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

Updated October 5, 2022 · 4 Min Read

There are unique differences between PAs and NPs. This guide compares factors like salary, education, and skills to help you choose your career.

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Nurse Practitioner vs. Physician Assistant: What’s the Difference?
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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 options provide career alternatives if you want to work in advanced healthcare roles but not as a physician.

An NP attends a nursing school, while a PA attends a medical school or center 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, but they can also specialize in areas like emergency medicine, orthopedics, and general surgery.

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

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

The job duties of nurse practitioners and physician assistants have many overlaps. They both provide direct patient care, perform assessments and make diagnoses, and develop treatment plans.

The primary difference is in the level of supervision, depending on which state they practice in. Nurse practitioners can practice independently in about half of the country and have the authority to prescribe medication in those states. Physician assistants always work under the supervision of a doctor.

Both PAs and NPs often serve as primary care providers, especially in rural and underserved communities. The similarities in their duties is reflected in their salaries, with NPs earning $118,040 per year, and PAs earning $119,460.

Comparison of Nurse Practitioners and Physicians 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.
Number Practicing in the U.S. 234,690 as of 2021, according to the U.S. Bureau of Labor Statistics (BLS) 132,940 as of 2021, according to the BLS

Pay

Average annual salary of $118,040, according to the BLS

Average annual salary of $119,460, according to the BLS

Projected Job Growth

40% from 2021 to 2031, much faster than the average for all occupations (5%), according to the BLS 28% from 2020 to 2030, much faster than average for all occupations (5%), according to the BLS
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.

In almost half of states, NPs have full practice authority. This includes writing prescriptions, with restrictions.

All physician assistants work under the supervision of a doctor. They are not permitted to work independently.

However, in many states there is increased movement toward allowing PAs full practice authority similar to nurse practitioners.

Schooling and Education Requirements for NPs vs. PAs

NPs and PAs must earn a master's degree 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 general education that allows them to work in any area of medicine right after graduation. Specific residencies are available for PAs seeking postgraduate training.

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

Schooling and Education Requirements
Points to Consider Nurse Practitioner Physician's Assistant
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.
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 need to 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 PRACTITIONER PHYSICIAN ASSISTANT
Certification

The American Nurses Credentialing Center and the American Association of Nurse Practitioners (AANP) offer national certifications for NPs in their specialty areas.

Certifications 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).
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 factors like salary, educational requirements, the scope and flexibility of practice for each position, and individual job duties before choosing your career path. Scope of practice laws in your state of residence may also influence your decision-making process.

Although both academic paths require graduate degrees, each path differs:

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

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

NPs and PAs may choose to specialize their work or practice 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 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 occupations 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?

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?

This question does not come with a clear-cut answer. For the most part, yes. However, some states impose limitations on 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 come from a nursing background, while a physician assistant comes from a medical-school learning model.

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


Page last reviewed September 27th, 2022

NurseJournal.org is an advertising-supported site. Featured or trusted partner programs and all school search, finder, or match results are for schools that compensate us. This compensation does not influence our school rankings, resource guides, or other editorially-independent information published on this site.

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