What’s the Difference Between a Nurse Practitioner (NP) and a Physician Assistant (PA)?

Choosing between a career as a Nurse Practitioner (NP) or a Physician Assistant (PA) involves understanding the distinct paths these professions offer. Both roles are integral to the healthcare system, providing critical services and improving patient outcomes, particularly in the face of a nationwide physician shortage. However, their training, scope of practice, and approach to patient care differ significantly. This guide explores the key differences between NPs and PAs, helping you gain insight into their educational requirements, practice settings, salary prospects, and job outlook, so you can make an informed decision about your future in healthcare.

Overview of NPs and PAs

Before we dive into the fine details of these two similar but unique roles, lets take a look at the general differences between the two:

Training

Nurse practitioners are advanced-practice nurses who have either a master's degree or doctoral degree in nursing and have completed an accredited NP program. They choose a specialty track based on their population foci in their course of study. For example, they can select pediatrics, adult/ gerontology, psychiatry, women’s health, etc. A specific number supervised of clinical hours is required to graduate and for licensure. Some NPs even choose to continue in a residency program to further their clinical experience. Specialty certification in their specialty is required as well to be able to practice. Learn more about the various NP specialties.

Physician assistants must complete a minimum of a bachelor's degree to enroll in a PA program. Physician assistant programs are competitive, so getting an early start in prerequisite work is crucial. A master's degree is awarded after completion of the PA program. PAs are trained in general medicine but can specialize later. Physician assistants must also complete a set number of clinical hours to graduate, and general certification is also required.

Both NP and PA programs can take 2-3 years to complete.

Scope of Practice

Both nurse practitioners and physician assistants have a clear scope of practice. Physician assistants must work in collaboration with a physician and prescribe under a physician. NPs, in some states, can practice independently. They can even open their own NP-run clinics. However, individual state regulations define specific scope of practice for each role. For example, some states allow NPs to prescribe controlled substances, and some do not. For both practitioners, state laws are becoming more relaxed as the United States faces a nationwide physician shortage.

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Practice Style

Perhaps one of the most significant differences between NPs and PAs is their practice style and approach to patient care. Nurse Practitioners are trained first as nurses, following the nursing model of care. They approach patients holistically and practice patient-centered care. Physician assistants are medically trained, following a medical model of care. They focus on disease processes and how to treat them.

Practice Settings

Since most PAs work in collaboration with a physician, they tend to work in clinics, hospitals, and nursing facilities. They don't necessarily need a physician on-site, but a physician should be accessible by phone or other communication.

Nurse practitioners also work in clinics, hospitals, and nursing facilities. However, depending on the state in which they practice, they can even own and operate an NP-run clinic.

Both NPs and PAs can work in a specialty area of choice; for example, emergency rooms or surgery clinics.

Salary

NPs and PAs have similar pay grades. According to the Bureau of Labor Statistics, NPs earn a median salary of $126,260 per year. PAs earn a median salary of $130,020 annually. Income can vary depending on the state, city, and organization of employment.

Read our guide to NP salary.

Job Outlook

Both NPs and PAs have a promising career outlook. The job outlook for NPs (and other advanced-practice nurses) is expected to rise 40% through 2032, while the PA job outlook is expected to grow 28%. This is due to an increase in demand for healthcare services as a result of an aging baby-boomer population, an emphasis on preventive health, and healthcare legislation. Additionally, the US is experiencing a nation-wide physician shortage. This shortage, along with increased demand, results in more opportunity for mid-level providers such as nurse practitioners and physician assistants.

Summary

Both nurse practitioners and physician assistants are essential to the healthcare team. These providers ensure that the healthcare needs are met at a time when access to physicians can be challenging. Both require strict training and are governed by state regulations. The most significant difference is the approach to patient care and level of independent practice.

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Amanda Bucceri Androus, RN, BSN

Amanda Bucceri Androus is a Registered Nurse from Sacramento, California. She graduated from California State University, Sacramento in 2000 with a bachelor's degree in nursing. She began her career working night shifts on a pediatric/ med-surg unit for six years, later transferring to a telemetry unit where she worked for four more years. She currently works as a charge nurse in a busy outpatient primary care department. In her spare time she likes to read, travel, write, and spend time with her husband and two children.