Physician Assistants vs. Nurse Practitioners

As the former owner of a hospitalist group and several ambulatory clinics, I focused on hiring all the physicians in the group. I was also responsible for hiring all the Physician Assistants (PAs) and Nurse Practitioners (NPs). Based on my experience, I can speak to the difference between PAs and NPs.

With medical school becoming nearly impossible (unless you’re willing to sacrifice your entire life to student loan debt), it’s no wonder that many pre-med aspirants are turning to alternative routes.

The two most popular options for those looking for jobs in healthcare are nurse practitioners and physician assistants. Both don’t require years of medical school and have a pretty good outlook for employment in the future.

Those aren’t the only similarities that the two fields share. Many students are often confused about their differences, as they have similar job descriptions. They also find it confusing to choose between the two majors at the academic level.

The professions share some common characteristics. Both NPs and PAs can:

• Conduct health assessments
• Order diagnostic tests
• Diagnose medical conditions
• Prescribe medications

Herein lies the dilemma: Nurse practitioner vs. physician assistant?

Contrary to how alike the two are, there are many differences between being a physician assistant and being a nurse practitioner. From their academic curriculum to their role in the healthcare system, let’s break it all down:

• What are the main differences between a physician assistant and a nurse practitioner?
• How do you choose which one is the right option for you?
• Why are both essential jobs in medicine?

Physician Assistant Vs. Nurse Practitioner: What’s The Difference?

Let’s get our definitions out first:

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A nurse practitioner is a nurse who has studied and been tested for an advanced level of clinical duties. Therefore, they can do some of the same work a doctor normally would, such as treating diseases, performing specific physical exams, and more. This means they go above and beyond what a registered nurse is usually allowed. In addition to coursework, NP programs typically include a clinical practicum of at least 500 hours under the supervision of a preceptor.

On the other hand, a physician assistant is a licensed healthcare professional who can practice medicine independently with a physician present. They usually hold a graduate degree and work as clinicians to provide direct patient care, which includes diagnosis and treatment, ordering texts and x-rays, and even assisting in surgery.

The two are often lumped together because of their similar roles. After all, nurse practitioners and physician assistants give direct patient care and can practice in the ambulatory clinic setting and in healthcare facilities including hospitals. So essentially you can see both in almost all healthcare settings.

However, the key difference lies in the training. Where nurse practitioners are required to approach their studying material from an advanced nursing perspective, physician assistants take a more medical school-aligned approach.

Physician assistants are usually required to have a Master of Science in Physician Assistant Studies (MSPAS) to qualify as one. And that master’s degree usually has a disease-and-treatment style curriculum that isn’t too different from what a regular medical student would study. And just like medical graduates, they can go on to do specialization.

Nurse practitioners, on the other hand, have a patient-centered curriculum model. They focus more on disease prevention rather than treatment alone, helping direct their patients to live a healthier lifestyle and counseling them where needed. It’s an overall more holistic approach.

As a career choice for a nurse who is currently doing bedside care and feels burned out and wants to do something different then going on to become a NP sounds like a great choice. Work satisfaction is particularly high for many reasons.

• More impact on patient care: NPs can assess, diagnose, and treat patients of all types.
• Versatility: NPs can work in many healthcare settings and combined with increased demand for NPs results in lots of career options.
• Leadership opportunities: NPS are inherently leaders and with a stronger clinical degree have more options for upward mobility.
• Flexible schedules: There are many variants of schedules and work-from-home options available to them.

How To Navigate Physician Assistant And Nurse Practitioner Work

Many people are confused about the scope of physician assistant and nurse practitioner work, seeing how they both practice giving clinical care similar to doctors. However, education alone isn’t what sets them apart; it’s also their role in healthcare.

Nurse practitioners often target specific health concerns. They have a more community-based approach, which might involve a particular group of patients with specific needs. Think of a women’s health nurse practitioner helping pregnant women even after birth or a geriatric nurse practitioner dealing with the concerns of an elderly crowd.

However, physician assistants work like physicians in treating actual diseases using the same principles taught in a medical school environment. Therefore, they have a much broader scope of specialization, similar to medical residents. Before becoming licensed they must complete at least 2,000 hours of supervised clinical rotations.

This means a physician assistant can specialize in family and general medicine and pursue more advanced specialties such as cardiology, otolaryngology, and even surgery.

While surgical nurse practitioners do exist, they don’t have the same authority that a general surgery physician assistant might have in the operating room.

Physician assistants who specialize in surgery are often seen as ‘lead assistants’ to attending surgeons and can perform procedures such as resetting fractures, performing biopsies, tackling abscesses, or suturing.

As a physician assistant, you must complete a fellowship or residency when attempting to specialize or get into a subspecialty. Meanwhile, a nurse practitioner usually decides their specialization field before starting their graduate program, meaning they are constrained to that specific field for the remainder of their academic career.

So, whether you work as a nurse practitioner or physician assistant, you are seen as an independent healthcare professional who can practice medicine and patient care effectively. It’s just that the two fields prioritize different things when executing said care. And you can specialize accordingly.

However, the other thing that doesn’t confuse possible nurse practitioners and physician assistant aspirants is the salary. Understanding the salary expectations for both careers is fairly simple, as they earn in the same six-figure bracket of $120,000. Please note that there is a lot of variability in salaries in both NPs and Pas. This is dependent on geographic location and previous experience (and of course the negotiating skills of the person). Furthermore, the clinical setting can also make a difference. An NP or a PA who works for a specialty clinic can make more than one who works in a primary care clinic (for example orthopedics vs primary care).

However, physician assistants (on average) earn more than nurse practitioners, with a median salary of $126,000 compared to $121,000 for a nurse practitioner. A possible explanation is that by the time an RN becomes a NP, they have several years of clinical experience while a PA can have no clinical experience and enter a PA program and graduate ready to work. This can be reflected in the small difference in salaries.

Both career options are seeing massive growth opportunities. According to the Bureau of Labor Statistics, the employment rate for physician assistants is expected to grow by 28% in the next decade. But nurse practitioners are doing even better, with a whopping 40% rise by 2033.

How The Two Work In Sync

Nurse practitioners and physician assistants have become the need of the hour. When discussing healthcare in the U.S., it’s impossible not to mention the current physician shortage, specifically in primary care.

Finding a healthcare specialist has become a severe issue, thanks to many active physicians entering retirement and young doctors leaving the profession due to burnout. And considering these primary care professionals directly impact a population’s health standards rise, a physician shortage is the last thing America needs.

Cue the nurse practitioners and physician assistants. They are now becoming the country’s most prevalent type of primary care provider, with their employment rate skyrocketing.

The two help ease the burden of a physician shortage because they are qualified to take charge of primary healthcare, even in the most rural areas. The reality is the physician care is expensive. Furthermore, physician shortages in certain areas make access to healthcare even more problematic. Physicians are overworked and hence that is why NPs and PAs are sometimes referred to as “physician extenders”. They can work as a team to scale healthcare delivery and manage patients that are within the scope of their training. In other words, complicated and sick patients should be managed with those specifically trained in higher acuity patients while the lower acuity and stable patients can be managed by physician extenders. This means you don’t always need a doctor on hand; a physician assistant and nurse practitioner are more than qualified.

It helps that to become a physician assistant you don’t have to spend years in medical school or pay hefty fees. That means it’s a more accessible career for many and has a faster turnover rate. It also happens to be the best-rated job in healthcare right now, followed by that of a nurse practitioner.

So, it’s more appealing to those aspiring to get into and stay in healthcare since there is significant job security whether you elect to be an NP or a PA. In short, physician assistants and nurse practitioners have similar duties and responsibilities. Still, where one takes a disease- and medicine-oriented view, the other is more holistic and patient-centric.

But both make good money, are growing exponentially, and are a massive boon to the healthcare industry. A career as an NP or a PA is considered a great choice due to a combination of factors including high demand for their services, substantial earning potential, some autonomy in patient care, diverse specialization options, and the ability to make a meaningful impact on patients’ lives across different healthcare settings.