Nurse Practitioner vs. Physician Assistant

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Reviewed by Meredith Wallis, CNM, NP


Prospective students considering an advanced degree in healthcare may want to learn the similarities and differences between nurse practitioner (NP) and physician assistant (PA) occupations. Both options provide career alternatives to professionals who wish to work in advanced healthcare roles, but not as physicians.

Both options provide career alternatives to professionals who wish to work in advanced healthcare roles, but not as physicians.

An NP attends a nursing school, while a PA attends a medical school or center of medicine. Nurses follow a patient-centered model, in which they focus on disease prevention and health education. NPs also handle assessment, diagnosis and treatment. Physician assistants follow a disease-centered model, in which they focus on the biological and pathological components of health while also practicing assessment, diagnosis, and treatment.

An NP attends a nursing school, while a PA attends a medical school or center of medicine.

NPs can specialize in several areas, including gerontology/geriatrics, mental health, pediatrics, and women's health. PAs undergo a more generalized education, but can also specialize in areas like emergency medicine, orthopedics, and general surgery.

When thinking through the similarities and differences between physician assistants and nurse practitioners, keep in mind the different health care philosophies, educational options, and available specializations to determine which might be the best fit for you.


Side-by-Side Comparison

The table below features a side-by-side comparison detailing nurse practitioner and physician assistant job preparation and training, on-the-job frameworks, and pay and career outlook. Both NPs and PAs should play important and growing roles in health care. According to the American Association of Medical Colleges (AAMC), the U.S. could see a shortage of 100,000 physicians by 2030. Additional NPs and PAs will almost surely need to step in to fill vital health care roles.

  Nurse Practitioner Physician Assistant
Number Practicing in the U.S. 189,100 as of 2019, according to the Bureau of Labor Statistics (BLS). 118,800 as of 2019, according to the BLS.
Pay The median annual wage, as of May 2019, was $109,820 for NPs, according to the BLS. The median annual wage for PAs, as of May 2019, was $112,260, the BLS reports.
Expected Job Growth 26% from 2018 to 2028, much faster than the average for all occupations (7%), according to the BLS (2019). 31 percent from 2018 to 2028, much faster than average.
Anticipated Number of New Positions Available by 2028 53,300 37,000

Meeting the Requirements

  Nurse Practitioner Physician Assistant
Degree Requirements Currently, NPs need a minimum of a master's degree from an accredited school to become licensed within a state. Even though the American Association of Colleges of Nursing (AACN) recommended the doctor of nursing practice (DNP) as the new NP standard, states and credentialing entities still just require a master's degree. PAs need a minimum of a master's degree from an accredited medical school or center of medicine to seek licensure.
Degrees Available An NP can seek a master's or DNP from a nursing school, although the AACN suggests the DNP. More than 200 physician assistant programs, most of which offer master's degrees, were available in 2019, according to the BLS.
Program Details NPs typically choose a specialty area and need to complete 500 didactic hours and between 500-700 clinical hours (1,000 for DNPs). PAs receive generalist training and typically need to complete about 1,000 didactic hours and more than 2,000 clinical hours.
School Accreditation NP programs typically hold accreditation through the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing, Inc. (ACEN). PA programs hold accreditation through the Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA). You can find a list of PA programs through the Physician Assistant Education Association (PAEA).

Certification and Licensing

  Nurse Practitioner Physician Assistant
Certification NPs can seek national certification in their specialty area through the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners. PAs need to pass the Physician Assistant National Certifying Examination (PANCE) available through the National Commission on Certification of Physician Assistants (NCCPA).
Licensing Generally, candidates for state licensure as NPs must hold an RN license, a master's (MSN) or doctoral (DNP) degree, and national certification Candidates seeking state licensure as PAs must generally hold a master's degree from an accredited school and national certification.
Licensing Agency NPs seek licensure through a state board of nursing or board of medical examiners. The AANP provides links to the licensing agencies. PAs seek licensure through a state medical board, board of medical examiners, or similar agency. You can find a list of state licensing agencies through the National Commission on Certification of Physician Assistants (NCCPA).
Recertification NPs must earn recertification every five years or less, depending on their population focus and credentialing entity. They may sit for the appropriate exam or complete a minimum 1,000 hours of clinical practice and 75-150 continuing education units in their NP specialty. PAs need 100 hours of continuing medical education (CME) hours every two years and an exam every six years.

Details about the Job

  Nurse Practitioner Physician Assistant
Practice Framework NPs often work with physician oversight. However, NP practice authority varies by state, and in almost half of states, NPs can possess full practice authority (FPA). View state-by-state NP practice authority status. PAs cannot work independently of physicians, although similar to NPs, there's a growing movement toward independent PA practice authority.

Frequently Asked Questions

Is NP higher than PA?

Neither profession ranks "higher" than the other. Both occupations work in the healthcare field, but with different qualifications, educational backgrounds, and responsibilities. They also work in different specialty categories. In addition, although both nurse practitioners and physician assistants certainly work with more independence than nurses or aides, they still often need some sort of physician oversight.

Do PAs make more than nurse practitioners?

On average, yes. The BLS reports that the median annual wage for nurse practitioners was $109,820 as of May 2019, while the median annual wage for physician assistants reached $112,260 during the same month. That said, income varies greatly in different locations and at different types of healthcare facilities.

Can nurse practitioners and physician assistants prescribe medications?

This question does not come with a clear cut answer. For the most part, yes. However, some states impose limitations on the type of medications that nurse practitioners and physicians assistants can prescribe. Those restrictions usually include schedule II medications, although each state sets different rules.

What is the difference between nurse practitioner and physician assistant?

Nurse practitioners and physicians assistants work in similar capacities. However, nurse practitioners come from a nursing background, while a physician assistant education comes from a medical learning model. They may also specialize in different categories. Physician assistants are more likely to go into a surgical specialty, for example, while nurse practitioners may focus on areas like adult-gerontology, pediatrics, or women's health.


Reviewed By:

Expert Reviewer: Meredith Wallis CNM, NP

Meredith Wallis CNM, NP is a certified nurse-midwife, nurse practitioner, and International Board Certified Lactation Consultant (IBCLC). She received her master’s degree in midwifery from Oregon Health & Science University in 2011. Meredith specializes in out-of-hospital birth, lactation support, and childbirth education. Her professional passions include holistic medicine, VBAC, and evidence-based care.


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