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

The roles of Nurse Practitioners (NPs) and Physician Assistants (PAs) are both crucial in delivering healthcare services, especially in primary care and underserved areas. While their responsibilities often overlap, there are key differences in their training, approach, and scope of practice.

Read on to learn the differences in NPs vs PAs when it comes to educational background, scope of practice, salary and more. 

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

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NP vs PA Comparison

	Nurse Practitioner (NP)	Physician Assistant (PA)
Duties	NPs are healthcare providers who 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	$129,210  / year (BLS)	$133,260 / year (BLS)
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	38% predicted career growth from 2023-2033	28% predicted career growth from 2023-2033
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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NP vs. PA Primary Differences

The main differences between nurse practitioners (NPs) and physician assistants (PAs) lie in their educational backgrounds, approach to care, and scope of practice.

Training & Approach

• NPs are trained in the nursing model, which emphasizes patient-centered care, health promotion, and disease prevention, and they typically specialize in specific populations (e.g., family, pediatrics, geriatrics). 
• PAs, on the other hand, are educated in the medical model, similar to physicians, with a focus on disease pathology and diagnosis across all populations.

Scope of Practice

Both NPs and PAs can diagnose conditions, prescribe treatments, and work independently in many states. However, there are some differences in their scope of practice:

• NPs often have more autonomy in practice, especially in states with full practice authority.
•  PAs generally work under a physician's supervision, though the degree of oversight varies by state and employer.

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Nurse Practitioner vs Physician Assistant Education Requirements 

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.

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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		✓

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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.

 

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NP vs PA Career Outlook

According to the US Bureau of Labor Statistics, the need for nurse practitioners is expected to grow by 38% by 2033. 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.

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How to Choose Between Becoming a PA or an NP

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.

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.