When comparing the nurse practitioner (NP) and physician associate (PA) professions, it’s important to note that both have had a major impact on the healthcare landscape.
Both produce primary care practitioners to fill much-needed gaps across the country, from rural towns to big cities.
According to the American Association of Nurse Practitioners website, Americans make more than 1 billion visits to NPs every year, and NPs serve as healthcare providers, educators, researchers, and more.
“The areas that you could go into were wide open as a nurse practitioner,” said Carolyn Coleman, DNP, MHP, FNP-BC, PMHNP-BC, president of the Mississippi Association of Nurse Practitioners. “It didn’t confine you to just being in management. Being a nurse practitioner opened up the nursing field.”
Because of that patients have a wider array of providers from whom they could seek treatment and healthcare advice, including NPs and PAs.
Formerly called "physician assistants" before the American Academy of Physician Associates' House of Delegates passed a resolution in 2021 to make “physician associate” the official title for the profession, these professionals also see millions of patients annually.
“We have 500 million patient interactions every year,” said Jennifer Orozco, DMSc, PA-C, DFAAPA, chief medical officer of the American Academy of Physician Associates. “[PAs] are a critical component of today’s modern healthcare delivery system. What we’re committed to is patient-centered, team-based care. It’s essential to who we are.”
So, what are the differences between the PA and NP roles?
NP versus PA: Their responsibilities
Depending on scope of practice in their state, nurse practitioners can prescribe medications and manage those medications for multiple patients.
They can also:
- Interpret blood tests, X-rays, and other tests
- Develop and implement patient care plans
- Diagnose and treat chronic or acute conditions
- Educate patients on their health and wellness, including disease prevention and healthy lifestyle choices
- Counsel patients and families, directing them to referrals, resources, and other materials
- Mentor and lead other nurses
- Conduct research
Nurse practitioners are advanced practice registered nurses (APRNs), a group that includes certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists.
Today, state nursing practice and license laws in 27 states permit NPs to practice fully independently, according to the American Association of Nurse Practitioners. Twelve states allow “reduced practice” while 11 states allow NPs “restricted practice.”
For PAs, their duties also can depend on the specialty, setting, experience, and state laws. According to the AAPA, their duties can include:
- Taking medical histories
- Conducting physical exams
- Diagnosing and treating illnesses
- Ordering and interpreting tests
- Prescribing medications
- Developing treatment plans
- Performing procedures
Like their colleagues in the nursing profession, PAs also conduct clinical research. In May 2023, Iowa became the sixth state to remove a requirement “for a PA to be supervised by a physician in order to practice medicine,” according to an AAPA news release.
Flexibility in specialties and settings
Coleman, who is the Nurse Practitioner Program Coordinator at The University of Southern Mississippi, said NPs have a higher level of flexibility in practice when compared to RNs and a range of specialties in which to practice.
Those specialties include:
- Family practice
- Pediatrics
- Psychiatry
- Adult gerontology
- Women’s health
- Neonatology
Nurse practitioners, depending on their specialization, can work in private practice, as well as in various healthcare settings including hospitals, clinics, emergency departments, urgent care facilities, nursing homes, schools, and public health departments.
PAs can be found in many of the same specialties and settings as NPs, including hospitals, community health centers, physician offices, retail clinics, educational facilities, correctional facilities, and government agencies.
NP vs. PA education and training
All nurse practitioners are required to finish a master's or doctoral program and undergo advanced clinical training beyond their initial nursing education.
Because of the additional education and training, NP salaries are usually higher than salaries for RNs.
The median salary for nurse practitioners in May 2022 – the most current Bureau of Labor Statistics (BLS) data available – is $121,610.
To become a PA, students normally earn an undergraduate degree and graduate from an accredited entry-level PA program, a course of study that lasts two to three years. Some schools, however, offer a pre-professional phase – lasting four to six years – for high school graduates and students with some college credits.
PA salaries are slightly higher, according to the BLS, with a median salary of $126,010.
When it comes to the NP versus PA job markets, the outlooks for both professions are quite rosy.
The BLS says from 2022-2032, the NP profession will see an estimated 45% job growth, while PAs will experience 27% growth, both of which rank much higher than other professions.
“As the demand for health care continues to rise, fueled by the growth of an aging population and the continued shortage of primary health care providers, AANP is committed to expanding and diversifying the NP workforce,” said AANP President Stephen A. Ferrara, DNP, in a news release. “NPs can increase access to high-quality primary, acute, and mental health care for patients of all ages in every community.”
