Nurse Practitioner (NP) vs Physician Assistant (PA): Which Role is Right for You?

9 Min Read Published July 27, 2023
Nurse practitioner vs physician assistant: What's the difference?

If you're considering advancing your healthcare career, you're likely well aware of the many different directions your career could take. Two very popular paths are becoming a nurse practitioner (NP) or physician assistant (PA).

To help you with this very important decision, we've put together this guide explaining the differences between a nurse practitioner vs physician assistant, what each role does, how much you can earn, and more. Keep reading to learn which path is right for you.

Nurse Practitioner vs Physician Assistant: What's the Difference?

What is a Nurse Practitioner (NP)? 

A nurse practitioner is an advanced practice registered nurse (APRN) who has additional responsibilities for administering patient care than RNs. NP model draws from the nursing tradition, one that includes a whole person and wellness approach.

What is a Physician Assistant (PA)?

A physician assistant is a master’s prepared individual who works interdependently with licensed physicians to diagnose and treat illness and disease and prescribe medication for patients. The PA tradition draws from a medical model.

NP vs PA Comparison

  Nurse Practitioner (NP) Physician Assistant (PA)
Duties NPs are healthcare providers that can prescribe medication, examine patients, order diagnostic tests, diagnose illnesses, and provide treatment, much like physicians do. In certain states, they can work independently from a physician.

PAs have the ability to treat patients independently of a medical physician. They perform a variety of duties, including writing prescriptions, ordering and interpreting laboratory tests, assisting in surgery, performing minor bedside procedures, diagnosing patients, developing treatment plans, and obtaining patient histories.

Salary $123,780 / year  $121,530 / year
Education Master's degree Master's degree
Program Costs $35,000 - $70,000 $60,000 to $90,000
Scope of Practice

Can operate own practice in certain states.

Can operate own practice in certain states.

Career Outlook 46% predicted career growth from 2021-2031 28% predicted career growth from 2021-2031
Certification

NP recertification is every five years and requires the following:

  • A minimum of 1,000 clinical hours in your certified specialty 
  • 75 continuing education hours

PA recertification has two parts:

  • Complete 100 continuing education hours every two years
  • Pass a recertification exam every ten years

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Nurse Practitioner vs Physician Assistant Job Duties

Physician Assistant Job Overview

Physician assistants are among the best healthcare and overall career choices nationwide, according to US World News & Report. PAs rank #2 in healthcare jobs (right behind NPs!), #4 in STEM jobs, and #4 in the 100 best jobs in 2023.

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. Increases in medical technology and access to healthcare services further strain the healthcare system requiring an increase in advanced practice providers.

Some of the responsibilities of a physician assistant include: 

  • Take or review patients’ medical histories
  • Examine patients
  • Develop treatment plans and provide treatment
  • Order and interpret diagnostic tests
  • Diagnose a patient’s injury or illness
  • Educate and counsel patients and their families
  • Prescribe medication
  • Manage and monitor inpatients in the hospital setting
  • Conduct pre-employment physicals 
  • Perform worker compensation assessments
  • Assess and record a patient’s progress
  • Research the latest treatments
  • Conduct or participate in outreach programs
  • Educate managing diseases and promoting wellness
  • Assist in surgical procedures

Nurse Practitioner Job Overview

Nurse practitioners deliver advanced care to a variety of patients in the clinical setting. According to the American Association of Nurse Practitioners (AANP), NPs work “autonomously and in collaboration with healthcare professionals and other individuals to provide a full range of primary, acute, and specialty healthcare services.”

The idea of working independently of physicians is a great incentive for some people to move into the nurse practitioner career. In fact, the profession rates #1 for healthcare jobs and #2 in the top 100 jobs, according to the US News & World Report.

Other NP job duties include providing teaching and supportive counseling and referring patients and families as appropriate. They focus on health education and nursing interventions like health promotion and disease prevention. Certified registered nurse practitioners also collaborate with others to provide healthcare services to individuals, families, and communities. 

>> Related: Top Online Nurse Practitioner Programs

NP vs PA Work Environments

NPs and PAs can work in many of the same environments, but there are some differences:

Work Location Nurse Practitioner (NP) Physician Assistant (PA)
Hospitals, acute, or ambulatory care settings
Outpatient care centers
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 healthcare facilities
Nurse-managed medical centers
Physician offices  
Employment service offices  
Urgent care centers  
Surgery centers and surgical departments  
Psychiatric hospitals  
Orthopedics  
Dermatology  
Pathology  
Emergency medicine and critical care  
Adolescent and pediatric medicine  

NP vs PA Salary 

You'll find a slight difference when comparing the average nurse practitioner vs physician assistant salary. Physician assistants typically earn about $1,000 more than nurse practitioners annually. But, specific salaries vary depending on where you live, the specialty you pursue, your experience level, and several other factors. 

Nurse Practitioner Salary

Nurse practitioners earn a median annual wage of $120,680, according to the US Bureau of Labor Statistics. However, the NP salary range spans from $79,870 in the bottom 10th percentile to $165,240 in the top 90th percentile.

Highest Paying States for Nurse Practitioners

Nurse practitioners earn the highest annual salaries in these states, according to BLS reports:

  • California: $158,130
  • New Jersey: $143,250
  • Massachusetts: $138,700
  • Oregon: $136,250
  • Nevada: $136,230

Physician Assistant Salary

PAs earn a median annual wage of $121,530, according to the most recent BLS reports. Physician assistant salary ranges from $77,940 or less in the lowest 10 percentile to more than $164,620 in the highest 90th percentile.

Highest Paying States for Physician Assistants

PAs earn the highest annual salaries in the following states, per BLS data:

  • Washington: $145,390
  • California: $144,520
  • Alaska: $144,460
  • Connecticut: $143,280
  • Nevada: $141,360

>> Get Started! Find Nurse Practitioner Programs

Nurse Practitioner vs Physician Assistant Education Requirements & Programs

Program length is roughly the same for both a PA vs an NP after earning a bachelor’s degree. Both tracks consist of master’s level programs that students can complete in 2-3 years, depending on the specific program.

  • Nurse Practitioner (NP): Individuals with a BSN should expect to spend 2-3 years obtaining their advanced practice nursing degree through a combination of didactic classroom learning and practicum hours. 
  • Physician Assistant (PA): With a bachelor’s degree and the required prerequisites, a PA program takes an additional 2-3 years of classroom and clinical practice hours.

NP vs PA Program Costs

NP school tends to be cheaper because the classroom portion is often completed online, while PA students must be on campus for all of their program components.

  • The average cost for NP school is between $35,000 and $70,000.
  • The average cost of PA school is between $60,000 to $90,000.

NP vs PA Scope of Practice

The nurse practitioner vs physician assistant scope of practice has subtle yet vital differences. For starters, NP education requires students to select a specialty that will prepare them to serve a specific population. Physician assistants have a broader, more general medical background. 

But PAs may also specialize. Often, physician assistants choose a surgical specialty, while NPs work mostly at the patient's bedside throughout their hospitalization.

Physician Assistant Scope of Practice

The American Academy of Physician Assistants reveals that a PA's scope of practice is often decided at the practice level rather than by the state. Although physician assistants take on many of the responsibilities of general physicians, the two have key differences.

PAs collaborate with general physicians to perform patient examinations, diagnose and treat illnesses, prescribe medications, and perform other day-to-day medical services. Similar to a nurse practitioner, PAs can also practice independently of a physician in certain states.

Nurse Practitioner Scope of Practice

In 23 states, nurse practitioners have “full practice authority,” which means they do not have to work under the supervision of a doctor. US states with nurse practitioner full practice authority include but aren't limited to:

  • Oregon
  • Maine
  • Alaska
  • Hawaii
  • Washington
  • Iowa

In states with reduced practice (Ohio, Pennsylvania, and Utah) and restricted practice (Texas, California, and Florida), NPs must have a medical doctor sign certain medical patient care decisions. NPs have prescriptive privileges in all 50 states and can administer controlled substances in 49 states.

Nurse practitioners evaluate their patients holistically, including both the emotional and mental aspects of the patient’s condition and not just the physical. For this reason, a great deal of time is spent on the education aspect of patient care.

Can NPs and/or PAs operate their own practice? 

In certain states, PAs and NPs may operate their own practice. This regulation is called full practice authority, which differs by state for each occupation.

>> Find Nurse Practitioner Programs Accepting Applications Now

NP vs PA Career Outlook

According to the US Bureau of Labor Statistics, the need for nurse practitioners is expected to grow by 46% by 2031. This is much faster than the national average of other healthcare-related professions, including physician assistants, which are expected to grow in demand by 28%. 

NP vs PA Certification

As an NP, you must complete a recertification every five years by completing 1,000 clinical hours in your certified specialty and separate continuing education (CEU) hours. The PA recertification process has two parts, which includes 100 hours of continuing medical education (CME) hours every two years and a recertification exam every 10.

Nurse Practitioner (NP) Certification

The American Nurses Credentialing Center requires certification renewal every five years. Before completing their recertification, NPs must complete 1,000 clinical hours and 75 CEU hours. Of the 75 CEU hours, 25 must be in pharmacology.

The National Council of State Boards of Nursing website also mentions the following five nurse practitioner certifying organizations:

  • American Academy of Nurse Practitioners (AANP-CP)
  • American Association of Critical-Care Nurses (AACN)
  • American Nurses Credentialing Center (ANCC)
  • National Certification Corporation (NCC)
  • Pediatric Nursing Certification Board (PNCB) 

Chart Source NCSBN.org

Physician Assistant (PA) Certification

The National Commission on Certification of Physician Assistants has 10-year certification cycles. PAs must earn at least 100 continuing education credits every two years. At the end of five of these 2-year cycles, every ten years, physician assistants also take a recertification exam.

Nurse Practitioner vs Physician Assistant: Why Both Are Great Career Choices

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 healthcare providers is increasing by the day. Plus, the need for these professions has escalated because of the Affordable Care Act, with more than 40 million more people added to the primary care systems after finally getting health insurance in the last two years.

“Physician assistants and nurse practitioners are more 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.

Nurse Practitioner vs Physician Assistant FAQs

  • Is an NP higher than a PA? 

    • Both NPs and PAs are mid-level practitioners, but in many states, NPs can operate independently, while PAs can not. 
  • Is it better to see a physician's assistant or a nurse practitioner?

    • Both NPs and PAs can provide safe and quality care. NPs follow more of a nursing model with a focus on preventive health and education, while PAs are trained more in a medical model. 
  • What can a PA do that an NP cannot?

    •  Both PAs and NPs can assess and diagnose medical conditions, issue orders such as lab work and diagnostic tests, and prescribe medications. 
  • Can PAs intubate?

    • An emergency medicine PA can intubate a patient. 
  • Is a PA higher than an RN?

    • A PA and RN both work together as part of a healthcare team, but PAs can legally diagnose and order medications, while RNs cannot. 

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Kathleen Gaines
MSN, RN, BA, CBC
Kathleen Gaines
News and Education Editor

Kathleen Gaines (nee Colduvell) is a nationally published writer turned Pediatric ICU nurse from Philadelphia with over 13 years of ICU experience. She has an extensive ICU background having formerly worked in the CICU and NICU at several major hospitals in the Philadelphia region. After earning her MSN in Education from Loyola University of New Orleans, she currently also teaches for several prominent Universities making sure the next generation is ready for the bedside. As a certified breastfeeding counselor and trauma certified nurse, she is always ready for the next nursing challenge.

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