Nurse Practitioner versus Physician Assistant

I decided to write this post because I know that I was confused about the difference between these two healthcare professions when I first started out. Some of you may be considering one or the other of these and are not quite sure exactly what each of them do. I will break down the main differences between these two roles.

PHYSICIAN ASSISTANT

Physician Assistant’s, like nurse practitioners are what are referred to as “mid-level practitioners”. These are non-physician healthcare personnel who provide some of the same services as a physician. They order and interpret diagnostic tests, diagnose and treat certain diseases, and prescribe medications. They also conduct physical exams and give medical orders. The first Physician Assistants were former navy hospital corpsmen, trained according to the curriculum, developed during World War II to quickly train Medical Doctors. While the role of the Physician Assistant is similar, in ways, to that of a Nurse Practitioner, there are some important differences. Perhaps the most important difference is that the Physician Assistant must always practice under the supervision of a Medical Doctor. Why is this important? Because every service that the Physician Assistant provides is, technically, being provided under the supervision of a physician, the PA is reliant on his or her supervising physician in a way that the NP is not. While, in practice, the PA is often quite autonomous, he or she is reliant on the Physician for their license. This means that the PA cannot ever practice completely independently, for instance setting up their own practice.

NURSE PRACTITIONER

This contrasts with the Nurse Practitioner, who can practice independently under their license and so can be considered more professionally independent. In fact, in some states, namely Arkansas, Arizona, Iowa, Idaho, Montana, New Hampshire, New Mexico, Oregon, and Washington, as well as Washington D.C., Nurse practitioners can function completely independently from a physician, setting up their own independent practices and billing Medicare or insurance companies directly for their services. Other states regulate NPs more strictly and often they require them to have an “agreement” with a physician, who will often sign off on their charts. In these states, the NP ultimately ends up with a similar level of autonomy in practice.

There are some other important differences between PAs and NPs. One is that they have different philosophies of care. Nurse Practitioners, being registered nurses themselves, approach patient care from a holistic, patient centered standpoint, while Physician Assistants are trained in the medical model of disease treatment. This difference can be subtle and hard to pin down in practice, however it is something to keep in mind if you are deciding which path to take. Check back soon for an explanations of the different education requirements for each of these two professions!