If you Google the topic, "np vs pa", you come up with several discussions that basically leave an NP offended or with nothing. You'll read that PAs don't even have a clue. PAs are referred to as "mini-doctors" and "doctor wannabes" and NPs, well, a nurse is some sort of nurse...Being an NP, maybe I am a little bias, but the patient's well-being is #1.
Overview:
Nurse Practitioner (NP): An NP is an "advanced practice RN" in the nursing world and a "mid-level provider" (sorry AANP) in the medical world. The Board of Nursing regulates NP licenses and certifications in specialties are through different organizations. There are several types of NP certifications such as family, adult, pediatric, women's health, and so on. Laws vary from state on what NPs can do, prescribe, and whether or not they have to have a collaborative agreement with a physician to practice. NPs can diagnose, prescribe some medications, perform some procedures... They general see less acute patients. NPs are generally trained to be more focused on patient education. Nurses also have some other options for post-grad degrees!
Physician Assistant (PA): PAs are also mid-level providers but they are regulated by the Board of Medicine. They have one national exam to pass. They always practice under a supervising physician.
*Mid-level provider (MLPs): Sorry, AANP. There are three types: NPs, PAs, and CRNAs (Certified Registered Nurse Anesthetists). They almost always have a supervising physician (NPs in some states may not).
Education:
Nurse Practitioners: The majority of NPs have an MSN, since now it is an MSN program. Programs are usually 1.5-2 years. NP programs require you be an RN (except accelerated programs where you have a BS and get a BSN, RN, and MSN in one year). A BSN might be required, but a BS in another area may be fine. The amount of required and type of experience may vary based on school and program.
Some NPs may have a doctorate degree. Nurses have the option of a DNP, Doctorate of Nursing Practice, in addition to the traditional Ph.D option now. The DNP is more clinically oriented, rather than going the academic/research route. This is another discussion for later.
Physician Assistants: PAs go to school at least 2 years post-grad with classroom and clinical training. Typically, the admission requirements seem to involve taking certain undergrad science classes, or a certain number of natural science classes (chemistry, physics). They are not required to have any previous medical training, however, some sort exposure to healthcare may be required. I believe they generally are exposed to more clinical areas than NPs, due to NP program specialties.
Duke calls itself "The birthplace of the PA profession". They report that:
Working interdependently with physicians, PAs provide diagnostic and therapeutic patient care in virtually all medical specialties and settings. They take patient histories, perform physical examinations, order laboratory and diagnostic studies and develop patient treatment plans. In all states, including North Carolina, PAs have the authority to write prescriptions. Their job descriptions are as diverse as those of their supervising physicians, and include patient education, team leadership, medical education, health administration and research.
One-third of graduate PAs provide primary health care services, especially in family and general internal medicine. About 40% of graduate PAs work in hospital settings. About one-fourth of all clinically active PAs work in surgery and its subspecialities.
Acceptance by MDs into practice:
So, that is a fun topic...I am still working on this article but for now, my opinion: Doctors who have worked with NPs, seem to love them, but PAs are more widely accepted in the medical world by physicians.
My father is an MD, so he gets all these wonderful free journals and newsletters my mom (a CRNA) and I can read! The Board of Medicine in my state has had this on-going idea that NPs are not worthy providers and that they are trying to get more freedom and expand their scope pf practice, which absolutely cannot be tolerated. So, those are always interesting articles to come across.
There are some areas you may typically see PAs but NPs can certainly fill those positions too.
The importance of mid-level providers to healthcare:
If 30 million Americans would be in need of a primary care provider (PCP), should we all receive healthcare, how are we going to handle that when we already have a PCP shortage? We have a major shortage in rural areas already. Plus, have MLPs are cheaper than MDs or DOs (that difference is easier to look up).
Resources:
NPs:
- Nurse Practitioner by International Foundation of Employee Benefit Plans, Inc. (2003): http://www.ifebp.org/pdf/harker/Nurse_Practitioners.pdf
PAs:
- Duke University School of Medicine: Physician Assistant Program: http://paprogram.mc.duke.edu/PA-Program/
- US Dept of Labor, Occupational Outlook Handbook 2010-11: http://www.bls.gov/oco/ocos081.htm
MLPs:
"Midlevel Providers Fill Primary Care Doctors' Shoes" by Julie Rovner: http://www.npr.org/templates/story/story.php?storyId=129398647
Who gets paid more money a nurse practitioner or a CRNA?
ReplyDeletenurse practitioner or crna