Nurse Practitioners versus Physician Associates

A nurse practitioner (NP) is a licensed, advanced practice registered nurse that provides primary and specialized health care across specific populations, including children, adults, and the elderly. NPs may practice in rural, urban, and suburban communities in many settings, including clinics, hospitals, nursing homes, schools, and public health departments. NPs can provide patient care in various specialty areas, including primary care, cardiology, and oncology. NPs most commonly practice independently, where the supervision of a physician is not required.

A physician assistant (PA), also known as a physician associate (PA) as per the American Academy of Physician Assistants, is a licensed health care professional who practices medicine under a licensed physician's direction and supervision. PAs may practice different specialties, such as family medicine and surgery, across various settings, including clinics and hospitals.

Nurse practitioners and physician associates both require a graduate-level degree, clinical training, and specific certifications; however, there are important differences in the type of education NPs and PAs receive.  

NPs typically begin their education by completing a four-year Bachelor of Science in Nursing degree, then obtaining a registered nurse license by passing the National Council Licensure Examination (NCLEX-RN) licensing exam. NPs will then typically complete a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) program, which may vary from two to four years in length. NP programs follow a patient-focused nursing model of education, consisting of didactic courses and a minimum of 500 clinical rotation hours under the supervision of a preceptor. Once NP educational requirements have been satisfied, graduates may obtain their certified NP license and recertify as appropriate. 

PAs typically begin their education by obtaining a bachelor’s degree, followed by a two-to-three-year master’s degree from an accredited physician assistant program, commonly known as a Master of Science in Physician Assistant Studies. PA programs follow a disease-centered, medical model of education, consisting of didactic courses and a minimum of 2000 hours of supervised clinical practice across various medical and surgical settings. Once PA educational requirements have been satisfied, graduates may proceed to obtain their PANCE license and recertify as appropriate.

Nurse practitioner and physician associate roles both intensely focus on providing direct patient care alongside physicians, with many similarities and a few key differences.

Nurse practitioners generally specialize and obtain licensure in providing care to a specific population, such as individuals of a particular age group or that fall under a clinical specialty, such as psychiatry. NP scope of practice commonly involves obtaining medical histories, performing physical examinations, diagnosing acute and chronic conditions, ordering laboratory tests and imaging, prescribing medications, performing procedures, monitoring results, and conducting research. In 26 American states, NPs have full practice authority and are not required to work under the supervision of a physician. If an NP switches specialties, additional training and licensure for the new specialty are required.

NPs and PAs earn competitive salaries and benefits, which vary based on certain factors such as geography, certification, specialty, years of experience, practice setting, and education level.

According to the United States Bureau of Labor Statistics, NPs earned an annual median salary of $123,780, whereas PAs earned an annual median salary of $121,530.