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


Updated February 13, 2023 · 4 Min Read

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Learn the differences between PAs and NPs. Compare factors like salary, education requirements, and skills to help you choose your career.
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Considering an advanced degree in healthcare? You may want to learn the similarities and differences between nurse practitioners (NPs) and physician assistants (PAs). Both careers are mid-level practitioner roles that are alternatives to working as a physician.

NPs attend nursing schools, while PAs attend medical schools or centers of medicine. Nurses follow a patient-centered model and handle assessment, diagnosis, and treatment. Physician assistants follow a disease-centered model. They also practice assessment, diagnosis, and treatment.

NPs can specialize in several areas, including gerontology, mental health, pediatrics, and women's health. PAs have a more generalized education and can specialize in areas like emergency medicine, orthopedics, and general surgery.

When considering the similarities and differences between physician assistants vs. nurse practitioners, keep in mind their different healthcare philosophies, educational options, and specializations to determine the best fit for you.

Side-by-Side Comparison of Nurse Practitioners and Physicians Assistants

Job duties of nurse practitioners and physician overlap. They both provide direct patient care, perform assessments, make diagnoses, and develop treatment plans.

The primary difference is in the level of supervision, depending on the state in which they practice. Nurse practitioners can practice independently and prescribe medications in many states. Physician assistants always work under the supervision of a doctor.

PAs and NPs often serve as primary care providers, especially in rural and underserved communities. They both make similar average salaries, with NPs earning $118,040 and PAs earning $119,460, according to the Bureau of Labor Statistics (BLS).

Comparison of Nurse Practitioners and Physician Assistants
Points to Consider Nurse Practitioner Physician Assistant
Role NPs may practice independently in some states. They perform physical assessments, order and interpret diagnostic tests, manage treatment, and coordinate care. They also provide patient education and counseling. According to the American Medical Association, PAs working under a physician's supervision are authorized to perform physical assessments, diagnose and treat illnesses, order and interpret tests, and assist in surgery. PAs also manage treatment plans, patient education, and coordination of care.
Number Practicing in the U.S. 234,690 132,940
Pay Average annual salary of $118,040 Average annual salary of $119,460
Projected Job Growth 40% from 2021 to 2031, much faster than the average for all occupations (5%) 28% from 2020 to 2030, much faster than average for all occupations (5%)
Anticipated Number of New Positions Available by 2030 112,700 from 2020 to 2030 40,100 from 2020 to 2030
Practice Framework State laws determine whether a nurse practitioner can practice independently or work under physician oversight. All physician assistants work under the supervision of a doctor. They are not permitted to work independently.

Source: BLS

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Schooling and Education Requirements for NPs vs. PAs

NPs and PAs must earn master's degrees in their respective discipline. Both NP programs and physician assistant programs feature similar coursework and focus on topics like pharmacology, pathophysiology, and advanced health assessment.

NPs can pursue nursing specialties. PAs receive a broad-based, general medical education that allows them to work in any area of medicine, including specialty clinics. PAs seeking postgraduate training can complete specific residencies and specialty certifications.

In contrast, NPs choose an MSN degree specialty before starting their program. For example, they can graduate as a family practice NP or mental health NP. Those wanting to practice in a different field later must receive training and nursing certification.

Schooling and Education Requirements
Points to Consider Nurse Practitioners Physician Assistants
Degree Requirements NPs need a minimum of a master of science in nursing (MSN) degree from an accredited school to become licensed within a state. Even though the American Association of Colleges of Nursing (AACN) recommends the doctor of nursing practice (DNP) as the new NP standard, states and credentialing entities still just require a master's degree. PAs need a minimum of a master's degree from an accredited medical school or center of medicine to seek licensure.PAs need a minimum of a master's degree from an accredited medical school or center of medicine to seek licensure.
Degrees Available An MSN is the minimum degree required for NPs. Licensed RNs with associate's degrees can opt for an RN to MSN bridge program, while those with a BSN can choose a direct entry master's program. A nurse with a BSN can enter a BSN to DNP program. An MSN from a program accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) is the minimum degree requirement for a PA. Some programs offer a pre-professional phase, which allows recent high school graduates and those with college credits to qualify for certification in 4-6 years.
Program Details NPs typically choose a specialty area and complete 500 instructional hours and between 500-700 clinical hours (1,000 for DNPs). PAs receive generalist training and typically complete about 1,000 instructional hours and more than 2,000 clinical hours.
School Accreditation NP programs typically hold accreditation through the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing. PA programs hold accreditation through the ARC-PA. You can find a list of PA programs through the Physician Assistant Education Association.
Certification and Licensing for NPs vs. PAs
Points to Consider Nurse Practitioners Physician Assistants
Certification The American Nurses Credentialing Center and the American Association of Nurse Practitioners (AANP) offer national certifications for NPs in their specialty areas. NPs can certify in specialty areas like orthopedics, hospice and palliative care, oncology, dermatology, and more are provided through industry organizations. PAs need to pass the physician assistant national certifying examination available through the National Commission on Certification of Physician Assistants (NCCPA). The NCCPA also offers specialty certifications in areas like orthopedics, cardiovascular and thoracic surgery, dermatology, and palliative care.
Licensing Candidates for state licensure as NPs must hold a registered nurse (RN) license, a master's or doctoral degree, and national certification. Candidates seeking state licensure as PAs must hold a master's degree from an accredited school and national certification.
Licensing Agency NPs seek licensure through a state board of nursing or board of medical examiners. The AANP provides links to the licensing agencies. PAs seek licensure through a state medical board, board of medical examiners, or similar agency. You can find a list of state licensing agencies through the NCCPA.
Recertification NPs must earn recertification every five years or less, depending on their population focus and credentialing entity. They may sit for the appropriate exam or complete a minimum 1,000 hours of clinical practice and 75-150 continuing education units in their NP specialty. According to the NCCPA, PAs maintain certification by completing 100 continuing education credits every two years, which must include at least 50 Category 1 credits. They must also pass a recertification exam every 10 years.

How to Choose Between Becoming an NP vs. a PA

Consider each position's salary, educational requirements, scope and flexibility of practice, and job duties before choosing your career path. Your state's scope of practice laws may also influence your decision-making process.

Although both NP and PA academic paths require graduate degrees, they differ in several ways:

  • NPs pursue nursing education, first earning RN licensure before completing graduate NP programs.
  • PA programs seek students with some experience in healthcare, including areas outside of nursing, like a paramedic, respiratory technician, radiology, or surgical technician.

While most nurses choose the NP route, it is not unheard of for nurses to become PAs. The decision reflects the person's goals, interests, and chosen specialty area.

NPs and PAs may choose to specialize in general or primary care:

  • NPs are advanced practice registered nurses, which includes an advanced nursing education with a specific population focus or field of practice.
  • PA programs emphasize general medical practice, diagnosis, procedures, and treatment.

Frequently Asked Questions About NPs and PAs

Is NP higher than PA?

Neither profession ranks "higher" than the other. Both NPs and PAs work in the healthcare field but with different qualifications, educational backgrounds, and responsibilities. They also work in different specialties. In addition, although both nurse practitioners and physician assistants work with more independence than nurses or aides, both often need some physician oversight.

Do PAs make more than nurse practitioners?

PAs and NPs earn similar salaires. According to the BLS, NPs earned a median salary of $120,680, and PAs earned a median salary of $121,530 in 2021. Outpatient care centers are the highest-paying workplaces for both roles.

Can nurse practitioners and physician assistants prescribe medications?

For the most part, yes. However, some states limit the type of medications that nurse practitioners and physician assistants can prescribe. Those restrictions usually include Schedule II medications, but each state sets different rules.

What is the difference between nurse practitioner and physician assistant?

Nurse practitioners and physician assistants work in similar capacities. However, NPs have a background in nursing theory, while physician assistants complete a medical-school learning model. NPs and PAs also take different licensing exams to practice.

They may also specialize in different categories. For example, physician assistants are more likely to go into a surgical specialty, while nurse practitioners may focus on areas like adult-gerontology, pediatrics, or women's health.

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