Nurse Practitioner or Physician Assistant

Exploring the Differences Between an NP and a PA

Of all the degrees in nursing and medicine, Nurse Practitioner (NP) and Physician Assistant (PA) are the two most commonly compared by aspiring healthcare students. From a patient perspective, there may be little or no apparent difference; patients are simply seeing a provider for care.

Both NPs and PAs also have advanced education. NPs earn their degrees in nursing and must achieve a minimum of a Master of Science in Nursing (MSN) from an accredited school to become licensed within a state. PAs need a minimum of a master’s-level degree from an accredited medical school or center of medicine to seek licensure. Both are certified to prescribe medications in most states. Both can order and perform diagnostics. Both may assess health and deliver prognoses. And both can determine courses of treatment for acute and chronic conditions. At first glance, you get a lot of “boths.”

At second glance, you’ll find the distinction between an NP and a PA meaningful, and it significantly affects how each studies and approaches patient care.

Approach to Learning

Let’s start with PAs. Physician Assistants are instructed and practice in the “medical model,” similarly to physicians. The education for a PA degree resembles study toward an MD, focusing on diagnosis, testing and treatment of a disorder through a disease-centric approach. A PA trains as a generalist, meaning that they can practice in just about any specialty: orthopedics, internal medicine, urology, etc.

By contrast, Nurse Practitioners (and nurses more generally) are educated in the “nursing model” to work with a specific patient population: children, women, geriatric, and more. And within those populations they may specialize further: neonatal, acute care, family care, etc. NPs train to focus on the patient and how they are affected by a disorder. A nursing course of study is highly patient-centric.

Approach to Practice

This major distinction in educational approach presents a philosophically different, if equally important, approach to practicing medicine. In oversimplified terms, the NP focuses on the individual while the PA focuses on the condition. Of course, the overlap is considerable and the foundational knowledge required for both professions is mutually inclusive when it comes to scientific base and clinical practice.

In many circumstances the patient’s primary point of contact throughout diagnosis, treatment and management can be an NP or a PA, and receive excellent care.

Autonomy

Another – and perhaps the most important – key difference between a PA and an NP is autonomy. A Nurse Practitioner is considered an independent provider who practices under their own license. Some NPs even choose private practice, though many continue to work in highly collaborative spaces and in close concert with other medical professionals. Physician Assistants operate with significant autonomy, but must practice under a collaborative physician’s license, although there is some ongoing movement within the industry to lift restrictions on autonomy for PAs.

In deciding which of these rigorous degrees to pursue, consider the path: medical school versus nursing school; patient centricity versus disease centricity; autonomy versus teamwork. Whichever path you choose, and wherever you opt to practice, you’ll be an indispensable authority on medicine and care.

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