Physician assistant vs nurse practitioner

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctor married to another with many physician friends: PA and NP are solid jobs we encourage for our own kids or relatives when it is clear the premed coursework will not lead to an MD admission, either from grades or the mcat score. All of us have encouraged our capable medical-interested kids to pursue MD. It is far more autonomy than mid-levels get, and one can pursue many fields to the level of expert. The PA or NP is never the expert, whether it be hospital rounds or clinics. The most common model is they are assigned the needed days(no taking off mon or fri) and the popular vacation weeks the docs are off. They are fillers. They can handle basic conditions but not the complex and for some fields they are never independent (surgery). They do not have ownership in practices nor vote. They are not privy to salary negotiations. If they get bonuses, which many do not, it is 1/10 of docs. Insurance does not reimburse Midlevels well, and that has gotten much worse the past 8yrs or so. Most of us as docs would never see one for our own care, unless it was a basic visit. The training is simply not there for them to be be able to handle complexity. PA spends 85-90k x 2 yrs to eventually get to a salary that is around 100-120k and that is the max for the better fields. Med school if you watch living expense loans is 85-90x 4 yrs BUT many schools at the ivy/Duke/ucsf/washU level have fellowships to cover 1-2 of those years which they award to a large segment of the med school class. The lowest paid fields (primary care) make 250-300k once you are past the 3 year buyin/ramp up. Specialties make 400-600k. Residency pays 80k now which is enough to save and start paying some loans back. 25 yrs ago it was 26k per yr for 80-100 hrs a week for 4 yrs. Half the docs I know are part time and love the balance because they still make 180k+. PA /NP are often not allowed to be parttime.
TLDR Docs only recommend PA/NP to those that have no realistic shot at MD. MD is by far preferable.

Thank you for your detailed reply. But I mean this nicely, everyone knows this. The people whose kids are consider PA or NP are very likely kids we have concluded will not get into med school. But thanks for reminding us of the very sucky pay and the fact that are second class citizens to MDs. With all due respect.

Not PP ... but ... they are. Sh!t rolls downhill in medicine.

At least we got to page 4 before the arrogant, dismissive, condescending posting came in to tell us how it is.

[Anonymous]

NPs and PAs can have a lot of the same jobs. I think some hospitals (especially more surgery based ones) have a bias for PAs. Both can be awesome.

Nurse Practitioners go to nursing school first and then complete a Master's or doctorate in nursing. An advantage of this is that you can always work as a nurse - I think in general there are more opportunities for nurses than PAs. NPS can practice autonomously in many states. They are also specialized - so that may limit practice - you can be adult, acute care, family, pediatric, neonatal, nurse midwife, nurse anesthetist, psychiatric. These are different master's programs with different boards and scope of practice.

PAs do not practice autonomously. They go to college and then PA school. They need medical experience (as a medical assistant or nursing assistant) before applying to PA school. This is also a master's program, generally 2 years.

Healthcare is wondering, rewarding, challenging work.

[Anonymous]

Anonymous wrote:Doctor married to another with many physician friends: PA and NP are solid jobs we encourage for our own kids or relatives when it is clear the premed coursework will not lead to an MD admission, either from grades or the mcat score. All of us have encouraged our capable medical-interested kids to pursue MD. It is far more autonomy than mid-levels get, and one can pursue many fields to the level of expert. The PA or NP is never the expert, whether it be hospital rounds or clinics. The most common model is they are assigned the needed days(no taking off mon or fri) and the popular vacation weeks the docs are off. They are fillers. They can handle basic conditions but not the complex and for some fields they are never independent (surgery). They do not have ownership in practices nor vote. They are not privy to salary negotiations. If they get bonuses, which many do not, it is 1/10 of docs. Insurance does not reimburse Midlevels well, and that has gotten much worse the past 8yrs or so. Most of us as docs would never see one for our own care, unless it was a basic visit. The training is simply not there for them to be be able to handle complexity. PA spends 85-90k x 2 yrs to eventually get to a salary that is around 100-120k and that is the max for the better fields. Med school if you watch living expense loans is 85-90x 4 yrs BUT many schools at the ivy/Duke/ucsf/washU level have fellowships to cover 1-2 of those years which they award to a large segment of the med school class. The lowest paid fields (primary care) make 250-300k once you are past the 3 year buyin/ramp up. Specialties make 400-600k. Residency pays 80k now which is enough to save and start paying some loans back. 25 yrs ago it was 26k per yr for 80-100 hrs a week for 4 yrs. Half the docs I know are part time and love the balance because they still make 180k+. PA /NP are often not allowed to be parttime.
TLDR Docs only recommend PA/NP to those that have no realistic shot at MD. MD is by far preferable.

Eh, I never go see an MD unless I really need a specialist. Don't feel like dealing with the egos and attitude.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is helpful, but really doesn't answer what the real difference are between the two. From what I read, they are very similar and both can do patient care. Do some of the above posters have insight.

Also, what if my DD goes to a direct admit nursing school, but then decides to switch to a PA after graduation (and will have her BSN). Anyone seen that happen?

PA school is 2 years after graduation. As long as you have the pre-requisite classes you can apply. Be careful with nursing science classes vs standard science classes taught at a university for STEM majors. The nursing classes are often not as rigorous and may not be accepted by the PA program. Your DD may have to do a post-Bacc year to get the requirements. Your best bet is to contact a few PA schools admissions offices and ask if they accept nursing science classes.

This is incorrect. Virtually all, if not all, PA programs require some medical work experience. What each program considers to be good enough experience varies.

The schools I've looked at require a minimum of 1,000 hours.

PP here. I looked into PA school as well, and this is pretty much what I saw too — 1000 hours with patients, minimum. As far as what kind of experience counts, that varies a bit (for example some will take the less complicated work — like phlebotomists and CNAs — and some won’t). If I were in college I’d consider getting certified as an EMT and spend summers getting experience on the ambulance, in a hospital, and volunteer hours with a fire dept/in the community.

EMTs spend the vast majority of their time sitting in parking lots. Of the calls they do get, vast majority are not emergencies at all (think morbidly obese person needs to go to the bathroom and cannot get out the recliner chair and they live alone). It isn’t the clinical experience you think it is.

What makes you think you know what I "think it is"? The only thing at issue here is hours required for admit to PA school.

The point is the “required” patient care hours people are getting to get into PA school are mostly nonsense and fluff and not very helpful toward their medical education. As where nurses working as RNs for years prior going to going to NP school are infinitely better prepared.

[Anonymous]

Anonymous wrote:My niece is about to start in PA school this fall. I don’t think she had aspirations to be a medical doctor, but was always interested in physical therapy and other roles related to sports medicine and orthopedics. She is an athlete.

Maybe the popularity of PAs has grown in the past few years because I had never really paid attention to PAs in the medical setting until my niece started pursuing it. She graduated 2 years ago and was behind in the process so spent the past few years working as a medical assistant and taking biology pre-reqs and getting “patient hours”.

From my understanding PA and medical Dr are pretty different. She says she will pretty much be able to do A lot of the procedures that doctors can, but will also have a lot of restrictions as well. But after four years of undergrad, 2.5 gap years taking classes and working for minimum wage, she can go to school and graduate with her masters in 2 years and start working…. So about 9 years total. She’s studying a lot and we are all rooting for her.

A doctor has a different path - a lot more schooling and in-depth knowledge and responsibility - with the main difference being at least 12 years of schooling and residency.

why didn't she do a DPT?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is helpful, but really doesn't answer what the real difference are between the two. From what I read, they are very similar and both can do patient care. Do some of the above posters have insight.

Also, what if my DD goes to a direct admit nursing school, but then decides to switch to a PA after graduation (and will have her BSN). Anyone seen that happen?

PA school is 2 years after graduation. As long as you have the pre-requisite classes you can apply. Be careful with nursing science classes vs standard science classes taught at a university for STEM majors. The nursing classes are often not as rigorous and may not be accepted by the PA program. Your DD may have to do a post-Bacc year to get the requirements. Your best bet is to contact a few PA schools admissions offices and ask if they accept nursing science classes.

This is incorrect. Virtually all, if not all, PA programs require some medical work experience. What each program considers to be good enough experience varies.

The schools I've looked at require a minimum of 1,000 hours.

PP here. I looked into PA school as well, and this is pretty much what I saw too — 1000 hours with patients, minimum. As far as what kind of experience counts, that varies a bit (for example some will take the less complicated work — like phlebotomists and CNAs — and some won’t). If I were in college I’d consider getting certified as an EMT and spend summers getting experience on the ambulance, in a hospital, and volunteer hours with a fire dept/in the community.

EMTs spend the vast majority of their time sitting in parking lots. Of the calls they do get, vast majority are not emergencies at all (think morbidly obese person needs to go to the bathroom and cannot get out the recliner chair and they live alone). It isn’t the clinical experience you think it is.

What makes you think you know what I "think it is"? The only thing at issue here is hours required for admit to PA school.

The point is the “required” patient care hours people are getting to get into PA school are mostly nonsense and fluff and not very helpful toward their medical education. As where nurses working as RNs for years prior going to going to NP school are infinitely better prepared.

Thanks to the hard work of the AANP, NP programs nationally have 0 required patient care hours. So, fluff or not, an incoming PA student is required to have infinitely more experience than an NP student, and this is by design of their respective national associations. If you're a nurse, ask the AANP to push for stricter regulation nationally.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is helpful, but really doesn't answer what the real difference are between the two. From what I read, they are very similar and both can do patient care. Do some of the above posters have insight.

Also, what if my DD goes to a direct admit nursing school, but then decides to switch to a PA after graduation (and will have her BSN). Anyone seen that happen?

PA school is 2 years after graduation. As long as you have the pre-requisite classes you can apply. Be careful with nursing science classes vs standard science classes taught at a university for STEM majors. The nursing classes are often not as rigorous and may not be accepted by the PA program. Your DD may have to do a post-Bacc year to get the requirements. Your best bet is to contact a few PA schools admissions offices and ask if they accept nursing science classes.

This is incorrect. Virtually all, if not all, PA programs require some medical work experience. What each program considers to be good enough experience varies.

The schools I've looked at require a minimum of 1,000 hours.

PP here. I looked into PA school as well, and this is pretty much what I saw too — 1000 hours with patients, minimum. As far as what kind of experience counts, that varies a bit (for example some will take the less complicated work — like phlebotomists and CNAs — and some won’t). If I were in college I’d consider getting certified as an EMT and spend summers getting experience on the ambulance, in a hospital, and volunteer hours with a fire dept/in the community.

EMTs spend the vast majority of their time sitting in parking lots. Of the calls they do get, vast majority are not emergencies at all (think morbidly obese person needs to go to the bathroom and cannot get out the recliner chair and they live alone). It isn’t the clinical experience you think it is.

What makes you think you know what I "think it is"? The only thing at issue here is hours required for admit to PA school.

The point is the “required” patient care hours people are getting to get into PA school are mostly nonsense and fluff and not very helpful toward their medical education. As where nurses working as RNs for years prior going to going to NP school are infinitely better prepared.

Thanks to the hard work of the AANP, NP programs nationally have 0 required patient care hours. So, fluff or not, an incoming PA student is required to have infinitely more experience than an NP student, and this is by design of their respective national associations. If you're a nurse, ask the AANP to push for stricter regulation nationally.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is helpful, but really doesn't answer what the real difference are between the two. From what I read, they are very similar and both can do patient care. Do some of the above posters have insight.

Also, what if my DD goes to a direct admit nursing school, but then decides to switch to a PA after graduation (and will have her BSN). Anyone seen that happen?

PA school is 2 years after graduation. As long as you have the pre-requisite classes you can apply. Be careful with nursing science classes vs standard science classes taught at a university for STEM majors. The nursing classes are often not as rigorous and may not be accepted by the PA program. Your DD may have to do a post-Bacc year to get the requirements. Your best bet is to contact a few PA schools admissions offices and ask if they accept nursing science classes.

This is incorrect. Virtually all, if not all, PA programs require some medical work experience. What each program considers to be good enough experience varies.

The schools I've looked at require a minimum of 1,000 hours.

PP here. I looked into PA school as well, and this is pretty much what I saw too — 1000 hours with patients, minimum. As far as what kind of experience counts, that varies a bit (for example some will take the less complicated work — like phlebotomists and CNAs — and some won’t). If I were in college I’d consider getting certified as an EMT and spend summers getting experience on the ambulance, in a hospital, and volunteer hours with a fire dept/in the community.

EMTs spend the vast majority of their time sitting in parking lots. Of the calls they do get, vast majority are not emergencies at all (think morbidly obese person needs to go to the bathroom and cannot get out the recliner chair and they live alone). It isn’t the clinical experience you think it is.

What makes you think you know what I "think it is"? The only thing at issue here is hours required for admit to PA school.

The point is the “required” patient care hours people are getting to get into PA school are mostly nonsense and fluff and not very helpful toward their medical education. As where nurses working as RNs for years prior going to going to NP school are infinitely better prepared.

Thanks to the hard work of the AANP, NP programs nationally have 0 required patient care hours. So, fluff or not, an incoming PA student is required to have infinitely more experience than an NP student, and this is by design of their respective national associations. If you're a nurse, ask the AANP to push for stricter regulation nationally.

Wrong, mostly. Majority of NP students have already gained lots of real clinical hours working as RNs prior to NP school plus all the clinical hours required in their BSN program. Even the direct entry programs (which are a minority), are typically done so students get their BSN and can sit for NCLEX exam after 18 months then they start working as nurses part or full while they finish up the MSN/NP portion.

[Anonymous]

What are the premed courses now?

[Anonymous]

Anonymous wrote:What are the premed courses now?

There aren’t set prereqs for med school. Different schools may want to see different courses. But in general, 1 yr of bio, chem (organic), physics, calc, statistics. Majoring in an of the sciences will likely fulfill this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What are the premed courses now?

There aren’t set prereqs for med school. Different schools may want to see different courses. But in general, 1 yr of bio, chem (organic), physics, calc, statistics. Majoring in an of the sciences will likely fulfill this.

wrong. There are set premed courses listed under AMCAS website for MD programs. some programs want courses in addition to this minimum.
The minimum is two years of Chem (2 sem gen chem and 2 sem Ochem), 1 sem physics (2 is often encouraged by undergrad premed advising and is needed for science majors anyway), 2 semesters Bio, 1 sem calc(top schools encourage 2), 1 sem stats, 1 sem psych, many schools encourage or require 1 sem biochem and one sem Cell bio or genetics and many encourage or require physiology with lab.

PA and NP do not get nearly the same basic science training, and the clinical hours are less than 1/4 of what MD programs and residency provide. and that is why they cannot do as much nor get paid as much.

[Anonymous]

To clarify from an earlier post poster. PAs can also specialize. The ones working in cardiothoracic or orthopedics are trained in that specialty and often well paid.

[Anonymous]

Anonymous wrote:How are these careers perceived? Seems like those who want/have kids looking to pursue medical field (which aren’t many to my surprise) always gun for pre-med. however I know more kids who switched out of that major than actually went to medical school.

How do NP and PA compare in terms of pay, work-life balance, job growth, stability, and I guess in DCUM fashion, I guess I have to say in prestige as well

Shadow both then make an educated decision. That being said, don't give up on medical school too hastily. I see more and more kids taking gap year, doing clinical research overseas, doing post baccalaureate to improve GPA, retaking MCAT etc and making it into medical school after 1-3 years of undergrad.

[Anonymous]

If you apply to DO schools in rural areas and requirement for doing family practice or public health, its easier to get accepted.

[Anonymous]

Some students are more focused on saving time, earning money or serving community, all of which can be done with any role in healthcare but other students want to dig deep and be become experts in their fields, they are better served by medical schools.