Should you pursue a career as a physician assistant or nurse practitioner?
Both physician assistants (PAs) and nurse practitioners (NPs) are vital members of the healthcare team, and often perform similar responsibilities.
PA and NP scope of practice depends on state laws, hospital rules and decisions about team practice made by the supervising or collaborating physician.
“From my perspective, they are both essential health professionals," says Kathy Magilvy, RN, PhD, FAAN, FWAN, professor and associate dean for academic programs at the University of Colorado College of Nursing, in Denver. "There is not one that is better than the other.”
A PA's medical responsibilities range from basic primary care to high-technology specialty procedures. They can also act as the first or second assistants in surgery and provide pre- and postoperative care.
State law governs the PA's role and responsibilities depend on education, experience and practice setting. Supervising physicians also have a say in what aspects of care a PA participates in, as they are often responsible for delegating work.
PAs are educated and credentialed as generalists with a primary care focus. PA education follows a medical model, similar to medical school training but shorter in duration (average 115 weeks vs. 155 weeks).
Anita Duhl Glicken, the associate dean for PA studies and director of the child health associate/physician assistant program at the University of Colorado School of Medicine, in Denver, said that the time it takes to become a PA depends on the program. “There is considerable variability in this. For example, we are a three-year program (36 months), with classroom and clinical experience integrated across all three years.”
The Physician Assistant Education Association (PAEA) requires that all PA students complete nine to 12 month of classroom studies and another nine to 15 months of supervised clinical rotations. All PAs except for those employed by the federal government and credentialed under a separate system, must have graduated from an accredited PA educational program and been certified by the National Commission on Certification of Physician Assistants (NCCPA). They must recertify every six years to maintain their NCCPA certification.
NPs diagnose and treat common acute illnesses and injuries, in addition to conducting physical exams. They can provide immunizations and manage chronic conditions including hypertension or diabetes. Some can interpret X-rays and lab tests. In addition to clinical care, NPs counsel patients in areas that include health promotion, disease prevention and health education.
“A nursing perspective means that we are interested in health as viewed holistically, not just the absence of disease," Magilvy told Clinical Advisor. "We are focused on individual patients/clients, as well as their families, communities and populations. We view health as influenced by many factors such as biology, genetics, environment, individual differences, family and community, and use a nursing model as we care for patients and their families."
To become an NP, students must first earn a registered nurse (RN) degree. Most nurses do this by attending a program to receive either an associate's degree in nursing (ADN) or a bachelor of science in nursing (BSN). After this aspiring nurses must pass the National Council Licensure Examination for RNs (NCLEX-RN) to earn license in the state in which they choose to practice.
Nurses wishing to pursue a graduate degree in nursing must complete a BS or BSN degree. After admission into a graduate program, an RN can then complete advanced practice education to earn either a master of science (MS) or a doctor of nursing practice (DNP).
If a student wishes to pursue a graduate education in nursing, he or she must complete a BS or BSN degree in nursing. After completing an advanced practice nursing program, NPs must become board certified in a specialty area of their choice.
NPs have the ability to prescribe medications in all states, according to the American Academy of Nurse Practitioners, and recently14 states and the District of Columbia granted NPs authority to practice independently.
Susan Schooleman is a freelance medical writer living in the greater Denver area.