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    EDUCATION
    August 23, 2021

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

    Kathleen Gaines
    By: Kathleen Gaines MSN, RN, BA, CBC

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

    To help you with this very important decision, we've put together this guide explaining the differences between a nurse practitioner and a 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 (NP) vs Physician Assistant (PA): What's the Difference?

    What is a Nurse Practitioner (NP)? 

    A Nurse Practitioner (NP) is an Advanced Practice Registered Nurse 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 (PA) is a Master’s prepared individual that works interdependently with physicians who are licensed to diagnose and treat illness and disease and to prescribe medication for patients. The PA tradition draws from a medical model.

    NP vs PA 

      Nurse Practitioner (NP) Physician Assistant (PA)
    Duties NPs are health care 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 $111,680 / year  $115,390 / 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 45% predicted career growth from 2019-2029 31% predicted career growth from 2019-2029
    Certification

    NP recertification is every two years and requires a minimum of 1,000 clinical hours in your certified specialty and continuing education hours.

    PA recertification is two parts. Every two years, 100 continuing education hours are required and every ten years a recertification exam must be passed.

    Show Me Nurse Practitioner Programs

    Nurse Practitioner vs Physician Assistant Job Duties

    Physician Assistant Job Overview

    According to U.S. World News & Report, working as a physician assistant is THE BEST job you can have in 2021. They ranked PAs as #1 in best health care jobs, #1 in 100 best jobs, and #1 in best STEM jobs. 

    An increase in the number of patients with chronic diseases, such as diabetes, are 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 strains 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
    • Order and interpret diagnostic tests
    • Diagnose a patient’s injury or illness
    • Provide treatment
    • 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 health care 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 #2 as the best job in health care and the #3 job overall in the top 100 jobs, according to the U.S. News & World Report.

    NPs provide teaching and supportive counseling and refer patients and families as appropriate. They focus on health education, health promotion, and disease prevention. CRNPs also collaborate with others to provide health care services to individuals, families, and communities. 

    Work Environments

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

    • Nurse Practitioner (NP)
      • Hospitals, acute care or ambulatory care settings
      • Outpatient settings
      • 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 health care facilities
      • Nurse-managed medical centers
    • Physician Assistant (PA)
      • Physician offices
      • Hospitals
      • Employment service office
      • Outpatient care centers
      • Urgent care centers
      • Surgery centers
      • Government and community health agencies
      • Universities and research agencies
      • Healthcare or health industry businesses
      • Phone triage centers
      • Rural health care facilities
      • Nurse-managed medical centers
      • Psychiatric Hospital
      • Orthopedics
      • Dermatology
      • Pathology
      • Critical Care
      • Surgery
      • Emergency Medicine
      • Adolescent Medicine
      • Pediatrics

    Nurse Practitioner vs Physician Assistant Salary 

    On average, physician assistants earn around $3.7K more than nurse practitioners annually. But salaries vary widely based on where you live, your specialty, and a number of other factors. 

    Nurse Practitioner Salary

    According to the Bureau of Labor Statistics, the median pay for nurse practitioners was $111,680, in 2020. The lowest end of the salary range for nurse practitioners is $84,120 and the high end of the range is $190,900.

    Highest Paying States for Nurse Practitioners

    The BLS reports the following states as having the highest mean salary.

    • California - $145,970
    • New Jersey - $130,890
    • Washington - $126,480
    • New York - $126,440
    • Massachusetts - $126,050

    Physician Assistant Salary

    According to the BLS, the median pay for physician assistants was $115,390 in 2020. The lowest 10 percent earned less than $76,700, and the highest 10 percent earned more than $162,740.

    Highest Paying States for Physician Assistants

    The BLS reports the following states as having the highest mean salary.

    • Alaska - $150,430
    • Connecticut - $146,110
    • Rhode Island - $135,800
    • California - $135,180
    • Nevada - $134,710

    Show Me Nurse Practitioner Programs

    NP vs PA Education Requirements & Programs

    Program length is roughly the same for both a PA and an NP after earning a bachelor’s degree. Both are master’s level programs and can be completed in 2-3 years depending on the specific program.

    • Nurse Practitioner (NP): Individuals with a BSN should expect to spend 2-3 years to obtain 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.

    Program Costs

    NP school tends to be cheaper because the classroom portion is often completed online while PAs must be on campus for the program. 

    • 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

    Nurse practitioners are educated to serve a specific population while Physician assistants have a more general background.

    Physician assistants tend to have a surgical specialty while NPs are more at the patient’s bedside throughout the hospitalization.

    Physician Assistant Scope of Practice

    The role of a physician assistant is confusing because the scope of practice is often similar to that of a general doctor, but there are some key differences. Similar to a nurse practitioner, PAs can 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. Full practice states include Oregon, Maine, Alaska, Hawaii, Washington, and 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? 

    Both PAs and NPs can operate their own practice in states that allow full authority. This is very state-specific. 

    Show Me Nurse Practitioner Programs

    NP vs PA Career Outlook

    According to the U.S. Bureau of Labor Statistics, the need for nurse practitioners is expected to grow by 45% by 2029. This is much faster than the national average of other healthcare-related professions included Registered Nurses. 

    According to the U.S. Bureau of Labor Statistics, the need for physician assistants is expected to grow by 31% by 2029. This is one of the largest growing fields in the healthcare industry. 

    NP vs PA Certification

    NP recertification is every two years and requires a minimum of 1,000 clinical hours in your certified specialty and continuing education hours.

    PA recertification is two parts. Every two years, 100 continuing education hours are required and every ten years a recertification exam must be passed.

    Nurse Practitioner (NP) Certification

    The American Nurses Credentialing Center requires certification renewal every two years. 1,000 clinical hours during the two-year certification and completion of 75 CEU hours including 25 of pharmacology CEU hours are required. 

    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. During every two-year period, professionals must earn at least 100 continuing education credits. At the end of each 10-year cycle, PAs must pass a recertification exam.

    Why Becoming Either an NP or a PA is a Great Career Path

    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 health care 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.

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