About the ads

Nurse Practitioner vs. PA

Discussion in 'Clinicians [ RN / NP / PA ]' started by Mcwalior, Mar 11, 2002.

  1. SDN is a nonprofit organization. Services are made possible through the generous support of SDN members and sponsors. Thank you.
Thread Status:
Not open for further replies.
  1. Mcwalior

    Mcwalior New Member

    Joined:
    Mar 9, 2002
    Messages:
    4
    Location:
    San Diego, CA

    SDN Members don't see this ad. (About Ads)
    What exactly is the difference? I even asked a PA and she couldn't tell me!?
  2. PACmatthew

    PACmatthew Senior Member

    Joined:
    Feb 27, 2002
    Messages:
    98
    Location:
    houston
    SDN 7+ Year Member
    A PA is a person who is trained by and with physicians, and who has to sweat it out for 14 months of clinical rotations right there next to the third year medical students. An NP is a person who completes about one fifth the amount of clinical hours in their curriculum as a PA, and has to spend their first year out of school really learning how to practice medicine. The PA profession is based on the medical model which is a watered down rushed curriculum of "medicine", while an NP curriculum is still "nursing" at its core. Where I went to school, PA's had an entire semester of learning to read EKG's for instance, while the NP students came to our class for one week to learn the basics. There is no comparrison between the education of a PA vs. an NP. However, like anything else in life, the NP profession has much better lobbyists, and thus they can practice more autonomously in certain places and with fewer restrictions. The theory behind NP training is that RN's are a natural transition to practitioners of medicine. Sadly, this is not true. Nurses, as in RN's, are highly trained medical providers that often times get the bad end of the stick from physicians, and thus they never really get to do much with their high degree of training. Some of the best PA students in my class were RN's, and when asked why they became PA's instead of NP's, they all said it was because they wanted to be able to practice with confidence and be respected. There are definitely good NP's out there but overall I think you will see that physicians favor PA's because of the very rigorous nature of PA training.

    NP's fill a niche where advanced knowledge is necessary, and where most PA's aren't "touchy feely" enough to provide good care. Often times this means in OB/GYN and Peds.
  3. MrBob

    MrBob Senior Member

    Joined:
    Jun 12, 2001
    Messages:
    105
    Location:
    N.C.
    SDN 7+ Year Member
    For an unbiased response, do this....go to <npeducation.com> for the Nurse practioners education process and then go to the site for the AAPA (American Academy of Physicians Assistants) for a synopsis of our training...maybe that will help. To ask this question on this forum is to open a can of snakes rather than worms
  4. PACmatthew

    PACmatthew Senior Member

    Joined:
    Feb 27, 2002
    Messages:
    98
    Location:
    houston
    SDN 7+ Year Member
    Did you hear me hissing Mr.Bob? HISSSSSSSSSSSS
  5. Freeeedom!

    Freeeedom! Senior Member

    Joined:
    Feb 21, 2001
    Messages:
    698
    Location:
    I am a ninja
    SDN 10+ Year Member
    Also, not being a Physicians Assistant, I would like to add that just as Matt stated, the PA curriculum is based upon an Allopathic abbreviated model and not Osteopathic. Osteopathic Physicians pride themselves on primary care with additional training not found in allopathic care (and obviously nursing).
  6. MrBob

    MrBob Senior Member

    Joined:
    Jun 12, 2001
    Messages:
    105
    Location:
    N.C.
    SDN 7+ Year Member
    Yeah...............but I heard yer rattles first..... Watch out....I might be a mongoose(LOL)
  7. Kimya

    Kimya Senior Member

    Joined:
    Aug 19, 2000
    Messages:
    192
    SDN 10+ Year Member
    That's a good question. I think it really varies from state to state and from program to program. I know that the UC Davis PA/NP program in California trains both NP's and PA's in the same program in the same way. The only difference is the NP's had the nursing degree first. The Stanford PA program allows you to get an NP after completing the program if you were a registered nurse first. Probably it would be best to check out the programs that you are interested in attending, and see what works best for your needs. There might be a lot of difference or, as in the programs above, there might be no difference.
  8. predoc

    predoc Member

    Joined:
    Apr 15, 2000
    Messages:
    91
    Location:
    Nevada
    SDN 10+ Year Member
    Originally posted by PACMatthew:

    I think you will see that physicians favor PA's because of the very rigorous nature of PA training.

    I have to disagree with the above quote. It's been my experience that doctors favor PAs because they were trained under the same medical model, and because they tend to have a bit more control over them. Doctors are sometimes threatened by the autonomy that NPs are afforded. Some doctors view them as competetion rather than "assistants". To say that doctors view an NP's training as somewhat inadequate, relative to a PA's training, is missing the point.

    Both are mid-level practitioners and are very qualified to fulfill that role.

    And finally, to imply that NPs are better serving in "touchy/feely" roles such as pediatrics and OB is insulting at best. I am not a nurse, nor a nurse practitioner, but I would hope that the changing roles of nursing would be better understood.

    Oh, and until all PA programs award master's degrees, I don't think that they will ever hold MORE respect than an NP.
  9. med student

    med student Senior Member

    Joined:
    Nov 6, 2001
    Messages:
    322
    Location:
    New York
    SDN 7+ Year Member
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> Oh, and until all PA programs award master's degrees, I don't think that they will ever hold MORE respect than an NP. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Ignoring the whole part about which is better aurgument I highly doubt that most people know that NP have a masters while PAs don't. Also I would guess if you asked the general public about who has a higher level of training and more respect they would would think PAs do. This doesn't make one better than the other but it is something to consider.
  10. predoc

    predoc Member

    Joined:
    Apr 15, 2000
    Messages:
    91
    Location:
    Nevada
    SDN 10+ Year Member
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Also I would guess if you asked the general public about who has a higher level of training and more respect they would would think PAs do. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">If you asked the general public about PAs or NPs, many wouldn't even know what they are. The PAs I work with are constantly explaining who they are and what they do. Many patients think they are residents or are somehow on their way to "becoming a doctor". In fact, I never knew what a PA was until I began exploring the idea after my EMT program three years ago.

    Consequently, the majority of respect comes from within the medical community. And my point was not to suggest that NPs are more respected than PAs, only to rebut the argument that PAs are more highly respected. That simply has not been my experience. And one reason I come to that conclusion is because many PAs leave school with a certificate. And while I know that their education is very rigorous and difficult (especially since it's so condensed), the peice of paper they hold is simply not the same as a master's degree.

    Please know that I actually wanted to be a PA until I made the decision to go to med school. So I certainly respect the profession a great deal. And if I were to return to that path, I would certainly choose PA school over becoming an NP. I just don't agree with the notion that one is more highly respected than the other--especially by the general public. Also keep in mind that I could be wrong.
  11. med student

    med student Senior Member

    Joined:
    Nov 6, 2001
    Messages:
    322
    Location:
    New York
    SDN 7+ Year Member
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> And one reason I come to that conclusion is because many PAs leave school with a certificate. And while I know that their education is very rigorous and difficult (especially since it's so condensed), the peice of paper they hold is simply not the same as a master's degree. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">I guess my question is how many people do you think know that PA programs give a certificate while NPs get a masters. I suspect that even in the medical profesion most people think that PAs have a higher level of training.
  12. efs

    efs SDN Advisor SDN Advisor

    Joined:
    Jul 20, 2001
    Messages:
    457
    Location:
    Germany
    Status:
    Podiatrist
    SDN 10+ Year Member
    Many of the PA programs now are Master's Degrees.
  13. predoc

    predoc Member

    Joined:
    Apr 15, 2000
    Messages:
    91
    Location:
    Nevada
    SDN 10+ Year Member
    I am well aware that many PA programs offer master's degrees. Notice in my original post that I said untill ALL PA programs offer master's degrees, they won't be more respected than NPs.

    As for Med Student's comments--I already put forth my opinion, regarding that assumption, in my previous post.
  14. Bandit

    Bandit Senior Member

    Joined:
    Nov 23, 2001
    Messages:
    470
    Status:
    Resident [Any Field]
    SDN 10+ Year Member
    Predoc, I think you are on the right track here about all programs should be masters, but I strongly disagree that np`s have greater respect. At least not in Newe York.
  15. predoc

    predoc Member

    Joined:
    Apr 15, 2000
    Messages:
    91
    Location:
    Nevada
    SDN 10+ Year Member
    Does anyone actually read my posts? No where did I ever say that NPs have more respect than PAs. My whole reason for making the point about the master's degree was to refute the notion that PAs have more respect than NPs.

    I will grant all of you the fact that PAs tend to be a bit more popular, in general, back east. I think they're more widely used, have more expansive roles, etc (than PAs on this side of the country). At least that's my understanding. Perhaps that's why we are running into this communication breakdown. Maybe those of you on that half of the country see PAs in different roles than I do.

    Oh yeah, and one more thing. This was posted by Med Student:

    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif"> I guess my question is how many people do you think know that PA programs give a certificate while NPs get a masters. </font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">How often do you suppose that PAs get asked what that "C" on their nametag stands for? Just something to consider.
  16. PACmatthew

    PACmatthew Senior Member

    Joined:
    Feb 27, 2002
    Messages:
    98
    Location:
    houston
    SDN 7+ Year Member
    Wow. much has transpired since I have written last. Someone brought up the idea that NP's all have Master's degree's. There are actually NP programs that do not award master's degrees. There are also PA programs that still give certificates. The certificate problem is why it took PA's a million years to get licensed in Mississippi, and thus should be abolished. The NP lobbyists said it best when they put up a billboard outside the state capital in Mississippi stating "Do you want your prescription coming from someone who only has a high school education?". As incredibly misleading as it was, it was still true.

    Whoever was offended by my statement that NP's do better in touchy feely roles, you simply are not up on the facts. NP's dominate those areas, like it or not, perhaps because they are better suited for them with their caring nature. Thats all it meant though, so relax. I actually think that midlevel providers should merge into a new title all their own called Physician Extenders, and take one board exam. The public will never be able to understand the role of midlevels unless there is consistency and standardization.

    In reality, I am probably going through all this torture to be a physician only to find out that the family doctor is only a memory in 2006! There are rumors that healthcare as insurance companies see it needs to head away from physicians in the PCP role, and use them more as specialists. The reason for this is twofold...1)shortage of FP's and those wanting to become one, and 2) economics. I think it will be a sad day when or if there are no longer FP docs, but I guess it could happen. Hec, did anyone see the number of FP programs that did not match all their spots! It was quite staggering.

    Yes Stayce, I agree that we should just all get along. I am done with all this bickering, but in the end there was some meaningful discussion. Its not that I don't mind bickering, but I am up to 2 Nexium a day to supress the "pissed off" acidity.

    Lets start a new thread....

    Here goes....
    Did anyone have a really interesting medical case this week? I had a guy who had come in for bilaterral lower leg cellulitis, two times in 4 weeks, with edema, pain, heat, medial surface only. His CBC was normal both times, a doppler was normal, SMAC normal, and the only thing strange was his inguinal adenopathy. It took using Levaquin and Rocephin daily to clear it up both times as well. Oh, he did have one interesting thing though that I had to inform him about today, and that was that he was actually HIV+. This was a strange presentation.

    Your turn!
  17. migraineboy

    migraineboy Member

    Joined:
    Dec 22, 2001
    Messages:
    94
    SDN 7+ Year Member
    Oh no you don't PACmatthew....we aren't done yet. I wanted a chance to throw in my two cents worth. First of all, Freedom, PA training is based on a medical model not an allopathic model. The same material is taught in allopathic, osteopathic, and PA programs. Secondly, my gripe with NP's is that their training is based on a nursing model, which seems to be more of an algorithmic approach than a science-based approach. There is much more to medicine than "if X, then Y". They have attempted to design computer programs that utilize medical algorithms for diagnosis and treatment, and these programs have failed because A) they lack clinical intuition and B) they are not able to deal with scenarios that do fit pre-determined algorithms. While I realize that much of medicine does fall into predictable patterns, situations do arise when one must fall back on a thorough understanding of physiology, pathophysiology, etc... I just don't feel that NP's obtain the scientific foundation that the practice of medicine is built upon during their training. All of the PA's that I know have graduated from master's programs which provide their students with a solid, scientific, medicine-based education. For this reason, I can honestly say that I will always choose a PA over an NP. Now, I would love to hear from those who think my logic is off the mark.
  18. Kimya

    Kimya Senior Member

    Joined:
    Aug 19, 2000
    Messages:
    192
    SDN 10+ Year Member
    Migraineboy,

    (and all the other PA's out there)
    I keep on hearing about the differences between PA and NP on this forum. I am looking into the professions in California. One PA program in Davis trains PA's and NP's in the same program. The only difference is that for the NP you had RN first. The Stanford PA program you can get a NP certification from if you had a RN first.

    My question is, how can all of these generalizations be made about PA's and NP's if the training programs themselves don't see the difference? Is this just California? If so, why is there such a huge variability in training programs? Is this a problem if you want to practice elsewhere?
  19. www.pa-c.com

    www.pa-c.com New Member

    Joined:
    Aug 13, 2001
    Messages:
    2
    <a href="http://www.PA-c.com" target="_blank">www.PA-c.com</a> Interested in being a physician assistant....come visit us.
  20. Caroline32669

    Caroline32669 New Member

    Joined:
    Nov 22, 2005
    Messages:
    1
    Migraineboy,
    I am suprised at the resentment and anger toward midlevel providers. We fill a vital role in the health care field. I am an NP and I work independently in a rural setting. I work where no MD would care to go at less than half the salary. I give care to patients who would other wise not have care. I have a wonderful MD to whom I can turn in times of need. My outcomes are rigorously measured and they consistently are good. My training is not a medical model, it is a nursing model. There are advantages and drawbacks to this. PAs are trained in a medical model and it is only logical that you would relate far more to this type of midlevel practitioner. But NPs provide good consistent care for the most part. There are many horrible NPs, PAs and MDs. It would serve you far better to judge each individual accordingly.


    NPs and PAs came about because there was a need in the health care field. I can honestly tell you, I have no desire to take the place of MDs. They are valuable and I respect the long hours and work that goes into becoming an MD.
  21. guetzow

    guetzow Senior Member

    Joined:
    Jul 7, 2005
    Messages:
    1,867
    SDN 5+ Year Member
    "the major difference between a pa and np eduaction is the amount of clinical time spent on rotations. the typical pa program requires around 2200 hrs and the yr is very similar in composition to the 3rd yr of medical school with typical rotations in fp, im, psych, peds, ob, surgery, em, and other primary care settings. np's do similar rotations but usually do no more than 800 hrs of total clinical time with some programs as short as 500 clinical hrs. if you do an np program yuou have to pick a focus(peds, womens health, psych, family, adult) and work within that specialty with very little flexibility. fnp is probably thge most flexible np cert. as it allows some mobility among the primary care fields. a peds np for example can not see adults. an adult np can't see kids. a psych np can't work in primary care, etc
    pa is a generalist degree and allows one to work in any field they desire and change as often as they like. a peds np who decides they want to work at a womens clinic has to go back to school for an additional cert while a pa just applies for the job."

    For more information, please refer to his many other level-headed, informative posts (Including Sate by State Scheduled Med scrip rights and average salaries!). I also Invite you to visit http://www.physicianassistant.net/index.php. Have fun!
  22. BSN

    BSN Member

    Joined:
    Jul 15, 2005
    Messages:
    33
    SDN 5+ Year Member
    Ok, so i have to be honest... i didn't even read past the first few lines... this post is biased... I think we need to stop this... always need someone to put down and hate, anyways.. there are good np and pa as there are bad ones... it's the person not the np/pa. In the "real world" they are still both mid-level prac. and work the same. To put it short there are pros/cons to both, it's just what's good for each individual.. dif strokes for dif fokes...
  23. Carolina Girl

    Carolina Girl Junior Member

    Joined:
    May 17, 2005
    Messages:
    16
    Location:
    AZ
    SDN 5+ Year Member
    Duke's FNP curriculum
    Duke's PA curriculum

    Quinnipiac's FNP curriculum
    Quinnipiac's PA curriculum

    Western University's FNP curriculum
    Western University's PA curriculum

    Yale's FNP curriculum
    Yale's PA curriculum

    Baylor's FNP curriculum
    Baylor's PA didactic curriculum
    Baylor's PA clinical curriculum

    I don't think it is biased or hateful to say that PAs get MUCH more education than NPs. Compare the programs for yourself, I think it is more fact than opinion.
  24. billydoc

    billydoc Senior Member

    Joined:
    Aug 2, 2005
    Messages:
    560
    Location:
    Lost in Nu Yok
    SDN 7+ Year Member
    This would've been a fair game to compare the two, if you had included the RN component which precedes the NP. You can't enter most reputable NP programs with less than RN/BSN or a BS in another health field, and at least a coupple of years as an RN. Another thing is that NP programs do not follow the medical model of education. They focus on advanced role, but from the nursing perspective. Nice try, but I think I know where most of these pi$$ing matches come from :smuggrin: Basically, in the nutshell: NP is a step up from being an RN(although I as an RN make a lot more $$$ than many NPs :D ), and PA is step down from being MD/DO (in many ppl minds). So we could argue about it till cows come home. But both are seen as physician extenders, compete for the same $$$, and fill the same jobs pretty much interchangebly, depending on the State of practicing.
    Good Luck to all
  25. emedpa

    emedpa GlobalDoc2B2015

    Joined:
    Aug 25, 2001
    Messages:
    5,663
    Location:
    Taking an Away team....
    Status:
    Other Health Professions Student
    SDN 10+ Year Member
    pa's have prior training too.... I have 2 bs degrees and a masters with around 300 credit hrs....not counting a 1 yr paramedic program....very few folks go to pa school without a prior degree......
  26. Carolina Girl

    Carolina Girl Junior Member

    Joined:
    May 17, 2005
    Messages:
    16
    Location:
    AZ
    SDN 5+ Year Member
    Every PA program I listed also requires a 4-year degree. Four of the five also require prior pt experience. Not that RN experience isn't valuable... but nurses aren't the only people who take care of patients and have valuable skills. My paramedic program was a 2-year degree, and that was after a 4-year BS in a health care related field.

    This isn't a pi$$ing match, as you put it. I agree 100% with your last sentence.
  27. Dr.MISHKA D.O.

    Dr.MISHKA D.O. Senior Member

    Joined:
    Nov 8, 2005
    Messages:
    133
    Location:
    Standing in the midst of a year long Code.......
    Status:
    Resident [Any Field]
    SDN 5+ Year Member
    Not to highjack your post, but I have been wondering (as I have a somewhat limited knowledge of Pa's, while knowing a little about NP's ) which would be better for a medical salon/women's health practice. I would want to have to minimally supervise them and would want them to be able to take care of most routine health issues (no OB) and I would do procedures 1-2 days q wk (e.g minimally invasive/laser/varicose veins/etc.) any tips greatly appreciated.

    And I think midlevels are great by the way. :)

    Best wishes

    The Mish :luck:
  28. billydoc

    billydoc Senior Member

    Joined:
    Aug 2, 2005
    Messages:
    560
    Location:
    Lost in Nu Yok
    SDN 7+ Year Member
    No nurses aren't the only ones taking care of their patients...although the time spent with the patient in an inpatient settings accounts for nearly 80% for RNs/LPNs, and the rest is for all other services. But that was not my point.
    The attempt to "compare" programs PA vs NP is not correct to begin with. There is no question that PAs are training in the medical model, therefore your courses closely resemble med school, except for the length of training. It's only natural. Your programs were created by a medicine for a medicine.NP/CRNA/CNM are not entering a new profession. They advance in the one they've been licensed before.That's why you have to include "the rest of the story" meaning pre and nursing curriculum with all basic science which you think is lacking from the NP programs. NP programs focus on the advanced role of a nurse. I think most ppl have a problem accepting a fact that nursing can diagnose, and prescribe. But I've never seen stats study which would suggest that more ppl are killed every year by more NPs than PAs or wise versa. I guess my main point was that despite differences in medical vs nursing model training, and different governing bodies for NPs and PAs most individual professionals are up for their jobs,rgardless of degree (NP/PA) they hold.Another part of this never-ending feud is that NPs are not regulated by the boards of medicine. There is nothing much that AMA could do other than introducing new bills and ammendments to the State legislatures trying to limit NPs. I'm not saying this is right or wrong. It's nothing more than a turf war. Things are drying up in the medical field, and those who have spent the most time and money for their training (MD/DO) are feeling the most of the acute impact of this crisis.
    Anyway, only one man's opinion. What's yours? :)
  29. billydoc

    billydoc Senior Member

    Joined:
    Aug 2, 2005
    Messages:
    560
    Location:
    Lost in Nu Yok
    SDN 7+ Year Member
    I think that either one will do just fine. That's the idea. Most ppl train on the jobs. Having an education background is helpful, but rarely the only thing needed to succeed. Although if you wanted to share the OB responsibilities I would definitely suggest CNM (certified nurse midwife). I know some personally. They are very,very busy, and seemed to be great at what they do.

    Good Luck with your practice :)
  30. oldManDO2009

    oldManDO2009 Senior Member

    Joined:
    Mar 26, 2005
    Messages:
    370
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    I think more mid levels are going to take up the slack created by less physicians training in FP. I would hate to go into FP - I want to live in rural America and salaries are pathetic! I will owe over 200K and would like to pay it back before I retire. As a specialist 200K a year is possible as an FP low to mid 100K. Now, let me be clear, I will have spent the last 7 years very poor and luckily my children are young and don't know the difference.

    I think the routine care of family practice backed up by a physician (and the algorithms of diabetes, htn, etc) are a good fit for NPs/PAs. When a patient presents with a complicated disease process a specialist is available. This happens throughout today healthcare - no doctor knows it all....


    as for NP v PA - a national exam would be interesting and would resolve the debate to some degree. Some of this debate is training/experience. I went to a lunch time presentation by a NP and she presented a more autonomous idea of practice and the PA students there quickly stated they were physician extenders and "knew there place" in healthcare. I think this is a deeply ingrained tradition of training were as nurses have been trained to act more autonomous (I had to learn the hated and worthless nursing diagnosis during my training). Both should have a role defined that provides a certain degree of autonomy but well regulated physician supervision which may be a degree of additional freedom for PAs and a step back for some NPs

    I would love to provide healthcare in a small town and work side-by-side with NPs/PAs because I have done so in the past and find them extremely competent

    just my opinion - no hate here....
  31. BSN

    BSN Member

    Joined:
    Jul 15, 2005
    Messages:
    33
    SDN 5+ Year Member
    Well, picking out one line is not the way to go.... overall the post is biased cause as i said there are pros and cons to both! Just pointing out the pros of pa is called biased.... Anyways... this is so childish...do we have nothing better to do then argue about pa/np... there are a lot of health care issues which deserve a lot more attention and time then is stupid (irrelevant) dissuasions. As I’ve said in the end and "real world" it’s the person not the pa/np and also what one wants from their job. Both require a lot of dedication so it should be a personal choice.
    This is my last post on this subject.... people love to bring themselves up by putting others down... so I’m out...
    Just for the records I’m not a pa or np… have done some research and found np to be the better choice because of the option to move around with all the different career path nursing has to offer… but then to say more would be biased, hahahaha
  32. Monika

    Monika PA-C

    Joined:
    Aug 15, 2002
    Messages:
    123
    Location:
    South Central USA
    SDN 7+ Year Member
    Doing your research is always good. Just for the record though PAs are able to work in any area of medicine. Our options are basically limitless in choosing what area we work in, that is what is so appealing for many of us who choose this career. As long as we have a 'supervising' physician or physician group we can work there.

    If you want to be an NP, my suggestion to you would be to pursue the 'Family' NP track because you will have more options that way. You have to choose an area of specialty as an NP. So, for example, if you choose 'pediatrics' you will not be able to treat adults unless you go back to NP school to get the training.

    Good luck.
    Monica, PA-C
  33. lawguil

    lawguil Senior Member

    Joined:
    Jun 24, 2004
    Messages:
    461
    Location:
    Florida
    SDN 7+ Year Member
    I find all this talk about NP's holding a master’s degree entertaining. Does anybody understand that any professional organization can mandate what the entry level education degree will be; however, means absolutely nothing. The APTA has mandated that entry level for the physical therapist move towards the "clinical doctorate - DPT". Does this mean that they are more educated than the BSPT or a MSPT? - NO! Not as far as their PT training is concerned. The education is identical, but the degree awarded is different because the organization mandated the change for political/respect/autonomy purposes. The NP vs. PA thing is the same thing. NP training is anything but a master’s level education by academic standards, but academic institutions that want to offer the program have to comply with the governing organizations rules. Could an RN with an associate’s degree complete two years of NP training and practice with the same results as a masters level NP. Of course! Everybody is being sucked into all these inflated degrees. Education (namely the “graduate level”) has become huge business for academia and has truly marginalized the value and respect that holding a masters or doctorate degree should have.

    Facts of the matter: Both are probably competent at what they do.
    The degree that one holds means absolutely nothing and in no way reflects how educated one practitioner is over another. One should simply investigate the content of the education rather than the degree. I was in a meeting two weeks ago at the university that I work and presented was that over 85% of all masters degrees awarded didn't include a thesis or scholarly level work. What this means is that 85% of all masters degrees are bogus and most people who hold a masters degree simply have another bachelors! If this is accurate - WOW! My opinion based on some objective factors = PA's are much better practitioners than NP's. PA's cover more material, have pre-reqs similar to a physician's, attend training full-time in the classroom, are trained using the same medical model, have longer training, are trained along side physicians, aren't subject to nursing protocols, and are properly supervised by physicians
    .
  34. zenman

    zenman Senior Member

    Joined:
    Apr 1, 2004
    Messages:
    2,185
    Location:
    Gesundheit!
    SDN 7+ Year Member
    Well said :thumbup:
  35. zenman

    zenman Senior Member

    Joined:
    Apr 1, 2004
    Messages:
    2,185
    Location:
    Gesundheit!
    SDN 7+ Year Member
    It's your opinion of course but you should have the educational background to understand what billydoc was saying in his posts...therefore don't try to compare them. I personally want the FNP route because of what the PA lacks.
  36. lawguil

    lawguil Senior Member

    Joined:
    Jun 24, 2004
    Messages:
    461
    Location:
    Florida
    SDN 7+ Year Member

    Perhaps the provisions of each degree are slightly different (NP vs. PA). As far as practicing medicine, a PA wins hands down (in a global sense). NP's are better trained within the provisions of nursing. I suspect that this is what you might mean when you suggest that I shouldn't compare them (?).

    What is concerning is the deceiving methods that NP's are using to create more autonomy. My understanding is that they want all the same rights and privileges to practice medicine without the appropriate training that MD's, DO's and PA's receive in the practice of medicine. If you are not trained/educated in the provisions of medicine as an entry level standard, how can this be justified?

    The only justification is that MD/DO/PA is over trained and the NP reflects a competent level of education to practice medicine. I hardly believe this is the case.

    I genuinely believe in a multi-disciplinary approach to healthcare, but NP's and PA's should practice their trade under the "supervision" of the physician.
  37. zenman

    zenman Senior Member

    Joined:
    Apr 1, 2004
    Messages:
    2,185
    Location:
    Gesundheit!
    SDN 7+ Year Member
    Yes. Perhaps nursing should leave medicine to PAs and MD/DOs and veer off into a separate profession focused more on "healing" rather than "curing."
  38. billydoc

    billydoc Senior Member

    Joined:
    Aug 2, 2005
    Messages:
    560
    Location:
    Lost in Nu Yok
    SDN 7+ Year Member
    Zen you are the Man! :)
    Thanks for the support. But I wouldn't hold my breath that we could get through a certain mindset which exists on this particular forum. Ppl come on here with some precocieved notions, pretending to know something about the subject they are talking about. Most of the time the loudest mouthes are clueless, and just the lock steppers with the bunker mentality just rambling on with their mantra "NP bad" , "PA good" like Frankenstein :laugh: .Why is it so difficult to understand that even the life itself is not that linear? So is not the approach to the Tx. Again, I've never seen any stats suggesting NPs being more risky practitioners than PAs or the MDs. All the studies, so far are quite on the contrary, suggesting the effectiveness of both PA/NP given the same setting of practice. This "I'm better than you" load of crap is nothing more than rubbish, and political turf war BS. BTW I'mnot an NP or PA but I work with both a lot. I have yet to hear/see such childishness in real life, as I see on this board. Of course there are morons practicing in every profession. But it's more indiviual related than any given profession.

    Take All!
    I think I'm done with this thread for now :D
  39. Bandit

    Bandit Senior Member

    Joined:
    Nov 23, 2001
    Messages:
    470
    Status:
    Resident [Any Field]
    SDN 10+ Year Member
    guys/gals---please---let this thread die.

    PS: how can one ever believe they are "overtrained" in medicine. oooohhhh weeeee that is dangerous thinking
  40. nonlethal

    nonlethal huzzah!

    Joined:
    Sep 23, 2005
    Messages:
    20
    Location:
    Utah
    Status:
    Pre-Medical
    SDN 5+ Year Member
    And after reading this thread, among other things, I have concluded that PA-Cs do their thing, and NPs do their thing. Alot of the time it happens to be the same thing, but not always. And they do their thing in a slightly different manner, because of a different training model. But they still do mostly the same thing: fix people. The only apparent difference is where they do it.
    It all boils down to what you want out of the education, and what exactly you want to do with it (and where, state depending).
  41. zenman

    zenman Senior Member

    Joined:
    Apr 1, 2004
    Messages:
    2,185
    Location:
    Gesundheit!
    SDN 7+ Year Member
    Close, but medicine tends to be the domain for "fixing" people. Nurses, and complementary medicine practitioners, tend to help people mobilize their intrinsic healing abilities.
  42. lawguil

    lawguil Senior Member

    Joined:
    Jun 24, 2004
    Messages:
    461
    Location:
    Florida
    SDN 7+ Year Member
    I don't think anybody said this!! Reread, L.
  43. lawguil

    lawguil Senior Member

    Joined:
    Jun 24, 2004
    Messages:
    461
    Location:
    Florida
    SDN 7+ Year Member
    The question isn't who is better subjectively, but evaluating the education of each profession objectively. The fact is that the education is different and thus the provisions and practice of their (NP vs. PA) trade should be different.
    To the contrary, NP's are FIGHTING a nasty and dirty fight for complete autonomy with no physician (medical) supervision to practice what is known as medicine. The question is how this efficient, how is is this safe, and how is this justified? Another fact is that the nursing organization is powerful politically. I have never questioned whether they were qualified to do what they were trained to do, but what they currently do or are fighting to do in which they were not trained. Their fight is malicious and self-serving. Nothing else! This is why they are under attack by some MD/DO/PA populations. L.
  44. hospitalistpac

    hospitalistpac hospitalistpac

    Joined:
    Apr 15, 2005
    Messages:
    45
    SDN 5+ Year Member
    I agree. So how is it that the NP proponents insist that they do not study medicine,but advanced nursing, yet they clamor for presciptive rights and the rights to admit a pt to the hospital independently and order MRIs and blood transfusions.
    I don't understand how legislators allow them to call their training advanced nursing, but then let them practice medicine.
    Either call NP school advanced training in medicine (which is probably what it is) or don;t have NP prescribe meds independently. Simply allow them to unlock thier patients intrinsic abilities to heal.
  45. oldManDO2009

    oldManDO2009 Senior Member

    Joined:
    Mar 26, 2005
    Messages:
    370
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    Simply allow them to unlock their patients intrinsic abilities to heal..... :laugh:


    okay, the level of training for a mid-level position is just that - a mid-level position. The depth that one studies pathophysiology determines the expertise as a diagnostician & managing disease for example. Physicians spend the most time in training followed by mid-level practitioner and generally speaking the physician tends to be the expert.

    Now with that said, it does not diminish the skills or expertise demonstrated by a mid-level - just the depth of training. So, a mid-level practitioners is trained (just like a physician) to dx diseases that fall within the scope of their training. It is dangerous to exert more autonomy then one is trained for because people will die - that is what a consult is for! What I don't understand is why SOME NPs would want to practice outside of that boundary.

    Nursing training is limited by design and when you get people demanding more privileges because they can write scripts and took some pathophysiology the patient suffers. I am not sure why some NPs (an maybe PAs - but not often mentioned) feel like they don't need collaboration with a physician.....

    I think it is just a few people screaming the loudest, because every NP & PA I have ever worked with realized that there was limitations to their training. That goes for physicians too - a family practice doc would never attempt neurosurgery unless he/she was tired of being a doctor and wanted to get really poor quick

    I used to work with a nut job that thought oils were the panacea of health and mental illness could be cured with meditation - reality - medication managed the illness and the oils made a mess!

    These complementary treatments have been pushed into the mainstream and they are being hocked by unqualified people (because they lack the medical knowledge) with little or no research as to their efficacy. Now, I know someone going to link a study with a n=4 and we all should be mighty impressed but it does not change the facts that these are unproven treatments and proven therapies have a better scientific outcome.

    once again I am on a rant (with finals just a week a way!)

    back to histology and the use of garlic oil in the treatment of depression :laugh:
  46. zenman

    zenman Senior Member

    Joined:
    Apr 1, 2004
    Messages:
    2,185
    Location:
    Gesundheit!
    SDN 7+ Year Member
    I don’t believe I use the word “simply!” Throughout history healers from every culture have recognized the compassion and caring that occurs between two individuals (and which is missing in high-tech medicine) is an essential component to getting well. “Diagnosis” means “a knowing that exists through or between two people.” This can only optimally be done through a relationship with a patient…which is rare in today’s healthcare environment.

    Medicine is like having a quality control inspector at the end of an assembly line when they should be at the head of the line making sure that everything is in place.

    You must…you really must, continue to ask yourself why people are unhappy with current healthcare and why they keep asking, “will things ever change?” For your financial survival you must also keep asking why patients are leaving you and going elsewhere. Actually, it’s ok with me if you don’t ask :laugh:

    “Integrative medicine” is real but it also recognizes the harsh reality of disease. But, according to Larry Dossey, MD, “the new medicine also honors the concept that consciousness is not limited to the physical body but extends beyond it-that consciousness is infinite or nonlocal in space and time, therefore eternal and immortal. This is the most significant way in which the new medicine differs from conventional approaches, and why it is always possible for sick and dying individuals to find hope and meaning.”

    Candace Pert, Ph.D. and very much a scientist…”The truth is so weird that I’ve only recently come to believe in it and experience it. And the truth comes out of Eastern thought in which molecules are secondary. The spirit, the subtle energy-which is the human body and the emotions that change the energies in it-that comes first and then things are manifested.”

    Marty Rossman, MD…after a couple of years the practice of medicine seemed like a futile dance. I would put people on medication and they’d feel better for a while, but after a few months they would have side effects. Then I’d either put them on another medication to treat the adverse effects of the first medication, or I’d take them off the medication. They’d feel better for a while and then they’d come back feeling bad again.”

    Rossman again…”Western medicine is the only medicine I’ve ever studied or heard of that doesn’t appreciate that life is different from anything else we know. Whether you call it life force or qi or prana, it’s self-repairing. Who knows where it comes from, and who knows where it goes, but it’s capable of incredible self-healing. And it’s totally ignored. Not only do we ignore it; we look down our nose at it because it’s not scientific. Our attitude is very bizarre, and it’s painful to everybody, including the doctors, because it’s disempowering.

    Thomas Rau, MD…I realized that orthodox medicine has a wrong thinking behind it. It doesn’t work on the real dynamics of life.”

    David Riley, MD…It is a myth that most of what we do in conventional medicine is research based. One of the common hallmarks of CAM is that they are individualized to the patient and often in combination with other therapies and lifestyle recommendations. It will be challenging to study these therapies, and it probably cannot be done using the cookie-cutter approach so common in contemporary medical research.”
  47. billydoc

    billydoc Senior Member

    Joined:
    Aug 2, 2005
    Messages:
    560
    Location:
    Lost in Nu Yok
    SDN 7+ Year Member
    For the "true believers" and the lock step dummies :laugh: check out this site,please:www.ACAM.org for starters.
    I guess it's only a few "renegates" from your own profession who recognize the public need. But these are practicing physicians, who live and practice in the real World.That "Big Dr" ego thing is premed to recidency deal. I guarantee you, big shot medical professionals, it will pass real quick once you'll face the reality :smuggrin: . Go ahead flame on now, but remember...nobody cares about your precious MD/DO/PA/NP/RN/Ph.D or whatever.Someone who is really, really sick doesn't care at 3 am from which big title or Ivy league school graduate his/her help arrives. Again, it's not about you. There are always more than one way to approach a problem. Sometimes it's very important to step back, close your mouth, and open your mind. May be, just may be you don't really know it all, no matter how long you,ve trained, what big arse title you've got, or if you've got as many degrees as thermometer has :rolleyes:

    Good Luck Everyone
  48. oldManDO2009

    oldManDO2009 Senior Member

    Joined:
    Mar 26, 2005
    Messages:
    370
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    Marty Rossman, MD…after a couple of years the practice of medicine seemed like a futile dance. I would put people on medication and they’d feel better for a while, but after a few months they would have side effects. Then I’d either put them on another medication to treat the adverse effects of the first medication, or I’d take them off the medication. They’d feel better for a while and then they’d come back feeling bad again.”


    I can't believe I would actually agree with you on anything zenman but you do make a valid point....

    Many patients I have worked with throughout the years do have an unrealistic expectation of medications and how they work.

    Most people ignore the doctor when they recommend dietary changes and increased exercise and expect that the glucaphage will solve their diabetes as if was unrelated to the 6-pack of cola and a dozen twinkies inhaled each day while watching daytime TV.

    Yet, they are disappointed when their condition gets worse and demand answers - because you the doctor prescribed a medication that didn't work. The fact that gaining another 20 lbs and complaining that walking to the car leaves you short of breath - they don't see the relationship.

    In reality if we had more than 15 minutes per patient we might be able to stem the tide of diminishing returns because we do not have the time to educate our patients. Some people do not want to do the hard work behind getting healthy - but some do and unfortunately the time spent with patients is probably based on those patients that just want a quick fix.

    It is unfortunate but it is assumed people understand the relationship between diet, exercise and disease - but the bulging waist lines tell a different story.

    Okay, so one for zenman - don't get to happy - I still don't see eye-to-eye on the rest of the 'voodoo" approach to medicine. I will stick with the crappy old western medicine when it comes to managing disease.
  49. oldManDO2009

    oldManDO2009 Senior Member

    Joined:
    Mar 26, 2005
    Messages:
    370
    Status:
    Resident [Any Field]
    SDN 7+ Year Member
    come on billydoc - you would care at 3 am who provides the treatment - I would think you would want a doctor shoving in chest tubes, ordering drugs, and saving your life. I do agree that no matter how many degrees you have - arrogance never works well with patient care. I took a brief look at the linked website and I agree that nutrition and preventative medicine is the best way to manage disease but you are going to have a hard time convincing patient to be responsible for their healthcare. It is easier to blame the doctor then give up the twinkies.
  50. hospPA

    hospPA Senior Member

    Joined:
    Apr 23, 2003
    Messages:
    146
    Location:
    USA
    SDN 7+ Year Member

    According to your reasoning, doing a BSN and then PA school versus BSN then NP school would make one better prepared as a midlevel provider than, right? ;) If so, I would have to agree with you on that.

    For the record once again, RN training or experience does not negate the necessity of rigorous medical (you call it nursing) training. That is where this arguement is false. I did it, so I should know. RN training is helpful yes, a substitute no. "Soft" NP clinical training seems to rely on this rather "unsturdy" crutch to justify it's existence.

    Frankly, there would be no arguement at all (PA vs. NP) if NP schools greatly expanded their clinical training. Obviously as a PA, I am quite glad that they have no intention of doing so:D I take that back, they are expanding it some, but then calling it a DNP. It's funny, it still does not equal the hours PA students put in. Better, but not their yet. I won't even go into the joke of calling themselves doctors.

    Pat, PA-C, BSN, MPAS
Thread Status:
Not open for further replies.

Share This Page


About the ads