Titles in nursing can be confusing, especially if you are just starting out in your nursing journey. So, if you ever asked yourself, “What exactly is the difference between a nurse practitioner (NP) and a physician assistant (PA)?” you’re not alone.
In fact, many people think that these roles are like comparing apples to apples because they perform similar roles and tasks—but this isn’t quite true.
What is true is that both an NP and a PA play pivotal roles in patient care. However, the main difference between a nurse practitioner and a physician assistant is that nurse practitioners learn to follow a more holistic approach to patient healing, whereas physician assistants learn a more clinical method of patient care.
In addition, there are differences between the type of education an NP vs. PA pursues, as well as each position’s certifications and scope of practice.
To clear up some common gray areas between these two professions, let’s break down these two very important healthcare roles:
What does a nurse practitioner do?
A nurse practitioner provides primary and direct care to patients. An NP is an advanced practice registered nurse (APRN) who focuses on disease prevention and patient-centered care.
Depending on the state in which they practice, NPs don’t need physician oversight. This means that as of 2024, NPs have a full scope of practice in 27 states throughout the U.S. Consequently, nurse practitioners generally have more autonomy when performing their roles compared to other health positions such as registered nurses or physician assistants.
Some primary duties and responsibilities of a nurse practitioner include:
- Keeping a record of a patient’s health history
- Updating medical records
- Documenting all symptoms
- Collecting samples, including blood and urine (etc.)
- Diagnosing medical conditions
- Developing and carrying out treatment plans
- Prescribing and/or administering medications (prescription authority will vary based on state regulations and the type of medication)
- Overseeing a team or individual nurses such as CNAs, LPNs, and RNs
The duties of a nurse practitioner vary depending on the state in which they choose to practice. Nurse practitioners also generally choose a patient population to specialize in.
What are some areas of specialization for NPs?
A major advantage of becoming a nurse practitioner is that they can choose to specialize in a certain area of medicine and work with distinct patient populations.
Some of the most common specialty areas for NPs include:
- Family Nurse Practitioner (FNP)
- Pediatric Nurse Practitioner (PNP)
- Adult-Gerontology Nurse Practitioner (AGNP)
Other specializations for nurse practitioners include (but are not limited to) working as a women’s health nurse practitioner (WHNP) or providing psychiatric care as a psychiatric-mental health nurse practitioner (PMHNP).
What does a physician assistant do?
A physician assistant, like a nurse practitioner, delivers direct care to patients. PAs are licensed medical professionals that can also diagnose and treat patients. This is typically done under the supervision of a physician.
Some of the primary duties and responsibilities of PAs include:
- Performing patient health assessments
- Developing treatment plans
- Diagnosing illnesses
- Assisting in medical and surgical procedures
- Prescribing medications (prescription authority will vary on the type of medication and state regulations)
A physician assistant’s duties are similar but not identical to a nurse practitioner’s duties and responsibilities. Physician assistants work in different care settings and can also specialize in various areas of medicine, such as emergency medicine or surgery.
What are some areas of specialization for PAs?
Physician assistants can specialize in a number of areas of clinical practice. There is some overlap in the specialty areas of PAs and NPs, such as family medicine.
PAs also commonly specialize in:
- Anesthesia
- Cardiology
- Dermatology
- Emergency medicine
- ENT/Otolaryngology.
Other specializations include (but are not limited to) orthopedics, obstetrics and gynecology (OB/GYN), neurology, and radiology.
Nurse practitioner vs. physician assistant: scope of practice
NP practice authority varies across the United States and can be categorized as either full, reduced, or restricted. Many states (currently 27) give full practice authority, allowing them independence and autonomy in practice.
Similarly, the level of autonomy for physician assistants varies by state. A PA’s scope of practice can be categorized as either optimal, advanced, moderate, or reduced in accordance with state regulations. With few exceptions, PAs work under the supervision of a licensed physician.
Yes. Physician assistants can prescribe medicine while under the supervision of a head physician. This practice, however, has limitations and varies from state to state. For instance, in the state of Kentucky, it is illegal for PAs to prescribe controlled substances. However, in many other states, they can prescribe Schedule II – V controlled substances with physician oversight.
To sum up, PAs are required to have some level of collaboration or supervision from a physician. Compared to physician assistants, NPs have more flexibility regarding their scope of practice in many states.
NP vs. PA: education and licensure
Below these key differences between NP vs. PA educational and license requirements are explored.
Education
Education is a key difference between NPs and PAs.
- Nurse practitioners: NPs are required to earn a Bachelor of Science in Nursing (BSN) and then an advanced nursing degree. Two common advanced nursing degrees are a Doctor of Nursing Practice (DNP) and a Master of Science in Nursing (MSN). Nurse practitioners must complete a certain number of clinical hours, often at least 500 hours of rotation.
- Physician assistants: PAs are required to earn a medical master’s degree, referred to as a master of science in physician assistant studies (MSPAS). Similar to nurse practitioners, PAs are required to complete a certain number of supervised clinical hours, often at least 2,000 hours of rotation.
Licensure
Both NPs and PAs must obtain a state license in order to engage in clinical practice.
- Nurse practitioners: NPs must pass the NCLEX-RN exam and obtain their state license from their state board of nursing. Some states also require that NPs take a national certification exam to become certified nurse practitioners (CNPs). Nurse practitioner license renewal occurs every five years and requires 100 hours of advanced continuing education and completing 1,000 hours of clinical practice.
- Physician assistants: PAs must pass the Physician Assistant National Certifying Examination (PANCE) to obtain licensure. This exam is administered by the National Commission on Certification of Physician Assistants (NCCPA). After completing and passing this exam, PAs will be Physician assistant-certified (PA-C). To keep their license active (maintain their national certification), PAs must commit to completing 100 hours of continuing medical education (CME) every two years.
Career outlook: NP vs. PA salary
Both NPs and PAs have a promising outlook for job growth and demand. According to the Bureau of Labor Statistics:
- NPs: The average annual salary for a nurse practitioner is $128,490, with a mean hourly wage of $61.78.
- PAs: The average annual salary for a physician assistant is $130,490, with a mean hourly wage of $62.74.
Jobs for PAs are projected to increase 28 percent from 2023 to 2033. For NPs, the job outlook is even higher and expected to jump 45 percent from 2023 to 2033.
PA or NP? It’s your choice
Whether you decide to pursue a career as a PA or an NP will depend on your personal preferences and working style. A PA generally has less autonomy than a nurse practitioner, but regulations for both professions can change. Education requirements to become a PA or an NP are rigorous and typically take anywhere from four to eight years to complete.
A nursing practitioner generally approaches medicine in a more holistic and patient-centered way. A physician assistant, on the other hand, takes a more clinical approach to patient care. Neither is better than the other.
In addition, the average salaries for both professions are competitive. Similarly, the job outlook for these positions is favorable. Ultimately, both NPs and PAs are an invaluable asset to care systems for patients in the medical world.
Need help to decide on a nurse practitioner degree program? Learn everything you need to know about MSN vs. DNP programs here.
Sources:
- Bureau of Labor Statistics: Occupational Employment and Wage Statistics: Physician Assistants
- Bureau of Labor Statistics: Occupational Employment and Wage Statistics: Nurse Practitioners
- Bureau of Labor Statistics: Occupational Outlook: Physician Assistant
- Bureau of Labor Statistics: Occupational Outlook Nurse Practitioners
- American Association of Nurse Practitioners: State Practice Environment
- American Academy of Physician Associates: PA State Practice Environment
