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Curious... How would you compare the Nurse Practitioner profession/role/career to that of the PA?

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Intel1122

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Nov 9, 2014
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    Hi all.. Just curious. As someone in NYC/NY or if you are not familiar with the Family NP/PA role in these areas you could address them wherever you are.
    How would you compare the role of the Family NP to that of the PA...? I know NPs are RNs with some level of experience with Graduate School education in a MS or DNP in a Family NP. PAs on the other hand graduated from a 2 year BS/MS in a Physical Assistant field of study not requiring substantial "true" clinical experience besides volunteering or the premed low key level clinical experience. I guess its NPs function under a Nursing mind set when diagnosing and Prescribing and PAs are people trained in an abridged version of medicine.

    I know PAs have licenses, but they function under a doctor's license, hence why their Rx pads always have MD/DO on top of the PA's name. But they could go into literally any specialty except anesthesia/doing surgery/and some exceptions.

    But after reading about NPs, it seems they have some looser rights and privileges than PAs. Sure this isn't the case in every state and every state has its own rules regulating the NP practice, but in the North East: specifically NY, CT, NH, and RH, NPs have only needed a collaborative agreement where they do not need to have their work reviewed by a doctor every day/week or require cosignature, they make require a review every 3 months, but that doesn't quality true "supervision." Every doctor/independent health care professional has some level of "collaboration" and job performance appraisals q 3 - 6 months.

    All I am asking is, why there isn't a role difference between NP and PA, similarly to that of NP vs MD/DO, is there a true difference in how they practice. Does this difference in independence and practice ? I read that NPs go mainly into family practice, psych, women's health, NICU since those are the fields that require limited supervision and someone that doesn't have to consult with a doc regularly. But PAs go into Emergency med/surgery assist? I know Family NPs could do nearly any specialty but they are MORE CENTERED into family practice/psych/outpatient areas but PAs are more inpatient.

    What is the real difference...? Do NPs have better rights long term in terms of opening up their practice more salary potential more opportunities..? Just curious.
     

    Mad Jack

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      NPs and PAs are hired interchangeably at most outpatient offices in the Northeast. PAs usually don't have to be directly supervised, but simply have to have an available physician that can be contacted if needed, plus there is a certain degree of chart review that is required (usually 10%). What that boils down to is we've got PAs that are working in primary care and urgent care with no physician on-site, as "available" simply means that they have to be able to contact the physician if the need arises. NPs and PAs have both been known to just pay a physician a set fee to "collaborate" with them, allowing both to essentially own their own practices, albeit at a cost. And nurses are limited to whatever population they choose when they sign up for their degree- family NPs cannot work with neonates, psych NPs cannot do general practice work, adult acute NPs can't do psych work, etc. PAs can work in any setting a physician will bring them on board and train them for. The PA road is also much, much shorter (average time to become an NP has increased to longer than it takes to become a physician, unless you're in an accelerated program, in which case it's 3-4 years, which, again, you could've been a physician in) while most PA programs are 24 months (some are 3 years, but usually have summers off, while the 24 month programs tend to run straight through).
       

      Intel1122

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        NPs and PAs are hired interchangeably at most outpatient offices in the Northeast. PAs usually don't have to be directly supervised, but simply have to have an available physician that can be contacted if needed, plus there is a certain degree of chart review that is required (usually 10%). What that boils down to is we've got PAs that are working in primary care and urgent care with no physician on-site, as "available" simply means that they have to be able to contact the physician if the need arises. NPs and PAs have both been known to just pay a physician a set fee to "collaborate" with them, allowing both to essentially own their own practices, albeit at a cost. And nurses are limited to whatever population they choose when they sign up for their degree- family NPs cannot work with neonates, psych NPs cannot do general practice work, adult acute NPs can't do psych work, etc. PAs can work in any setting a physician will bring them on board and train them for. The PA road is also much, much shorter (average time to become an NP has increased to longer than it takes to become a physician, unless you're in an accelerated program, in which case it's 3-4 years, which, again, you could've been a physician in) while most PA programs are 24 months (some are 3 years, but usually have summers off, while the 24 month programs tend to run straight through).
        Right, but NPs don't need a 10% supervision. They don't need any, depending on the state.

        From what you said, I feel as if NPs are more trained to be independent since they do not have to be supervised really at all. Its a collaboration. Family NPs are limited to everything except teens, adults, older people, women's health pediatric populations... except neonates. But what credible professional could seriously be proficient in every specialty.? Jack of all master of none IMO.

        NPs have more independence is what I seem to be getting at. Its title doesn't imply some sort of Physician subordinate as "Physician assistant."

        Essentially when you compare the two, I feel PAs of course are trained in every specialty but that doesn't mean you'll do every field. NPs are more focused on 1 area just like MDs/DOs, hence they are have more independence to practice in that field. With more independence = More opportunity to function longer, have higher positions = More pay and opportunities.
        Not sure if PAs could ever be independent in a specialty, not as a Physician subordinate, but certainly NPs are not Physician subordinates, they are Health care providers not mid level providers, they only collaborate with physicians just like podiatrists do. But they are more independent and that is an opportunity to succeed.

        Also NPs are RNs, they could still deliver anesthesia as a CRNA, independent in many states and mainly autonomous in all making over 160-250 k. Not sure if PAs could be CRNAs, but they could be first assists just like RN First Assists.
         
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        Mad Jack

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          Right, but NPs don't need a 10% supervision. They don't need any, depending on the state.

          From what you said, I feel as if NPs are more trained to be independent since they do not have to be supervised really at all. Its a collaboration. Family NPs are limited to everything except teens, adults, older people, pediatric populations... except neonates. but I would never work with neonates.

          NPs have more independence is what I seem to be getting at. Its title doesn't imply some sort of Physician subordinate as "Physician assistant."

          Essentially when you compare the two, I feel PAs of course are trained in every specialty but that doesn't mean you'll do every field. NPs are more focused on 1 area just like MDs/DOs, hence they are have more independence to practice in that field. With more independence = More opportunity to function longer, have higher positions = More pay and opportunities.
          Not sure if PAs could ever be independent in a specialty, not as a Physician subordinate, but certainly NPs are not Physician subordinates, they are Health care providers not mid level providers, they only collaborate with physicians just like podiatrists do. But they are more independent and that is an opportunity to succeed.

          Also NPs are RNs, they could still deliver anesthesia as a CRNA, independent in many states and mainly autonomous in all making over 160-250 k. Not sure if PAs could be CRNAs, but they could be first assists just like RN First Assists.
          But why would someone spend 2-4 years getting an RN then 5 years getting a DNP when they could spend 4 years in medical school and another three in residency to have more autonomy and make more money? The only real advantage to nursing over PA education is that it opens up doors in management- all other things being equal, PAs and NPs are treated as equivalent in every practice environment I've ever worked in, but PAs get their education in a far shorter period of time.
           

          Intel1122

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            But why would someone spend 2-4 years getting an RN then 5 years getting a DNP when they could spend 4 years in medical school and another three in residency to have more autonomy and make more money? The only real advantage to nursing over PA education is that it opens up doors in management- all other things being equal, PAs and NPs are treated as equivalent in every practice environment I've ever worked in, but PAs get their education in a far shorter period of time.
            Clearly your biased towards the PA profession, Idk why. Maybe because you are a PA/PA student/aspiring PA. Ok that is fine, whatever you want to believe in.

            Its not 5 years getting a DNP, that is absurd. Its a 4 year undergrad RN degree and then a 2-3 yr MS/DNP. Its not 5 years unless you go part time. Most of the time a MS suffices since a DNP doesn't necessarily increase pay, is expensive and isn't mandatory. No that 2015 rule is not a mandate, its a recommendation. There will be plenty of MS FNPs/NPs that will be grandfathered in and asked to acquire their DNP later (2020 me thinks)

            PAs/NPs have similar functions, just like how NPs/Physicians have similar functions. But they have different philosophies and professions. PAs are PAs , NPs are Rns with advanced didactic training.

            Clearly PAs get their education in a shorter time, Not "farr" shorter dude, my cousin became a PA after 4 years, didn't get a job in 1 year and finally is working after 5 years.. The other cousin dropped out of PA due to health reasons, but he did a 4 year Bio BS undergrad and then a 2 year MS in Physician assistant studies program, equaling 6 years.. That is how long it takes to get a MS in FNP/NP, so that is not totally accurate.

            I mean look I am not bashing the PA or NP profession, I just think its a matter of priority. As a PA yeah you'll do every specialty, but believe me when I tell you that its hard to be proficient and get promotions by changing your fields constantly. Btw NPs control primary care not PAs, go to any clinic ask anyone you'll see. RNs/NPs are born for primary care lol.

            Also don't forget NPs don't just have to remain as NPs, they could become CRNAs, making more than primary care doctors: 160-250k.

            The RN license is such a versatile degree friend. Not only could you do clinician tasks as an NP, you could be a pseudoanesthesiologist as a nurse anesthetist. Heck CRNAs delier over 60% of the anesthesia in this country .. its the norm. 2 of my cousins currently in MD school contemplating dropping out to do CRNA since CRNA is so easy to do and boasting high salaries, but they won't because they invested too much time in medicine already lol.

            Again... not bashing the PA field, but its just look you won't ever be a "master" at anything you do, sure you can do anything, but can you do anything well..? NPs certainly do, their basically running 70% of primary care in the country and will continue to with the increasing Rights. PAs can not, and I feel that leaves them open to manipulation by docs. Look NPs/PAs are always being compared to doctors, but at least NPs don't really have to.
             

            Mad Jack

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              I'm actually a medical student. I've got no dog in this fight. PAs work in specialty fields more often because the pay is higher- nurses get locked into primary care when they select the FNP option, which locks them out of surgery and 80% of acute care jobs. PAs can also practice independent of a physician in several states, a number which will no doubt grow in the future. As to CRNAs, every industry analysis conducted in recent years has come to the conclusion that there will be a glut of several thousand CRNAs by 2020, which will place substantial downward pressure on wages and make it difficult for future CRNAs to find employment.

              http://www.healthecareers.com/artic...assistants-opening-their-own-practices/171163

              http://www.rand.org/pubs/research_briefs/RB9541/index1.html

              Per the NPs I have known that later went back to school to get a PA degree to allow them more ability to move specialties, the education they were afforded in PA school was far more rigorous and almost entirely absent of fluff, while their NP degree was very fluffy and shallow in substance. They certainly would not conclude that their NP education made them feel exceptional or as experts in a given field lol. Talk to a few fresh grad NPs. Most will openly lament that they feel their education has left them completely unprepared for independent practice. The only ones that feel reasonably competent are the nurses with a couple decades of experience that become NPs.
               
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              FCMike11

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                Clearly your biased towards the PA profession, Idk why. Maybe because you are a PA/PA student/aspiring PA. Ok that is fine, whatever you want to believe in.

                Its not 5 years getting a DNP, that is absurd. Its a 4 year undergrad RN degree and then a 2-3 yr MS/DNP. Its not 5 years unless you go part time. Most of the time a MS suffices since a DNP doesn't necessarily increase pay, is expensive and isn't mandatory. No that 2015 rule is not a mandate, its a recommendation. There will be plenty of MS FNPs/NPs that will be grandfathered in and asked to acquire their DNP later (2020 me thinks)

                PAs/NPs have similar functions, just like how NPs/Physicians have similar functions. But they have different philosophies and professions. PAs are PAs , NPs are Rns with advanced didactic training.

                Clearly PAs get their education in a shorter time, Not "farr" shorter dude, my cousin became a PA after 4 years, didn't get a job in 1 year and finally is working after 5 years.. The other cousin dropped out of PA due to health reasons, but he did a 4 year Bio BS undergrad and then a 2 year MS in Physician assistant studies program, equaling 6 years.. That is how long it takes to get a MS in FNP/NP, so that is not totally accurate.

                I mean look I am not bashing the PA or NP profession, I just think its a matter of priority. As a PA yeah you'll do every specialty, but believe me when I tell you that its hard to be proficient and get promotions by changing your fields constantly. Btw NPs control primary care not PAs, go to any clinic ask anyone you'll see. RNs/NPs are born for primary care lol.

                Also don't forget NPs don't just have to remain as NPs, they could become CRNAs, making more than primary care doctors: 160-250k.

                The RN license is such a versatile degree friend. Not only could you do clinician tasks as an NP, you could be a pseudoanesthesiologist as a nurse anesthetist. Heck CRNAs delier over 60% of the anesthesia in this country .. its the norm. 2 of my cousins currently in MD school contemplating dropping out to do CRNA since CRNA is so easy to do and boasting high salaries, but they won't because they invested too much time in medicine already lol.

                Again... not bashing the PA field, but its just look you won't ever be a "master" at anything you do, sure you can do anything, but can you do anything well..? NPs certainly do, their basically running 70% of primary care in the country and will continue to with the increasing Rights. PAs can not, and I feel that leaves them open to manipulation by docs. Look NPs/PAs are always being compared to doctors, but at least NPs don't really have to.
                You keep saying he is biased, while it is clear you are biased towards the nursing profession (BTW, I am an RN). First of all, your stated 160k+ for all CRNA's isn't true. Close friend of mine just graduated first salary off of 115k plus potential overtime and call pay. Why do you keep saying NP's have control of primary care? What are you basing this off of? I see PA/NP's in this setting and not really one more than the other.
                 
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                Intel1122

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                  I'm actually a medical student. I've got no dog in this fight. PAs work in specialty fields more often because the pay is higher- nurses get locked into primary care when they select the FNP option, which locks them out of surgery and 80% of acute care jobs. PAs can also practice independent of a physician in several states, a number which will no doubt grow in the future. As to CRNAs, every industry analysis conducted in recent years has come to the conclusion that there will be a glut of several thousand CRNAs by 2020, which will place substantial downward pressure on wages and make it difficult for future CRNAs to find employment.

                  http://www.healthecareers.com/artic...assistants-opening-their-own-practices/171163

                  http://www.rand.org/pubs/research_briefs/RB9541/index1.html

                  Per the NPs I have known that later went back to school to get a PA degree to allow them more ability to move specialties, the education they were afforded in PA school was far more rigorous and almost entirely absent of fluff, while their NP degree was very fluffy and shallow in substance. They certainly would not conclude that their NP education made them feel exceptional or as experts in a given field lol. Talk to a few fresh grad NPs. Most will openly lament that they feel their education has left them completely unprepared for independent practice. The only ones that feel reasonably competent are the nurses with a couple decades of experience that become NPs.

                  You calling yourself a medical student is besides the point and irrelevant in this discussion, or maybe it is applicable. It seems you are threatened by not just the NP profession, but the advancements of the Nursing profession.
                  In whatever forms it may entail: CRNA, NP, etc.

                  I have no dog in this fight either as I am becoming a Physician as well, but come on. We all know what your answer is heavily biased. Clearly your answer is as its riddled with biases and a one sided opinion. Its easy to defend a profession that is a subordinate of a profession that you are allegedly entering. Certainly a "Medical student" would defend a profession that is growing but still in the end functions under Physicians.

                  You aren't addressing the advancement in rights of NPs and why would you? Its a threat to your profession, Or I should say Our profession, as I am entering Medicine. I would be threatened by NPs not PAs, because if you read the Nurse Practice Act, NPs are becoming autonomous.


                  Again your answer is cherry picking and I do not think I would be doing anything by debating a one sided answer. Its just like asking someone Would you argue to Bill O'Reilly that Obama's policy helped this country? He would say it destroyed it without discussing how it helped millions of Americans. I guess he'd say how Obama's care also destroyed the Medical Profession, your profession me thinks.
                   

                  Intel1122

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                    You keep saying he is biased, while it is clear you are biased towards the nursing profession (BTW, I am an RN). First of all, your stated 160k+ for all CRNA's isn't true. Close friend of mine just graduated first salary off of 115k plus potential overtime and call pay. Why do you keep saying NP's have control of primary care? What are you basing this off of? I see PA/NP's in this setting and not really one more than the other.
                    CRNA pay depends on the location. Where I live they start of at 160k and go up to 250k. That is what recruiters, CEOs, CNOs, and professionals in the health care field have said. I can't say for where you live. And please do not say my statistic is untrue. You do not even know where I live lol. So how can you say its untrue..?

                    NPs have control of primary care? That is the opinions of several Physicians I know, my experience in my career, and NPs in the field.

                    I never said one is better/more than the other, but certainly NPs have more autonomy than PAs and regardless of what field I am in, that is the case.
                     

                    FCMike11

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                      I also have not seen instances when NP has greater autonomy than PA's. Every position I've seen them in is interchangeable. Our CV surgeon has an NP who makes rounds for him and after surgeries he comes back and cosigns her notes and makes changes occasionally. My point is its up to your collaborating physician. Also did you just tell the other poster you are going to become a physician? I've seen you post threads for MD/DO, Pharmacy, Podiatry, PA and NP in the the last few months. If I don't go to medical school, I will go to PA school. I have friends who have done their online NP, I've seen their curriculum and that's not how I want to be trained. I'd rather be trained in basic sciences (condensed medical school).
                       
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                      Mad Jack

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                        Per the AANA's 2014 salary and compensation report, the average salary (not total compensation, which is what many surveys put out) of nurse anesthetists is 120-140k, depending on region, in 2014. The last reliable total compensation report I know of was the LocumTenens report, which pegs total comp (salary+benefits) at 169k. This fits well with the AANA's numbers, as benefits usually amount to 25-30% of a compensation package. While there are certainty higher paying CRNA positions out there, they're usually in areas with substantially higher CoL (such as CA), making the increase in wages amount to a wash overall. Even worse than places like CA are places like NY, where wages are deflated and CoL is astronomical. The average CRNA certainly isn't pulling 200k+ per any data available.
                         

                        Intel1122

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                          I also have not seen instances when NP has greater autonomy than PA's. Every position I've seen them in is interchangeable. Our CV surgeon has an NP who makes rounds for him and after surgeries he comes back and cosigns her notes and makes changes occasionally. My point is its up to your collaborating physician. Also did you just tell the other poster you are going to become a physician? I've seen you post threads for MD/DO, Pharmacy, Podiatry, PA and NP in the the last few months. If I don't go to medical school, I will go to PA school. I have friends who have done their online NP, I've seen their curriculum and that's not how I want to be trained. I'd rather be trained in basic sciences (condensed medical school).

                          Why are you looking at my other posts..? Lol. Do not worry about that.

                          I don't think anyone should do an online NP. I think you should be in person. But again, I guess thats why the NP profession values experience more than what you learn in school. The NP profession doesn't revolve around the medical field, NPs are not mini doctors, they are RNs with graduate education in Nursing to become a FNP.

                          We already have knowledge as RNs, we don't have to start from scratch as PA students do. As RNs, we simply needed extra classes to become NPs.
                           
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                          Intel1122

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                            Per the AANA's 2014 salary and compensation report, the average salary (not total compensation, which is what many surveys put out) of nurse anesthetists is 120-140k, depending on region, in 2014. The last reliable total compensation report I know of was the LocumTenens report, which pegs total comp (salary+benefits) at 169k. This fits well with the AANA's numbers, as benefits usually amount to 25-30% of a compensation package. While there are certainty higher paying CRNA positions out there, they're usually in areas with substantially higher CoL (such as CA), making the increase in wages amount to a wash overall. Even worse than places like CA are places like NY, where wages are deflated and CoL is astronomical. The average CRNA certainly isn't pulling 200k+ per any data available.
                            The average CRNA doesn't pull off 200k but they do pull of 160k starting where I live and with experience it goes to 200k.

                            But you didn't answer my questions about the question, you scrolled down to something else. Could we please stick with the question?
                             

                            FCMike11

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                              I'm not cherry picking....you are making generalizations based on anecdotal experience "physicians told me NP's are taking over primary care", what research have you done to come up with that? You honestly sound like my coworkers, who all were disappointed that I'm not going to NP school and using the same generalizations we've all heard (PA's always have to be under physician, NP's can open their own practice etc).

                              Looking at someone's post history when they are making unusual posts is pretty common here to determine someone's credibility.
                               
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                              Intel1122

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                                I'm not cherry picking....you are making generalizations based on anecdotal experience "physicians told me NP's are taking over primary care", what research have you done to come up with that? You honestly sound like my coworkers, who all were disappointed that I'm not going to NP school and using the same generalizations we've all heard (PA's always have to be under physician, NP's can open their own practice etc).

                                Looking at someone's post history when they are making unusual posts is pretty common here to determine someone's credibility.

                                Looking up someone's post history for what..? You going to give me a recommendation lol. I did not know my credibility was judged. If you do not want to respond you do not have to, thank you very much.

                                But we need to stick to the question, so stick to it, don't let your ego get in the way, or please do not respond. Thank you very much.
                                 

                                Mad Jack

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                                  You calling yourself a medical student is besides the point and irrelevant in this discussion, or maybe it is applicable. It seems you are threatened by not just the NP profession, but the advancements of the Nursing profession.
                                  In whatever forms it may entail: CRNA, NP, etc.

                                  I have no dog in this fight either as I am becoming a Physician as well, but come on. We all know what your answer is heavily biased. Clearly your answer is as its riddled with biases and a one sided opinion. Its easy to defend a profession that is a subordinate of a profession that you are allegedly entering. Certainly a "Medical student" would defend a profession that is growing but still in the end functions under Physicians.

                                  You aren't addressing the advancement in rights of NPs and why would you? Its a threat to your profession, Or I should say Our profession, as I am entering Medicine. I would be threatened by NPs not PAs, because if you read the Nurse Practice Act, NPs are becoming autonomous.


                                  Again your answer is cherry picking and I do not think I would be doing anything by debating a one sided answer. Its just like asking someone Would you argue to Bill O'Reilly that Obama's policy helped this country? He would say it destroyed it without discussing how it helped millions of Americans. I guess he'd say how Obama's care also destroyed the Medical Profession, your profession me thinks.
                                  In regard to your initial question, most nursing programs only provide 675 hours of clinical training at the advanced level, while a BSN requires approximately 1,000 hours at the basic level (putting in lines, administering meds, and changing bedpans is barely contributory to the practice of a midlevel, as it is usually delegated work at that point, so most of these hours end up being less than useful in regard to midlevel practice), while PA students are required to have 2,000 clinical hours at the advanced level. Their preclinical education does not train them in proper differential diagnosis like PAs, but rather in the nursing diagnosis model, which is quite flawed and only utilized so that nurses can say that they are not "practicing medical diagnosis." PAs are trained in differential diagnosis, learn the same basic sciences as physicians, and learn the medical model of diagnosis, assessment, and treatment. The average PA applicant has 3,560 paid professional patient contact hours prior to matriculation (most programs require paid HCE for consideration, and typically actively recruit paramedics, RNs, and RTs) per the last PAEA report, in addition to whatever contact hours they had during being educated for their position.

                                  Here is a typical NP program curriculum: http://nursing.msu.edu/msn programs/Nurse Practitioner Concentration/NP Curriculum.htm
                                  Courses

                                  NUR 802: Theoretical Foundations and Role Development for the Advanced Practice Nurse
                                  NUR 804: Statistics for the Healthcare Professional
                                  NUR 805: Pathophysiology for Advanced Practice Nurses
                                  NUR 806: Research for Practice Nurses
                                  NUR 807: Clinical Decision Making
                                  NUR 809: Applied Pharmacology for Advanced Practice
                                  NUR 814: Health Care Policy and Politics
                                  NUR 820/835: Health Assessment
                                  NUR 821/836: Primary Care Management I
                                  NUR 822/832: Practicum I Primary Care
                                  NUR 823/837: Primary Care Management II
                                  NUR 824/834: Practicum II
                                  NUR 838: Care for Aging Individuals

                                  Here is a typical PA program curriculum: http://www.quinnipiac.edu/school-of...master-of-health-science-physician-assistant/

                                  First Year
                                  Summer Session
                                  Course Title Credits
                                  PY 501 Human Physiology 4
                                  PY 503 Principles of Interviewing 3
                                  PY 507 Principles of Electrocardiography 1
                                  PY 508 Diagnostic Methods I 2
                                  PY 515 Clinical Pathology 3
                                  PY 517 Human Anatomy 4
                                  Total 17
                                  Fall Session
                                  PY 502 Physical Diagnosis 4
                                  PY 505 Clinical Pharmacology I 2
                                  FY 506 Principles of Medicine 6
                                  PY 514 Diagnostic Methods II 1
                                  FY 572 Medical Microbiology & Infectious Diseases 4
                                  Total 17
                                  Spring Session
                                  PY 504 History, Roles & Responsibilities of the Physician Assistant 1
                                  FY 509 Principles of Obstetrics & Gynecology 3
                                  FY 510 Principles of Pediatrics 3
                                  PY 511 Principles of Surgical & Emergency Management 4
                                  PY 512 Psychosocial Issues in Health Care 2
                                  PY 512 Behavioral Medicine 3
                                  PY 516 Clinical Pharmacology II 2
                                  Total 18
                                  Second Year
                                  PY 611 Clinical Residency I 3
                                  PY 612 Clinical Residency II 3
                                  PY 613 Clinical Residency III 3
                                  PY 614 Clinical Residency IV 3
                                  PY 615 Clinical Residency V 3
                                  PY 616 Clinical Residency VI 3
                                  PY 617 Clinical Residency VII 3
                                  PY 618 Clinical Residency VIII 3
                                  PY 619 Clinical Residency IX 3
                                  Total 27
                                  Third Year
                                  PY 526 Principles of Epidemiology 3
                                  PY 536 Biostatistics 3
                                  PY 546 Ethics in health Care Delivery 3
                                  PY 608 Graduate Seminar 4
                                  PY 676 Comprehensive Examination 2
                                  Total 15

                                  If you honestly feel like the quality of an MSN educated NP is equal to that of a PA, you're gravely mistaken. As to "NPs taking over primary care" and physician assistants not being present, here's some data:
                                  http://www.ahrq.gov/research/findings/factsheets/primary/pcwork2/index.html

                                  Estimated number of nurse practitioners and physician assistants practicing primary care in the United States, 2010
                                  Provider type Total Percent primary care Practicing primary care
                                  Nurse practitioners 106,073 52.0% 55,625
                                  Physician assistants 70,383 43.4% 30,402
                                  pcworkfig2.jpg


                                  Nurse practitioners are only 9% more likely to practice in primary care than physician assistants, and are more prevalent largely because there's simply way more of them.

                                  As to salary, PAs make more than NPs (and often substantially more, with male PAs earning $25,000/yr more, on average, than female NPs), but NPs have the option to work their way into management via easier paths overall, so there is more upward mobility on the NP side of things.
                                  http://nurse-practitioners-and-phys...cles/2013-National-Salary-Survey-Results.aspx
                                  salaryaverage_tables_595x.jpg


                                  As I've said before, there is no functional difference in how PAs and NPs practice when employed. NPs can currently operate their own clinics in 22 states. Owning your own clinic is a lot easier said than done with all of the new EHR requirements and such, so it isn't as much of a possibility as most would think. PAs and NPs have essentially identical roles within New York state because "supervision" and "collaboration" both require the same thing- a physician essentially saying, "well, if something happens, call me" and that's it. There's no required chart review, no required signing off of the PA's work, etc. Just that the physician be available should their consult be required. So there's the long answer to your question- NP education is lower quality, PAs and NPs are both about equally as enticing to hire, and PAs practice in primary care in numbers that are actually pretty close to NPs, percentage wise. Physician assistants make more money on average, and sometimes substantially more, than NPs. Whether you prefer the term "assistant" or "nurse" attached to your career, if you're the sort of person to be insecure about titles, either one can breed equal insecurity. If you are, however, interested in working in a health profession that contributes in a valuable way to the health care team (and not insecure about what people call you), both are viable options.
                                   
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                                  Intel1122

                                  Full Member
                                  Nov 9, 2014
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                                    In regard to your initial question, most nursing programs only provide 675 hours of clinical training at the advanced level, while a BSN requires approximately 1,000 hours at the basic level (putting in lines, administering meds, and changing bedpans is barely contributory to the practice of a midlevel, as it is usually delegated work at that point, so most of these hours end up being less than useful in regard to midlevel practice), while PA students are required to have 2,000 clinical hours at the advanced level. Their preclinical education does not train them in proper differential diagnosis like PAs, but rather in the nursing diagnosis model, which is quite flawed and only utilized so that nurses can say that they are not "practicing medical diagnosis." PAs are trained in differential diagnosis, learn the same basic sciences as physicians, and learn the medical model of diagnosis, assessment, and treatment. The average PA applicant has 3,560 paid professional patient contact hours prior to matriculation (most programs require paid HCE for consideration, and typically actively recruit paramedics, RNs, and RTs) per the last PAEA report, in addition to whatever contact hours they had during being educated for their position.

                                    Here is a typical NP program curriculum: http://nursing.msu.edu/msn programs/Nurse Practitioner Concentration/NP Curriculum.htm
                                    Courses

                                    NUR 802: Theoretical Foundations and Role Development for the Advanced Practice Nurse
                                    NUR 804: Statistics for the Healthcare Professional
                                    NUR 805: Pathophysiology for Advanced Practice Nurses
                                    NUR 806: Research for Practice Nurses
                                    NUR 807: Clinical Decision Making
                                    NUR 809: Applied Pharmacology for Advanced Practice
                                    NUR 814: Health Care Policy and Politics
                                    NUR 820/835: Health Assessment
                                    NUR 821/836: Primary Care Management I
                                    NUR 822/832: Practicum I Primary Care
                                    NUR 823/837: Primary Care Management II
                                    NUR 824/834: Practicum II
                                    NUR 838: Care for Aging Individuals

                                    Here is a typical PA program curriculum: http://www.quinnipiac.edu/school-of...master-of-health-science-physician-assistant/

                                    First Year
                                    Summer Session
                                    Course Title Credits
                                    PY 501 Human Physiology 4
                                    PY 503 Principles of Interviewing 3
                                    PY 507 Principles of Electrocardiography 1
                                    PY 508 Diagnostic Methods I 2
                                    PY 515 Clinical Pathology 3
                                    PY 517 Human Anatomy 4
                                    Total 17
                                    Fall Session
                                    PY 502 Physical Diagnosis 4
                                    PY 505 Clinical Pharmacology I 2
                                    FY 506 Principles of Medicine 6
                                    PY 514 Diagnostic Methods II 1
                                    FY 572 Medical Microbiology & Infectious Diseases 4
                                    Total 17
                                    Spring Session
                                    PY 504 History, Roles & Responsibilities of the Physician Assistant 1
                                    FY 509 Principles of Obstetrics & Gynecology 3
                                    FY 510 Principles of Pediatrics 3
                                    PY 511 Principles of Surgical & Emergency Management 4
                                    PY 512 Psychosocial Issues in Health Care 2
                                    PY 512 Behavioral Medicine 3
                                    PY 516 Clinical Pharmacology II 2
                                    Total 18
                                    Second Year
                                    PY 611 Clinical Residency I 3
                                    PY 612 Clinical Residency II 3
                                    PY 613 Clinical Residency III 3
                                    PY 614 Clinical Residency IV 3
                                    PY 615 Clinical Residency V 3
                                    PY 616 Clinical Residency VI 3
                                    PY 617 Clinical Residency VII 3
                                    PY 618 Clinical Residency VIII 3
                                    PY 619 Clinical Residency IX 3
                                    Total 27
                                    Third Year
                                    PY 526 Principles of Epidemiology 3
                                    PY 536 Biostatistics 3
                                    PY 546 Ethics in health Care Delivery 3
                                    PY 608 Graduate Seminar 4
                                    PY 676 Comprehensive Examination 2
                                    Total 15

                                    If you honestly feel like the quality of an MSN educated NP is equal to that of a PA, you're gravely mistaken. As to "NPs taking over primary care" and physician assistants not being present, here's some data:
                                    http://www.ahrq.gov/research/findings/factsheets/primary/pcwork2/index.html

                                    Estimated number of nurse practitioners and physician assistants practicing primary care in the United States, 2010
                                    Provider type Total Percent primary care Practicing primary care
                                    Nurse practitioners 106,073 52.0% 55,625
                                    Physician assistants 70,383 43.4% 30,402
                                    pcworkfig2.jpg


                                    Nurse practitioners are only 9% more likely to practice in primary care than physician assistants, and are more prevalent largely because there's simply way more of them.

                                    As to salary, PAs make more than NPs (and often substantially more, with male PAs earning $25,000/yr more, on average, than female NPs), but NPs have the option to work their way into management via easier paths overall, so there is more upward mobility on the NP side of things.
                                    http://nurse-practitioners-and-phys...cles/2013-National-Salary-Survey-Results.aspx
                                    salaryaverage_tables_595x.jpg


                                    As I've said before, there is no functional difference in how PAs and NPs practice when employed. NPs can currently operate their own clinics in 22 states. Owning your own clinic is a lot easier said than done with all of the new EHR requirements and such, so it isn't as much of a possibility as most would think. PAs and NPs have essentially identical roles within New York state because "supervision" and "collaboration" both require the same thing- a physician essentially saying, "well, if something happens, call me" and that's it. There's no required chart review, no required signing off of the PA's work, etc. Just that the physician be available should their consult be required. So there's the long answer to your question- NP education is lower quality, PAs and NPs are both about equally as enticing to hire, and PAs practice in primary care in numbers that are actually pretty close to NPs, percentage wise. Physician assistants make more money on average, and sometimes substantially more, than NPs. Whether you prefer the term "assistant" or "nurse" attached to your career, if you're the sort of person to be insecure about titles, either one can breed equal insecurity. If you are, however, interested in working in a health profession that contributes in a valuable way to the health care team (and not insecure about what people call you), both are viable options.

                                    Can I ask you something. Do you have a life..?
                                    Seems like you enjoying debating and arguing. After those initial cherry picking comments from you I am not in a position to listen to you. I would prefer to listen to Health Care Professionals such as Physicians, NPs, Pas, etc, more experienced than you. I'm done talking to you.
                                     

                                    Mad Jack

                                    Critically Caring
                                    7+ Year Member
                                    Jul 27, 2013
                                    37,346
                                    72,384
                                    4th Dimension
                                      Can I ask you something. Do you have a life..?
                                      Seems like you enjoying debating and arguing. After those initial cherry picking comments from you I am not in a position to listen to you. I'm done talking to you.
                                      I answered literally all of your questions. It seems you must be a troll.
                                       
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                                      FCMike11

                                      Full Member
                                      10+ Year Member
                                      Aug 24, 2011
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                                      Texas
                                      1. Resident [Any Field]
                                        Can I ask you something. Do you have a life..?
                                        Seems like you enjoying debating and arguing. After those initial cherry picking comments from you I am not in a position to listen to you. I'm done talking to you.
                                        He just provided real time numbers and statistics to debunk the statements you made. If you are just looking for confirmation on your decision, just go to allnurses.com. Because you created the post looking for information, someone posted said information, and then you asked him if he had a life. Grow up.
                                         
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                                        Intel1122

                                        Full Member
                                        Nov 9, 2014
                                        112
                                        6
                                          He just provided real time numbers and statistics to debunk the statements you made. If you are just looking for confirmation on your decision, just go to allnurses.com. Because you created the post looking for information, someone posted said information, and then you asked him if he had a life. Grow up.

                                          @Mad Jack I've got news man.....
                                          bce6dcb3ca0e46d0a3812cdf1c8f5abd.jpg
                                          Do you also suck Mad Jack's crotch..? :-D. Btw. Don't worry I understand this is a troll thread. Thats why I created another one to get Real answers. :).
                                           
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