Nurse Practitioner vs. Physician Assistant: What’s The Difference?

By Chris Kolmar - Nov. 18, 2020

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Healthcare professionals seeking a well-paying career are often torn between two similar positions: nurse practitioners (NPs) and physician assistants (PAs).

The two roles share many similarities, to the point of frequently competing for the same positions.

Both are independently licensed providers and work in the collaborative healthcare teams that work closely with physicians.

Additionally, both are vital to the country’s healthcare system, providing critical help to patients dealing with illnesses or seeking preventative care.

Yet, the two positions differ significantly in many aspects. These are mainly their healthcare philosophies, specialized roles, and previous medical experience needed.

This article will provide you a detailed understanding of each of these differing aspects.

Differences in Healthcare Philosophy

Possibly the greatest difference between physician assistants and nurse practitioners is how they approach patient care.

Physician assistants train according to the medical model, whereas nurse practitioners are educated through the nursing model.

  • The nursing model. This is often called the patient-centered model, focusing primarily on the physical and mental needs of a patient.

    While nurses receive extensive medical training, their focus is not on directly curing patients. They promote better health by addressing the patient’s physical comfort and hygiene, as well as providing appropriate care for whatever symptoms they may be displaying.

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    Putting patients at physical and mental ease allows their body to better fight against illness and react positively to treatments. For this reason, the nursing model is described as a holistic approach.

  • The medical model. This model primarily focuses on curing the patient’s problem, emphasizing topics such as disease pathology, anatomy, and physiology.

    Rather than the nursing model’s holistic approach, the medical model addresses illnesses in terms of “cause and effect.”

    Symptoms are systematically observed, described, and differentiated. Identified diseases are then directly combated with the appropriate treatment or cure.

Differences in Job Responsibilities

While there are overlapping duties between nurse practitioners and physician assistants, there are just as many fundamental differences.

  • Physician assistant responsibilities. The day-to-day duties of physician assistants include writing prescriptions, creating treatment plans, and performing medical examinations.

    They also play a direct role in the diagnosis and treatment of illnesses, as well as the ordering and interpretation of labs and imaging.

    The specific range of a physician assistant’s duties follows a written agreement between the assistant and a supervising physician.

    In addition to clinics and hospitals, physician assistants also work at research centers.

  • Nurse practitioner responsibilities. Nurse practitioners also provide treatment, but mostly focus on preventative care and health promotion.

    Their primary day-to-day function is to conduct physicals for patients, order tests, and serve as their primary healthcare provider.

    Importantly, nurse practitioners also provide essential information to patients by educating them on preventative care and prescribed treatments. Some are even able to prescribe medications themselves.

    Whether the scope of a nurse practitioner’s work is determined by a supervising physician is determined by their state. Some states allow nurses to run independent practices, while others demand a collaborative agreement with hospitals.

Differences in Specializations

As nurse practitioners and physician assistants further their education and training, different specialized positions become available options.

  • Nurse practitioner specialties. Specialization for nurse practitioners focuses on specific population demographics, disease states, or stages in life.

    These include:

    • Mental health. This field covers comprehensive mental health care to patients suffering from mental health disorders or behavioral problems.

    • Women’s health. Care that focuses on conditions that are unique or more common in women. This encompasses care for women across their lifespans.

    • Pediatrics. Pediatric nurses focus on the physical, mental, and behavioral health of children. This can range from minor health problems to serious diseases.

    • Geriatrics. Management of the health and care of elderly people.

    • Primary care. Primary-care nurses typically work in physicians’ offices. They’re skilled in providing day-to-day basic nursing procedures.

    • Neurosurgical. Neurosurgical nurses focus on assessing, diagnosing, and treating patients with neurosurgery needs.

    • Palliative care. These nurse practitioners provide care and support to patients who are near death. They focus on their physical, psychological, and spiritual needs to create an environment of comfort.

    Within these specialties are even further specializations.

    These include:

    • Pulmonary. Pulmonary nurses address respiratory issues involving the patient’s lungs and bronchial tubes.

    • Long-term care. This specialty covers both short-term and long-term care. Nurse practitioners address both medical and non-medical needs. The focus is on helping patients suffering from chronic illnesses perform everyday activities on their own.

    • ICU. ICU nurse practitioners specialize in aiding patients that are critically ill or in an unstable condition.

    • Trauma care. This field aids patients suffering from serious injuries such as strokes, heart attacks, and car accidents. Nurse practitioners must be able to handle minor and acute problems, as well as assist surgeons during operations.

    • Emergency department. ER nurse practitioners treat patients who require immediate, urgent treatment. These are often crises, demanding that workers quickly identify how to stabilize patients and reduce pain.

  • Physician assistant specialties. Specialties for physician assistants are focused on areas of medicine rather than demographics or life stages.

    These include:

    • Emergency medicine. Emergency medicine physician assistants work in both ICU and ER settings. They provide immediate treatments to unstable patients.

    • Internal medicine. This field involves both common and complex health conditions. Physician assistants for this specialty offer care over a wide range of health conditions.

    • Surgery. General surgery physician assistants cannot perform surgery themselves. However, they perform the critical tasks of diagnosing illnesses, creating treatment plans, and assisting surgeons.

    • Pediatric. Pediatric physician assistants diagnose young patients and may even prescribe medications and apply vaccinations.

    • Dermatology. These professionals collaborate with board-certified physicians, diagnosing and treating skin conditions through medical and surgical means.

    • Radiology. Physician assistants of the specialty perform both invasive and non-invasive procedures on patients. The main focus is on creating images and scans.

    • Addiction medicine. Working in clinics and recovery centers, these PAs assist with assessing patients and creating treatment plans. After obtaining a waiver from the Substance Abuse and Mental Health Services Administration, they may also prescribe addiction treatment drugs such as buprenorphine.

Differences in Breadth and Depth of Clinical Training

The education and training process for physician assistants and nursing practitioners are fairly specific. Rather than listing the differences, we’ll provide a comprehensive guide for both routes.

  • Education and training for nurse practitioners. The first step is to earn a nursing degree from an accredited associate or bachelor’s program. Many graduate schools will require a bachelor’s degree as a prerequisite for applying.

    However, most schools do offer direct entry into accelerated or bridge programs. These only require an associate’s degree, even one not related to nursing.

    All nurse practitioners must eventually acquire a master’s degree in nursing (MSN) to work as an advanced practice nurse.

    When applying to nursing school, make sure you include the following on your application:

    If your application passes the institution’s standards, they’ll invite you for an interview. Questions asked will usually pertain to your knowledge, experience, and assess your personality.

  • Education and training for physician assistant. Physician assistants must become certified through a PA program that has been accredited by the Accreditation Review Commission on Education for the Physician Assistant.

    To reach this step, you must first earn a bachelor’s degree. Although it’s recommended that your diploma is in a related field, it’s not a requirement.

    Work experience in the medical field is also a recommendation but not a requirement.

    When applying to a physician assistant program, documents applicants must provide include:

    • Resume

    • Documentation of experience

    • Transcripts

    • Documentation of community service

    • Records of clinical hours

    • GRE scores

    • Letters of reference

    • Application fees

    Some schools will additionally require a full background check of applicants. Students who reach the next step will be called in for an interview to assess their personality and qualifications.

Job Growth and Salaries of Nurse Practitioners and Physician Assistants

Physician assistants and nurse practitioners both earn sizable salaries.

According to the U.S Bureau of Labor Statistics, nurse practitioners’ median salary was $109,820 in 2019, while physician assistants’ median salary was $112,260 during the same period.

Job growth for both positions is expected to accelerate in the coming years, as the average age in the United States is steadily rising. This patient population will require a greater need for healthcare professionals.

The growing popularity of telehealth further strengthens this. More than ever, nurse practitioners and physician assistants are applying their services remotely.

Nurse Practitioners and Physician Assistants are Both Vital Healthcare Roles

While nurse practitioners and physician assistants’ philosophies and specific duties may differ, they both serve equally crucial roles in patient care.

The holistic approach of nurse practitioners puts patients in a greater physical and mental state to fight their symptoms and illnesses. Also, the general education patients often receive from nurse practitioners empowers them to play a more decisive role in bettering their own health.

Physician assistants can determine the specific treatments and cures for patient illnesses through a more systematic approach. Their greater focus on pathology, anatomy, and physiology helps address the specific issues patients face.

In the end, both careers are well-paying, growing fields that serve as the backbone of the country’s healthcare industry.

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Chris Kolmar


Chris Kolmar

Chris Kolmar is a co-founder of Zippia and the editor-in-chief of the Zippia career advice blog. He has hired over 50 people in his career, been hired five times, and wants to help you land your next job. His research has been featured on the New York Times, Thrillist, VOX, The Atlantic, and a host of local news. More recently, he's been quoted on USA Today, BusinessInsider, and CNBC.

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