Nurse Practitioner vs. Physician Assistant: Key Differences
Health-care jobs are projected to grow faster than average for all occupations through 2033, resulting in about 1.9 million openings each year, according to the Bureau of Labor Statistics. If heath care is a field you’re interested in, two positions to consider that are expected to see substantial employment growth are nurse practitioner (NP) and physician assistant (PA).
NPs and PAs are advanced practitioners with similar job responsibilities but also some key differences. If you’re trying to decide between the two, read on to learn what you need to know about the difference between a PA vs NP.
Key Points
• Both nurse practitioners and physician assistants are advanced health-care professionals with similar responsibilities but different educational and practice approaches.
• Nurse practitioners emphasize patient-centered care while physician assistants focus on a disease-centered approach.
• Nurse practitioners can operate independently in many states, whereas physician assistants must collaborate with supervising physicians.
• Salaries for both professions are comparable, with physician assistants typically earning slightly more.
• Employment growth is expected to be robust for both professions, with nurse practitioners projected to see faster growth.
Physician Assistant vs Nurse Practitioner: Key Similarities and Differences
PAs and NPs are both important health-care professionals. They work in similar settings, including hospitals, clinics, and physicians’ offices. Here’s how the two specialties are alike and how they differ.
What Is a Physician Assistant?
A physician assistant is a licensed medical professional with an advanced degree who provides direct patient care in primary-care settings, performing many of the same jobs a physician does. This includes doing medical exams, diagnosing conditions, prescribing medication, and treating illnesses. PAs work in collaboration with a supervising physician as determined by state law.
A PA’s education is in general medicine, and their training is disease-centered and similar to that of a physician.
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What Is a Nurse Practitioner?
Nurse practitioners are registered nurses (RNs) with advanced education and training for patient care. They typically choose a primary specialty before they enter their graduate program.
NPs provide comprehensive health care and can examine patients, diagnose conditions, prescribe medication, and treat illnesses. In approximately 28 states, NPs can practice without a doctor’s supervision.
Physician Assistant vs. Nurse Practitioner: Key Responsibilities
One of the major differences between an NP and PA is their approach to health care, which is based on different medical models. PAs focus on disease treatment, while NPs focus on patient treatment. So while many of their responsibilities may be similar, the context in which they perform them is not.
The duties of NPs revolve around the patient and include:
• Recording health histories
• Conducting physical exams
• Diagnosing and treating health problems
• Interpreting lab results and X-rays
• Prescribing medications and therapies
• Referring patients to other health professionals if needed
• Patient education
By comparison, PAs take a biology-based approach to diagnose and treat diseases. They perform such duties as:
• Doing hospital rounds
• Performing patient exams
• Diagnosing illnesses
• Assisting with surgeries
• Ordering and interpreting lab tests and X-rays
• Prescribing medications
• Developing and managing treatment plans
• Advising patients on preventative care and treatments
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What Is a Nurse Practitioner’s Scope of Practice?
NPs choose a primary specialty, concentrating on a specific patient population. They can specialize in such areas as acute care, family care, neonatal, pediatric, oncology, gerontology, and women’s health.
As mentioned, in 28 states, NPs can treat patients and prescribe medications without a physician’s supervision.
What Is a Physician Assistant’s Scope of Practice?
PAs typically collaborate with supervising physicians as determined by state law. They are trained as generalists, meaning they can practice in almost any medical field. Many PAs have a variety of specialties and sub-specialties, which might include emergency medicine, internal medicine, radiology, pediatrics, surgery, and orthopedics.
Nurse Practitioner vs. Physician Assistant: Education and Certification
PAs and NPs must earn advanced degrees and become licensed and certified. Here’s what’s required for each role.
How to Become a Nurse Practitioner
It typically takes six to eight years to become an NP, including undergraduate and graduate school. The first step is to become an RN by earning a bachelor of science in nursing (BSN) degree. After that, a student can choose to pursue a master of science in nursing (MSN), which usually takes two years to complete, or a doctor of nursing practice (DNP), which typically takes four years to complete.
After earning an MSN or DNP, an NP must receive accreditation from a certification board, such as the American Academy of Nurse Practitioners (AANP-CP), which confirms that their coursework and clinical training meets the licensure board’s requirements. They then get licensed.
How to Become a Physician Assistant
It takes about six to eight years to become a PA. First, an aspiring PA must earn a bachelor’s degree with an emphasis on science. Then they must complete a PA program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), which involves classes and clinical rotations. Students graduate with a master’s in PA studies.
Finally, a PA needs to take the Physician Assistant National Certifying Exam (PANCE), and get licensed in the state(s) where they wish to practice.
Nurse Practitioner and Physician Assistant Specializations
As noted, NPs specialize in certain practice areas, while PAs have a more general medical education.
Types of Nurse Practitioners
There are many different types of NPs with different specializations. Some types of NP you may want to consider include:
• Family nurse practitioner (FNP): FNPs specialize in family medicine and work with people of all ages. They perform physical exams and health screenings, monitor patients, and develop treatment plans. They also provide continuing education and support.
• Pediatric nurse practitioner (PNP): PNPs work with children and conduct physical exams, health screenings, and diagnosis and treatment. They may work in private practice, public health centers, pediatric ICUs, emergency departments, and specialty-based clinics.
• Adult-gerontology nurse practitioner (AGNP): AGNPs work with patients ranging in age from adolescence to the elderly, offering continuing comprehensive care for a broad spectrum of needs. They may work in private practice, hospital settings, nursing homes, or in the homes of patients.
• Psychiatric nurse practitioner (PMHNP): These mental health professionals treat mental illnesses, disorders, and substance abuse problems. They may work in private psychiatric practices, schools, and community mental health centers.
• Neonatal nurse practitioner (NNP): NNPs work with premature and sick infants and babies with birth defects and other health conditions. They often work in neonatal ICUs.
• Women’s health nurse practitioner (WHNP): NPs who work in women’s health advise women on reproductive and sexual health and treat reproductive system disorders. They may work in fertility clinics, hospitals, or private practices.
Types of Physician Assistants
PAs work in primary care or in specialty and subspecialty roles. Those in primary care positions may work in family medicine, internal medicine, or pediatrics, for instance.
If they specialize in internal medicine, the subspecialties they could focus on include:
• Cardiology
• Critical care
• Endocrinology
• Gastroenterology
• Hematology and oncology
• Infectious disease
• Nephrology
• Neurology
• Pulmonology
• Rheumatology
There are also surgical subspecialties a PA might choose, such as:
• Cardiovascular or cardiothoracic surgery
• Bariatric surgery
• General surgery
• Neurosurgery
• Oncology surgery
• Orthopedic surgery
• Pediatric surgery
• Plastic surgery
• Transplant surgery
• Trauma surgery
Other specialties a PA might pursue include: allergy and immunology, dermatology, geriatrics, obstetrics and gynecology, pain management, emergency medicine, psychiatry, and radiology.
Nurse Practitioner vs. Physician Assistant: Salary and Career Outlooks
As you’re deciding between nurse practitioner vs physician assistant, it’s important to consider the career and salary opportunities for each.
Average Annual Salary
PAs and NPs earn similar salaries, with PAs making slightly more. However, employment for NPs is projected to be higher than that of PAs.
Nurse Practitioner Salary and Career Outlook
When it comes to salary opportunities as a nurse, the median annual salary for an NP in 2023 was $129,480 per year, or $62.25 per hour. The overall employment for nurse practitioners is projected to grow 40% between 2023 and 2033.
About 31,900 NP openings are projected on average for each year over the next decade.
Physician Assistant Salary and Career Outlook
The median annual salary for a PA was $130,020 in 2023, and the overall employment for these medical professionals is expected to grow 28% from 2023 to 2033.
Approximately 12,900 openings for PAs are projected on average each year over the next 10 years.
Nurse Practitioner vs. Physician Assistant: Which Career Is Right For Me?
PAs and NPs are equally important roles in the health-care system. They make similar salaries and the employment outlook for each is strong.
As you debate which career is the best fit for you, think about your interests and goals. If you are drawn to the patient-centered model of care, an NP might be the right choice for you. If you prefer a disease-centered model, a PA could be the job you’re looking for.
In addition, consider the cost of college for each. An NP may spend as much as $78,820 on their education. In contrast, a PA might spend up to $95,165.
Whether you decide to pursue a NP or PA degree, there are a variety of funding options to help you pay for school, including federal student loans, scholarships and grants, and private student loans.
In addition, there are ways to make paying your student loans more affordable or manageable, including income-driven repayment (IDR) plans for federal student loans, loan repayment assistance programs offered by states and organizations, and student loan refinancing.
By refinancing student loans, you replace your current loans with a new loan from a private lender that ideally will have a lower interest rate and more favorable loan terms.
If you can secure a lower interest rate, refinancing student loans to save money may make sense for you to help pay for schooling to become an NP or PA. Just be aware that refinancing federal student loans makes them ineligible for federal benefits like income-driven repayment.
Using a student loan refinancing calculator can help you see what your monthly payment might be if you choose to refinance.
If you need more information, our student loan refinancing guide can give you additional details about the process and whether it’s right for you.
The Takeaway
Nursing practitioner and physician assistant are both rewarding careers in the medical field. The main difference between the two is their approach to health care. An NP’s approach is patient-centered, while a PA’s is disease-centered. Think carefully about which role offers the best career path — and the most rewarding type of work — for you.
And while schooling to become a PA or an NP can be expensive, remember that there are a multitude of ways to help pay for it including federal and private student loans.
Looking to lower your monthly student loan payment? Refinancing may be one way to do it — by extending your loan term, getting a lower interest rate than what you currently have, or both. (Please note that refinancing federal loans makes them ineligible for federal forgiveness and protections. Also, lengthening your loan term may mean paying more in interest over the life of the loan.) SoFi student loan refinancing offers flexible terms that fit your budget.
FAQs
Who goes to school longer, a PA or a nurse practitioner?
It takes about the same amount of time to become an NP and a PA — approximately six to eight years, including graduate school. However, to become an NP, some universities require at least one year of experience as an RN before a student can pursue their master of science in nursing.
Is it harder to become a nurse practitioner or a PA?
The schooling and experience necessary to become both a nurse practitioner and a PA is challenging. Which one is more difficult for you depends on your unique skills and strengths. If you’re good at patient care, an NP might be a better fit for you. If you’re drawn to a more traditional medical school approach, you may find that it makes sense for you to become a PA.
Is a nurse practitioner higher than a PA?
As licensed health-care professionals who play important roles in medical care, neither a nurse practitioner nor physician assistant is higher than the other. One thing to keep in mind, however, is that NPs can work independently in many states, while PAs work in collaboration with a physician.
Photo credit: iStock/SDI Productions
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