nurse NPs are required to pass the FNP exam in order to become certified as a family nurse practitioner, PAs typically take the five-hour PANCE exam after graduation.

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Should I become a nurse practitioner or a physician assistant?

Many students have a hard time choosing between these two exciting career options. To make your decision easier, you should consider your own educational background. If you already have a nursing degree, then a career as a nurse practitioner would be the most logical choice. However, if you have an undergraduate degree in a different field, such as Biology or Chemistry, PA school may be the best option for you.

Pursuing a career as a PA will allow you to undergo extensive training before you ever see your first patient. Since you’ll go through 2,000 clinical hours before earning your license, you’ll be better prepared than nurse practitioners when you land your first job. You’ll also work closely with doctors throughout your entire career, so you’ll always have someone to consult if you encounter a difficult case. Plus, you’ll be better-equipped to identify complex diseases in your patients.

Also, it’s important to note that PAs are facing slightly faster job growth than NPs in the United States. Although the growth rate between the two fields isn’t a major difference, it’s still something to take into account when browsing through programs.

Nurse practitioners have greater autonomy than physician assistants, but this also means more responsibility: If you choose a career as an NP, it won’t be as easy to consult with a doctor, especially if you run your own practice—however, you’ll earn a slightly higher salary for your trouble.

Since the two fields have so much overlap, choosing between a career as a NP or a PA can be difficult. However, with a bit of research and determination, you’ll be able to make the right choice and find your perfect school!

Erica Ciko Campbell

Bachelor of Science (B.S.), Biology| Utica College

Associate of Science (A.S.)| Herkimer County Community College

November 2019

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