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Do You Know the Differences Between NPs and PAs?
Nurse practitioners (NPs) and physician assistants (PAs) are increasingly mentioned as a collective solution to the nation’s primary health care shortage. The 158,000 NPs and 89,000 PAs in the United States provide cost-effective patient care, preventive care, and health promotion. But what exactly is the difference between these 2 groups of health care practitioners? Practicing Clinicians Exchange provides a quick snapshot of how these growing professions compare:
What Are the Differences Between NPs and PAs?
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Nurse Practitioner (NP) |
Physician Assistant (PA) |
| Definition |
- RN with advanced education and clinical training
- Provide a wide range of health care services, including the diagnosis and management of common as well as complex medical conditions
- Practice independently or in collaboration with physician, depending on state requirements
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- Licensed to practice medicine with physician supervision
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Philosophy/
model |
- Advanced nursing practice builds on RN competencies
- Patient-centered model
- Besides health assessment, diagnosis, and treatment, NPs focus on health promotion, disease prevention, health education, and counseling
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- Medical/physician model
- Disease centered, emphasis on the biologic/pathologic aspects of health, assessment, diagnosis, and treatment
- Team approach relationship with physicians
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Certification/
licensure |
- Nursing accreditation and graduate education (master's or doctoral degree) with preparation in the NP role and at least 1 specialty population
- National board certification in neonatal, pediatric, family, women's health, adult, geriatric, psychiatric, or acute care
- Major national certifying agencies: AANP and ANCC
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- Separate accreditation and certification bodies require successful completion of an accredited program; most settings require NCCPA national certification exam and state licensure
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| Recertification |
- Recertified every 5 years
- May sit for appropriate examination or meet clinical practice and continuing education requirements
- Minimum of 1000 hours of clinical practice as an NP in area of specialization and 75-150 CEUs relevant to the area of specialization
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- Requires 100 hours of Category 1 CME every 2 years and exam every 6 years
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| Scope of practice |
- Authorized to practice independently without physician oversight in 22 states and DC; in remaining states, practice with varying degrees of physician involvement
- Prescriptive authority in all states
- Controlled substance prescribing restrictions in some states
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- Supervising physician delegates medical tasks to PAs in accordance with state regulation
- Prescriptive authority in all states based on state-enabling legislation
- Controlled substance prescribing restrictions in some states
- On-site supervision not required
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| Third-party coverage and reimbursement |
- Eligible for certification as Medicare and Medicaid providers
- Generally receive favorable reimbursement from commercial payers
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Sources: www.aanp.org; www.nursecredentialing.org/Certification/CertificationRenewal/NP-CNS-RenewalFAQ.aspx; www.aapa.org.
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