Do You Know the Differences Between NPs and PAs?
Nurse practitioners (NPs) and physician assistants (PAs) are increasingly mentioned as a collective solution to the nation’s primary healthcare shortage. There are approximately 234,000 NPs and 115,500 PAs in the United States providing cost-effective patient care, preventive care, and health promotion. But what exactly is the difference between these two groups of clinicians? Practicing Clinicians Exchange provides a quick snapshot of how these growing professions compare:
NURSE PRACTITIONER
Definition
- Registered nurse (RN) with advanced education and clinical training
- Provides a wide range of healthcare services, including the diagnosis and management of common as well as complex medical conditions
- Practices independently or in collaboration with physician, depending on state requirements
Philosophy/Model
- Medical/nursing model
- Patient-centered
- Focuses on health promotion, disease prevention, health education, and counseling, in addition to health assessment, diagnosis, and treatment
Certification/Licensure
- Nursing accreditation and graduate education (master’s or doctoral degree), with preparation in the NP role and at least one specialty population
- National board certification in acute care, adult, family, gerontology, neonatal, oncology, pediatric, psychiatric, or women’s health specialty
- Major national certifying agencies: American Association of Nurse Practitioners, American Nurses Credentialing Center
Recertification
- Recertified every 5 years
- May sit for appropriate examination or meet clinical practice and continuing education (CE) requirements
- Minimum of 1000 hours of clinical practice as an NP in area of specialization and 75 contact hours of CE relevant to the area of specialization
- Pharmacology credits required for some recertification
Scope of Practice
- Authorized to practice independently without physician oversight in 23 states and DC; in remaining states, practice with varying degrees of physician involvement
- Prescriptive authority in all 50 states and DC
Third-Party Coverage and Reimbursement
- Eligible for certification as Medicare and Medicaid providers
- Generally receive favorable reimbursement from commercial payers
PHYSICIAN ASSISTANT
Definition
- Nationally certified and state-licensed medical professional with advanced education and clinical training; trained in the medical model alongside physicians
- Practices medicine in a collaborative team with physicians and other healthcare providers
- May diagnose, treat, prescribe, and perform surgery—there are no limits on what a PA may do
- Any setting in which you see a physician, you will likely see a PA
Philosophy/Model
- Medical/physician model
- Disease-centered; emphasis on the biologic/pathologic aspects of health, assessment, diagnosis, and treatment
- Team-approach relationship with physicians
Certification/Licensure
- Graduate education
- Separate accreditation and certification bodies require successful completion of an accredited program
Recertification
- Requires 100 continuing medical education (CME) credits every 2 years and examination every 10 years
- PA certification maintenance mirrors physician maintenance of certification process
Scope of Practice
- The scope of supervision of PAs by physician is determined by state regulations
- Prescriptive authority in all 50 states
- Controlled substance prescribing restrictions in Kentucky
- Onsite collaboration not required
Third-Party Coverage and Reimbursement
- Eligible for certification as Medicare and Medicaid providers
- Generally receive favorable reimbursement from commercial payers
- Embraced by large healthcare systems and private practices for ability to deliver high-quality, cost-effective care