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Physician Assistant and Nurse Practitioner - What is the Difference?

Updated on April 28, 2013

Physician Assistant

With the coming changes in healthcare, there is a growing need to expand the reach of primary care physicians without sacrificing the quality of patient visits, or dramatically increasing the cost. Even as far back as the mid 1960’s, there were some far-seeing individuals who realized that shortages of doctors were inevitable, especially in some geographic locations. Thus, literally in the same decade, the 1960’s, two new fields of medicine were established, that of Physician Assistant and Nurse Practitioner. The questions often arise as to who these professionals are, what their education and training is, and what does their job entail in the whole scope of health care. A detailed look at each will answer many of these.

The first class of Physician Assistants graduated in 1967 from Duke University, having undergone rigorous instruction and training, much the same as today. To be accepted into a PA program, one needs to have fulfilled at least two years of undergraduate study, with the required basic courses being biology, chemistry, anatomy, physiology, and microbiology. Courses in Psychology, Math and English are recommended. Between 500 and 1000 hours of direct patient care are also required. These hours can come from EMT or paramedic work, as well as traditional hospital and clinic experience. These highly competitive programs also suggest a GPA of 3.5 or higher, and three letters of recommendation to be considered.

Once in the program, which takes about 27 months to complete, students take advanced science courses in all of the above fields as well as pathophysiology, behavioral science and medical ethics. Additionally, there are 2000 hours of clinical rotations in hospitals, doctors’ offices and walk-in clinics, covering all fields of medicine – pediatrics, general surgery, emergency, ob-gyn, internal and family practice. Continuing education after degree program is completed includes 100 hours every two years.

Physician Assistants diagnose and treat illnesses, perform physicals, assist in surgery, make hospital rounds and provide patient education. They also can write prescriptions and order lab tests. Often, after a doctor does surgery or completes an initial evaluation on a patient, he or she will have the PA in the practice do the follow-up visits. This allows the doctor to treat other patients, while giving the initial patient a caring, competent medical professional who can spend more time examining and counseling, ensuring a positive experience.

Nurse Practitioner

Like Physician Assistants, Nurse Practitioners are also primary care providers, although their philosophy of care is somewhat different. All NPs are nurses first, so there is usually a nurturing aspect to their role. Often they work in fields such as family practice, women’s health, pediatrics – areas where there will be an ongoing relationship. Their focus is often wellness, patient education, and prevention. Usually they will work under a physician in a clinic or office, although some do go into private practice. In all 50 states, an RN license is required. Beyond that, some states, (27 of them), require a master’s degree in nursing, while the others require advanced training in the form of certification in a specialty area. These areas can include neonatology, gerontology, emergency, oncology and psychiatry.

Nurse practitioners treat patients by giving physicals, taking a detailed medical history, ordering tests, screenings and therapy, giving basic diagnoses and recommendations, and, in some states, prescribing medications. In some states, they can perform minor surgeries such as sutures, dermatological biopsies and casting.


Interestingly enough, the median annual salary in the United States for both Physician Assistants and Nurse Practitioners is $91,000. Of course, this varies by location, with the range being from $70,000 to $105,000.

With all the uncertainty surrounding the health care situation in our country, it is reassuring to know that both of these professions will continue to provide individuals and families with quality care, individual attention, and more affordable health care

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