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Virginia is among the states that don't have decent independent practice rights for NP's, so it would be low on my list for that. However, DC and Maryland is an independent practice location for NP's. I'd personally aim to locate there rather than Virginia if independent practice is a goal of yours.

Psyche NP is typically going to be a better route overall than PA if someone wants to practice in psyche. More specialization, opportunities for independent practice in half of states.
 
If you want to know the most for your patients, go to med school

If you just want the fastest path to legally writing prescriptions in psych with a high likelihood of findkng work? NP
 
If you want to be wrong about the fastest way to legally writing prescriptions in psyche with a high likelyhood of finding work, call yourself sb247 and don’t read the OPs post fully, because PA would probably be faster for someone who already has pre med coursework.
 
pamac said:
If you want to be wrong about the fastest way to legally writing prescriptions in psyche with a high likelyhood of finding work, call yourself sb247 and don’t read the OPs post fully, because PA would probably be faster for someone who already has pre med coursework.
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Direct entry psych np programs are only 3 yrs, which I get is longer than PA. But despite my comcerns about midlevel Independance I am able to see the nurses are kicking that rock down the road faster then the PAs and in the places I’ve been there were more employed psych NPs than PAs....and that was before considering the increased odds of Independance being available to the OP three years from now.

You’re welcome to disagree with me but that’s how I weighed out my answer
 
I agree that psyche NPs seem to have a corner in the market compared to psyche NPs. But if the OP has premed undergrad prerequisites, and has a bachelors already (and indicated by the fact that they are considering a post Bach degree), then PA school is the rapid route. Probably not the route with the most reward for the reasons we both mentioned.

My friend has a sibling that is a psyche PA working for wages slightly lower than even a typical PA makes in family practice here. My friend was shocked to hear how much a psych Np in the area makes (typically at least $40k more per year than my friends sibling). That’s what independence does for a provider. Psych Nps can run their own practices, become true partners with physicians (not merely employees), be employed as stand alone employees by therapist practice groups and psychologists, have their own admitting privileges to facilities and hospitals, negotiate with telepsyche companies to deliver care to other independent NP states. PAs have to have a signed agreement with a physician and operate under their oversight in order to see even one patient. Without that relationship, PAs cannot practice. It’s ironic and unfortunate given their good training. But that’s how it is. In states like Virginia, that kind of relationship is also required of NPs, until that state gets the laws changed (which might not happen for a long time). And a physician isn’t going to allow a PA to function under his or her umbrella without some kind of financial incentive. Additionally, a physician is going to have a vested interest in reigning in a PA due to the fact that they can be named in any malpractice lawsuit if the PA that they supervise makes is sued. And a lawyer will want to sue the physician because they are perceived as having deeper pockets, and insurance that covers more liability. That’s one reason why Np liability insurance is around $1,000- 2,000 annually, and PA malpractice liability insurance is around $6000 or more. NPs get sued considerably less than do PAs and physicians, which isn’t a quality of care issue as much as a fact that lawyers go where the gold is, and suing a PA/MD pair offers a richer target.

Being independent does not mean that NPs can demand certain privelages from hospitals or insurance companies though. A hospital can decide that as part of their contract agreement with NPs that they be willing to be closely supervised by a physician. Insurance companies can also decide in many places that they wont reimburse for the services you provide. And a physician can tell you that they aren’t interested in being a partner in practice with you, but rather hire you as an employee. However, in an independent practice state, as an Np, you are in the position to negotiate better, and also tout the benefits that come from employing an independent NP instead of a supervised PA.
 
I mentioned Virginia having a tough practice environment, but it looks like they are going through the finalization process of allowing NPs to practice independently there... complete independence will be approved in the coming weeks after the bill slowing for that gets approved in the senate there, which is apparently a given at this point because it has the votes. Already passed through the necessary committees unanimously. The catch is that the NP has to have 10,000 hours behind them or must practice under collaboration with an MD for 5 years if they are brand new before independent practice is allowed. That probably will get knocked down over time, as apparently Virginia likes to do things incrementally. So there you go... one more state in the NP independence column, and a significant one at that.
 
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