Difference between NP & PA....

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oldManDO2009 said:
people lie zen give NP and medicine a bad name - I gonna assume that this guy will bad mouth traditional medicine in favor of "holistic" medicine and that these "herbs" will cure everything that the mechanic will throw at you (those corporate money mongers) but we do it naturally. Until the patient gets really sick and shows up in my ER!
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I do not "bad mouth" what you call "traditional" medicine. However "traditional medicine" is not what "modern" Western medicine is called. There were other "traditional" medicines here prior to modern Western medicine. I am all for "complementary medicine as I've stated several times. Since I'm not a zealot to any one system, I can call it like other physicians and myself see it. Modern Western medicine has many faults and if you woud like me to get you many, many quotes from enlightened physicians I will do so. (Just wait till I get my library shipped here and internet set up at home). Modern Western medicine, which according to some in the sciences, has already become "ancient," is great at surgery, trauma emergencies, but sucks at chronic diseases. Almost all medicine causes additional problems which are then treated by more medicine till medicine becomes one of the highest causes of death.

This is quackery at its worst - if you had solid scientific research to back such claims (double blind studies and not some nut on a paid infomercial) than this would be more accepted!
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Double blind studies can only give you an opinion to work with as they cannot measure "consciousness." In light of that, there needs to be more research in alternative practices. But they will be limited as to what info they provide.

I think "holistic" or integrative medicine has its place but as part of the whole approach and not some separate treatment that conflicts with more accepted practices of medicine.
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Basically, what I've been saying. But you are aware of the number of people and money that is going to "alternative" medicine. You better figure out why really quick before you don't have a job!

I will probably get flamed for my rant but this herb crap really hits a sore spot!
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Why does it hit a sore spot with you?
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Yo Zen...I'm just curious. What do you think the best approach to chronic diseases? You seem to point out the failures of allopathic medicine when it comes to treating them, but you do not offer up any suggestions of of how you feel it could be done better.

Give me your suggestions on AIDS, Lupus, COPD, and Chronic Myelogenous Leukemia.
 
I just picked up my books for my first semester of med school and I realized that all of my previous training amounts to very little when I look at the very comprehensive studies I am about to undertake. The pharmacology I studied as a nurse is no where close to the understanding I will have to master to be able to prescribe medication. That said, it is easy to say that the holistic approach to medicine is superior to traditional medicine when you are using non scientific methods to report success. Patients may say they feel better or that this non traditional treatment works for them, but these non traditional treatments do not follow disease progression and quantify symptomatic improvement - just "this is great". There are no lab test, x-rays, ct scans etc. to objectively assess disease progression and symptom improvement. That is what I am referring to when I talk about scientific studies. Now, if somebody in a research lab would like to correct me I am open to such feedback. It has been my experience that most of the treatments lack such scientific rigors and people tend to gravitate towards such treatments because they do not have the training in the traditional treatments (read medicine).
 
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To the OP:
The difference is that the PA is taught within the medical model and the NP is taught through the nursing model. Now, before the "pro NP" folks here get all hot and bothered saying that it doesn't matter, this very difference in methodology is the excuse used at every institution I know to justify a rule that only a nurse can supervise clinical nursing staff. If this methodological difference is so great that it requires two distinct administrative pathways (medical and nursing) be created in an institution, then it is far too great for me, as a lowly physician, to hire an NP. I mean, I have been flat out told that it is impossible for me to understand nursing's role sufficently to supervise them at the RN level, so how could I, with my limited understanding of nursing, work with an NP?

- H
 
I am not sure why nursing holds this idea of supervision so dear - but in terms of a PA v NP - I think the PA has superior training. At my school the PA's take many of the same courses the first and second year med students take and they get a one-year comprehensive rotation through medicine. I have looked in to many NP programs (since I AM a nurse) and I was really turned off by the survey style courses - where were the sciences?? So I have a better understanding of med-level providers today than I did several years ago and when people trivialize western medicine because they DO NOT have a comprehensive understanding of the subject - and all the sudden amidst this ignorance blossoms herbal remedies - I am annoyed! So I am not "anti - NP" so to speak I just wish they would require more PA style course/training - this would go a long way in creating a better working relationship with the doctor - who no matter what is ultimately responsible for the patient. I know that NP licensure allows a more independent practice model (which is fine) but REQUIRES the NP to consult with a physician when in the patient’s best interest. This reads any medical problem outside the scope of his/her training - which is limited to a set of common problems. I think mid-level providers are extremely important to healthcare and have worked with some excellent people - just go to John C; Lincoln in AZ (deer valley) some of the best I've seen! Oh this is so long winded - I apologize for those taken verbal hostage :) I think I have made some point here......
 
oldManDO2009 said:
I have looked in to many NP programs (since I AM a nurse) and I was really turned off by the survey style courses - where were the sciences??
So I am not "anti - NP" so to speak I just wish they would require more PA style course/training - this would go a long way in creating a better working relationship with the doctor - who no matter what is ultimately responsible for the patient.
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Thanks so much for this response. You are a future physician explaining exactly why a nurse like me went to PA school. I looked into and saw things the same way you did, just picking PA instead of D.O.

Pat, RN, PA-C
 
Pat,

you are the kind of professional I look forward to working with collaboratively in the (it seems so far away) future. We will have a common training background and will compliment the services we provider to our patients.
 
oldManDO2009 said:
Pat,

you are the kind of professional I look forward to working with collaboratively in the (it seems so far away) future. We will have a common training background and will compliment the services we provider to our patients.
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Ditto.
 
oldManDO2009 said:
That said, it is easy to say that the holistic approach to medicine is superior to traditional medicine when you are using non scientific methods to report success.
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Well....what about the areas of mental health and addiction medicine? I mean pyschotherapy (i.e. cognitive behaivoral therapy, pyschodrama, pyschoanalysis) has often produced better results in the long term for treating many mental illnesses/disorders such as Depression, Anxiety disorders like OCD, ADHD, Sexual Disfunction, Anger/Temperment Disorders, etc. The scientific method is used in determing whether such therapy works but it is almost all observation based. It isn't "hard" science like psychiatry.

And what about current treatments for addiction? Twelve Step programs
(and individual/group pyschotherapy) often produce much more permament recovery for addicts (alcoholics, compulsive overaters, bulimics, anorexics, sexual addicts, narcotic abusers, gamblers, etc.) than any pharmacological interventions. There is no scientific evidence to prove this (especially with Twelve Step programs as they are based on spiritual tenets) but the truth is evident when you ask the patients which type of treatment worked best.

I think what zenman is getting at is that medicine has yet to understand that much of the science it is based on is fastly becoming outdated. Talk to any
quantum physicist, biochemist, and sit them down with a buddhist monk or jewish rabbi and they will probably have much in common. We have still yet to discover the real roots of disease on the molecular/spiritual level.

Medicince has no place to go but holistic as western science begins confirming all of the so-called "hogwash" we thought of eastern (and other aboriganal) medicine.
 
Mr.Nurse said:
And what about current treatments for addiction? Twelve Step programs
(and individual/group pyschotherapy) often produce much more permament recovery for addicts (alcoholics, compulsive overaters, bulimics, anorexics, sexual addicts, narcotic abusers, gamblers, etc.) than any pharmacological interventions. There is no scientific evidence to prove this (especially with Twelve Step programs as they are based on spiritual tenets) but the truth is evident when you ask the patients which type of treatment worked best.
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I guess I am jaded. I see former 12 steppers everyday on the hospital wards having withdrawl seizures (after restarting drinking again, then trying to stop without medical assistance), getting alcoholic pancreatitis yet again, and alcoholic ketoacidosis placing them on death's door. These are just to name a few. 12 step programs work quite well for those who want to quit. For those who don't, we are left with medicinal measures of cessation and medical treatment of the complications of alcoholism.

So, we can stop the research on heart failure, CAD, stroke, etc. because there is "nowhere to go"? Come on, wake up my friend. There is quite a way to go. Studying the science of how a body works is where we have to go, not hocus pocus.

Pat
 
:)
 
I worked 10 years in mental health (finally paroled :D from that hellish career)! Have you heard of lithium, tegertol, and depakote levels? These are OBJECTIVE findings that are used in parallel with subjective findings such as how do you feel? Furthermore, OBJECTIVE findings such as appetite, hygiene, affect, energy level, mood are all used in conjunction with subjective findings such as are you homicidal?

So I do not accept your position that western medicine is dead and if we all just have a big group hug all disease will be cured. You hold on to that belief and let me know how it works out when you are really sick and tell me who you go to a doctor of western medicine or some guy wearing goat skin chaps?

Now that said, I believe eastern medicine has its place is supportive care. I think many patients that show up in the ER with chronic back pain would benefit from meditation and yoga. It may reduce there pain and provide some mental relief from chronic pain. Most doctors probably (in my experience) would not prescribe such treatments and that is a shame. Using alternative modalities is complementary and NOT mutually exclusive when it comes to treating a problem.

So stop trying to sell the eastern medicine will cure the world crap and realize that the human body is complex and there is room for both!

rant done!
 
oldmanDO wrote:

I worked 10 years in mental health (finally paroled from that hellish career)!
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LOL...good thing you got out before the patients started making sense!
 
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a_ditchdoc said:
Yo Zen...I'm just curious. What do you think the best approach to chronic diseases? You seem to point out the failures of allopathic medicine when it comes to treating them, but you do not offer up any suggestions of of how you feel it could be done better.

Give me your suggestions on AIDS, Lupus, COPD, and Chronic Myelogenous Leukemia.
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I'm playing catch up. The book at this website, written by two MDs pretty much echos most of what I believe. http://www.ultraprevention.com/
 
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nitecap said:
I can vouch for one thing. I am currently a RN and in CRNA school within a college of Allied hlth which also contains a PA program. We take all our sciences together including, A & P, bio chem, O chem, patho and what not. Of course our pharm is much diff and we take many different classes when in upper levels.

I see the PA's, the majority of the 32 are young just out of undrgrad with no clinical experience what so ever. 10 out of the 32 do have some marginal level of experience like helping out in a clinic of some sort. The PA's go thru a year of intense didactics then enter the clinical setting after. Most have never even came in close contact with a pt. unless it was grams or gramps that was sick. It scared me when I saw them practicing physical assessments on one another and It reminded me of myself when I was in nursing school taking the assessment course, i didnt have a clue.

To compare the level of entry I entered the CRNA program with along with NP 's entering their course work , especially those NP's that have worked in the critical care setting to that on the PA's is not even comparable. All CRNA's have at least a year, most more of critical care experience. Many RN's that i personally know to have 10 plus yrs of Level I trauma ER experience and major CVICU experience are returning to get Masters Degree NP. Theses RN's have fine tuned clinical assessment skills, titrated numerous vasoactive drips, adjusted and weaned mechanical vents and balloon pumps, and rescusitate pt's weekly without MD supervision in code and other ACLS situations.

Comparison of the PA students I know to this large numer on critical care nurses that I know is not even a comparison. The PA students, though I do give them credit are very smart, dont even know how to put on a stethoscope.

As a graduate RN in the ICU I had no critical thinking skills. With time and experience providing care for very sick high acuity pt's i developed them and became an expert critical care nurse.

RN's especially ICU and ER Rn's already have a solid foundation of critical thinking pathways which to build upon as they aquire and learm more knowledge. PA's learn this same knowledge put lack these thinking pathways and hands on clinical experience that enabe them to not only be bright practitioners but also be quick, efficient and proficient practitioners that respond to changes in pt's conditions on a dime.

I conclude that if the new grad NP and PA got for the most part the same education at their respective programs, which for the most part they do. That upon graduation the NP especially if they have Critical care experience is a far more effective practitioner. This statement of course does not account for PA's that maybe do have more clinical experience upon entering PA school.

Now give the PA a few years of clinical experience working and actualy getting more than the 1.5 or so yrs of clical experience that they receive in school and I have no doubt that the PA with be just as effective as any NP out there. My 2 cents.
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Can I get an "AMEN" from the choir?!!
 
FoughtFyr said:
To the OP:
The difference is that the PA is taught within the medical model and the NP is taught through the nursing model. Now, before the "pro NP" folks here get all hot and bothered saying that it doesn't matter, this very difference in methodology is the excuse used at every institution I know to justify a rule that only a nurse can supervise clinical nursing staff. If this methodological difference is so great that it requires two distinct administrative pathways (medical and nursing) be created in an institution, then it is far too great for me, as a lowly physician, to hire an NP. I mean, I have been flat out told that it is impossible for me to understand nursing's role sufficently to supervise them at the RN level, so how could I, with my limited understanding of nursing, work with an NP?

- H
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I don't know which NP program you are talking about, but I can assure you that I was trained in both the medical AND nursing models at my school. The majority of my classes were taught by the same physicians who taught the medical students. Plus, I spent my clinical rotations with internists (who hired me when I graduated). I'm just amazed at how doctors/PA's bash nurses, especially considering how highly the public regards us. From what I understand the NP programs are going to require doctorate degrees in the near future. Also, the NP will have N.D. (Nursing Doctorate) after their name. In fact, I know a couple of NP's in town who not only own their own clinics, but they are Ph.D's...yes, the patients call them "doctor". What do you think about THAT?
 
You weren't talking to me, but I can tell you what I think.

I think that anyone who is working in a healthcare setting should acknowledge that in that setting, the word "doctor" has traditionally meant "physician" and not PhD. Of course PhD's are doctors too, but in the health care setting the word "doctor" means something specific, and it's not PhD (or ND or any other doctorate-level degree). Therefore, anyone who works in healthcare (in a patient contact capacity) and asks people to call them "doctor" is, whether by design or by accident, representing themselves as a physician.

I also think that anyone who works in healthcare should be proud to stand on the quality of their work, and get over petty and superficial booshwah like one-upsmanship with other practitioners over titles.
 
As an RN - the science courses I took to get my RN does not compare with the pre-reqs required to get into PA school - they are the same as required for medical school.

PA program require courses such as bio-chemistry, pharmacology, cadaver anatomy, and pathophysiology which is VERY different than what many (not all) NP programs offer which is usually a year of pharm & pathophysiology and then clinical specialization compared to rotations through most services that a PA student is required to complete (similar to the 3rd year of med school).

Now you can say that the training that a nurse receives prepares the nurse for the clinical aspect - there is a huge difference between what a nurse does working and what a PA does during their rotations - it’s night and day. Nursing may offer an introduction but in no way supplants the clinical experience gained during those rotations.

So if you compare a nurse to a PA student with no experience you are still comparing apples and oranges because they are different jobs and nursing does not prepare you for that job by way of its curriculum. In other words, the PA will gain insight in to the disease process via the rigorous science where as the nurse will have been trained to recognize certain diseases but not the treatment modalities required to manage the disease. That is a huge difference.

Now I took my nursing courses MANY years ago and they include A&P, micro, basic chemistry, and then a series of nursing specific course to prepare me for my future career. These were undergraduate science courses that in no way prepared me to understand the complexity for example of the respiratory system - nursing does not cover the subject in great detail. But to treat COPD effectively you must understand many of the details associated with the respiratory system. Henceforth nursing undergraduate pathophysiology does not equal PA graduate level pathophysiology.

I continue to work as a nurse and have a very different perspective of the patient encounter. I can apply some of the principles I have learned to develop a differential DX (not even accurately :laugh: ) - did nursing provide the foundation - yes it did! But I can see the difference from what I am expected to know as a nurse and what I will someday learn when I finish school. I can tell you it is very different. So, my point (took me long enough :D ) is that you can not compare a PA to an NP without first realizing that they have different educational curriculums and working environment. PAs will always work with a physicians and NPs will work more independently but that does not equate to equal training!

So now I have really gone on a rant - before you flame me please prove me wrong and compare the curriculums of the NP and PA program that you have in mind. I look forward to the information but don't try to sell the old "being nurse on the floor makes the difference" argument because it does not make up for the requisite knowledge required to diagnose disease IMHO.
 
Oh don't worry - the NP/I don't need an MD/I'm better than an MD crowd isn't really concerned with facts.

And Cyndee, YOU'RE not practicing independently - I guess you're just pretending to be something you're NOT!!!. And aren't we just a busy little poster/basher on all three BB's your first couple days of being online?
 
Cyndee said:
I don't know which NP program you are talking about, but I can assure you that I was trained in both the medical AND nursing models at my school.
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WOW! Now NP's are claiming that they are trained in both the nursing and medical models! All this in a part-time 3 day a week night course for 24 months with a focus in one discipline during the clinical rotation. Tell me about your undergraduate organic and general chem. and biology courses that were required during your undergraduate years. Your training as an NP would give you little help in PA school let alone being an RN. I'm now convinced that next natural step for NP's would be chiropractic school! Just joking, but don't pretend that you're equal to a PA even though you don't have the training. Further, awarding a doctorate is not the same as earning a doctorate. The fact is that many professional organizations are mandating that entry level become a clinical doctorate and that if academic institutions want to maintain accreditation, they must comply despite the fact that academia doesn't approve of marginalizing the degree. Buying a degree doesn't make you more competent as a clinician - didactic training and extensive and dynamic exposure to a variety of clinical rotations will! Please don't insist on being ignorant! If you simply force yourself to ignore what you’re inclined to believe and analyze the facts, you will see the light.

PS - the public may have a very positive impression of the NP profession, but is due to very deliberate marketing by the NP organization that has been very powerful politically. If they put the same efforts and money that they do for political endeavors into education and curriculum development, they would be well prepared for the practice of medicine. They simply figured out that the better they market - the better they will sell regardless of the quality, safety and effectiveness of the products and services.
 
Cyndee said:
Can I get an "AMEN" from the choir?!!
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NO! It would be wrong to bless such deliberatately fabricated information. What's troubling is that this person who may or may not be an NP acually believes what they are saying.
 
Ugh

Enough of this tired argument. Here are the facts:

1) A Critical Care RN whith experience will definitly make a better NP or PA. End of story. Dave, your assumptions that all critical care RN's do not understand disease process and tx modality are fallicous. Any RN who has been around long enough working critical care often does. This is not the priority of 90% of nursing which is not critical care and more organizational skill focused ( so your right, most nurses dont fit this profile).

2) PA programs are putting out as many crappy practitioners as NP programs who do not require the experience. EMEDPA and i both agree that the PA program was created to take in experienced health care providers such as RN's and EMT-P's. The ones pumping out people whos previous hospital experience was as candy stripers in 24 months are Sub-Par and not in the founding spirit of the Physician Assistant model.

3) those of you balking at the entrance req's for PA vs NP get off your high horse. Any seasoned physician will tell you Ochem, Inorganic Chem and Physics have played absolutely NO PART in their medical career or contributed to understanding medicine. Many of you out there dont actually know any, so let me be the one to confirm this.

4) Not all Nursing programs are created equal (nor PA and NP programs). In Canada I did a 4 year degree to become an RN (the standard now). We did alot of training and excellent classes

1) Full Cadaver Anatomy Labs
2) 1 year Anatomy
3) 1 year Physiology
4) 1 Year Pharmacology
5) BioChem 1/2 year
6) Microbiology 1 year
7) Ochem/Inorganic chem mix 1 year
8) Pathophysiology 1 year
9) advanced patho 1/2 year
10) Medical Research 1 year
11) Statistics 1 year

So, not all nursing programs are "soft Science". We had classes of 130 with a failure rate of 30% be the end of the 4 year science degree in nursing.

There are alot of generalizations about RN's, NP's and PA's here by peoiple who dont have a clue. Your either In training or so damn green your making arrogant assumptions which are baseless.

Both PA's and NP's can be excellent midlevel practitioners. Let me be the first to tell you there is only ONE thing that seperates the crappy mid-level from the excellent mid-level and thats PERSONAL DEDICATION of the individual. Nothing more, nothing less.
 
Mike I agree with your post but I am glad I remembered 10% of my OChem as we now start studying genetics & immunology. It seems every enzyme has some cofactor and I need to understand the basic relationship. So I do use the basic concepts covered by pre-reqs - I could not have got through respiratory with out an understanding of physics.

So my point is that the depth of material covered in PA and NP programs may be different. The NP program may not go through the physics of respirations in any depth compared to a PA program which requires those pre-reqs.

Now, not having attended either program I may be wrong and the course descriptions are not very telling. But if the basic medical science course in the PA programs are anything like the basic science foundations course I am currently taking - you would need a good understanding of chemistry and physics. That is the difference I am talking about. The subject material is not covered at that level of detail in nursing school. The NP course descriptions I reviewed did not seem to describe the detail I was looking for - and again I could be wrong. But it seems that the depth of sciences studied in the PA programs may not compare to those studied in an NP program.

I invite cyndeeeee to refute this argument and describe the depth of sciences studied in areas such as immunology, pharmacology, and the bio-chemistry of the major organs. If the depth and detail is equivalent to that of a PA program than I can easily admit I was wrong. I will wait and see....
 
Mike MacKinnon said:
Ugh

Enough of this tired argument. Here are the facts:

1) A Critical Care RN whith experience will definitly make a better NP or PA. End of story. Dave, your assumptions that all critical care RN's do not understand disease process and tx modality are fallicous. Any RN who has been around long enough working critical care often does. This is not the priority of 90% of nursing which is not critical care and more organizational skill focused ( so your right, most nurses dont fit this profile).

2) PA programs are putting out as many crappy practitioners as NP programs who do not require the experience. EMEDPA and i both agree that the PA program was created to take in experienced health care providers such as RN's and EMT-P's. The ones pumping out people whos previous hospital experience was as candy stripers in 24 months are Sub-Par and not in the founding spirit of the Physician Assistant model.

3) those of you balking at the entrance req's for PA vs NP get off your high horse. Any seasoned physician will tell you Ochem, Inorganic Chem and Physics have played absolutely NO PART in their medical career or contributed to understanding medicine. Many of you out there dont actually know any, so let me be the one to confirm this.

4) Not all Nursing programs are created equal (nor PA and NP programs). In Canada I did a 4 year degree to become an RN (the standard now). We did alot of training and excellent classes

1) Full Cadaver Anatomy Labs
2) 1 year Anatomy
3) 1 year Physiology
4) 1 Year Pharmacology
5) BioChem 1/2 year
6) Microbiology 1 year
7) Ochem/Inorganic chem mix 1 year
8) Pathophysiology 1 year
9) advanced patho 1/2 year
10) Medical Research 1 year
11) Statistics 1 year

So, not all nursing programs are "soft Science". We had classes of 130 with a failure rate of 30% be the end of the 4 year science degree in nursing.

There are alot of generalizations about RN's, NP's and PA's here by peoiple who dont have a clue. Your either In training or so damn green your making arrogant assumptions which are baseless.

Both PA's and NP's can be excellent midlevel practitioners. Let me be the first to tell you there is only ONE thing that seperates the crappy mid-level from the excellent mid-level and thats PERSONAL DEDICATION of the individual. Nothing more, nothing less.
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How could a person disagree with what you are saying? Unfortunately, you are only approaching the issue at a very superficial level. Fact - NP's and PA's have very different training and standards! Fact - The provisions of each profession should be different as they are trained differently. Fact - PA training is much more standardized. Fact - The PA organization has worried less about stature and malicious political maneuvers and more about educational content and a sound multi-disciplinary approach to medicine. Fact - NP's want to be autonomous and practice in the capacity of a physician, but without the training or residency requirements. Fact - the nursing organization has been very deliberate and effective in marketing the NP's abilities. The research that has been performed to analyze the quality of care compared to physicians is jaded. Treating common problems, the NP should be equally effective in treating patients, but no research has shown that they are equally effective in treating the more complex patient presentations. I believe they are deliberately misleading the public and legislative bodies for one purpose - to make more money and become more autonomous. They are simply looking at what they can take from healthcare rather than what they can contribute. Please don't you worry - the debate will continue Mr. Mike MacKinnon until the nursing organization is viewed at face value! L.
 
Nifty. I enjoy sarcasm but i prefer facts.

Fact: PA and NP schools differ from school to school as far as consistency and in depth of training goes. It could easily be argued that PA schools are fractured by their various preperation levels (associates, BA and Masters). I also would argue that NP schools are a crap shoot as well. But then, that could be said of many professions, look into your school and its training before you go.

Your "PA worries less about politics and malicious blah blah blah." is totally basless. Nursing has been around a few hundread years longer than PA's and therefore are politically empowered. This has nothing to do with standards or level of care/knowledge. You smack of ignorance in your arrogant dismissal of another profession making you as guilty as that b*tch cyndee.

You said

Fact - NP's want to be autonomous and practice in the capacity of a physician

Thats no true. it isnt written anywhere nor is there current political movement in that direction. Physicians are the Generals of medicine because of far superior education, no more no less. Your post is loaded with ignorant propoganda, again, you sound just like cyndee.


lawguil, you need to check both your attitude and your arrogance. You balk at Cyndee, (i agree she is an idiot) then you utilize the same antagonistic ignorant tactics which she employeed in your posts.

Please, grow up. People with that attitude neither make good physicians or mid-levels.



lawguil said:
How could a person disagree with what you are saying? Unfortunately, you are only approaching the issue at a very superficial level. Fact - NP's and PA's have very different training and standards! Fact - The provisions of each profession should be different as they are trained differently. Fact - PA training is much more standardized. Fact - The PA organization has worried less about stature and malicious political maneuvers and more about educational content and a sound multi-disciplinary approach to medicine. Fact - NP's want to be autonomous and practice in the capacity of a physician, but without the training or residency requirements. Fact - the nursing organization has been very deliberate and effective in marketing the NP's abilities. The research that has been performed to analyze the quality of care compared to physicians is jaded. Treating common problems, the NP should be equally effective in treating patients, but no research has shown that they are equally effective in treating the more complex patient presentations. I believe they are deliberately misleading the public and legislative bodies for one purpose - to make more money and become more autonomous. They are simply looking at what they can take from healthcare rather than what they can contribute. Please don't you worry - the debate will continue Mr. Mike MacKinnon until the nursing organization is viewed at face value! L.
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Mike MacKinnon said:
Nifty. I enjoy sarcasm but i prefer facts.

Fact: PA and NP schools differ from school to school as far as consistency and in depth of training goes. It could easily be argued that PA schools are fractured by their various preperation levels (associates, BA and Masters). I also would argue that NP schools are a crap shoot as well. But then, that could be said of many professions, look into your school and its training before you go.

Your "PA worries less about politics and malicious blah blah blah." is totally basless. Nursing has been around a few hundread years longer than PA's and therefore are politically empowered. This has nothing to do with standards or level of care/knowledge. You smack of ignorance in your arrogant dismissal of another profession making you as guilty as that b*tch cyndee.

You said

Fact - NP's want to be autonomous and practice in the capacity of a physician

Thats no true. it isnt written anywhere nor is there current political movement in that direction. Physicians are the Generals of medicine because of far superior education, no more no less. Your post is loaded with ignorant propoganda, again, you sound just like cyndee.


lawguil, you need to check both your attitude and your arrogance. You balk at Cyndee, (i agree she is an idiot) then you utilize the same antagonistic ignorant tactics which she employeed in your posts.

Please, grow up. People with that attitude neither make good physicians or mid-levels.
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Agreed - I am being antagonistic! Anyway!

1. My understanding is that the AAPA mandates certain academic standards in the PA curriculum. Certainly, any program can embellish, but the standards exceed those mandated by the nursing organization within the provisions of the practice of medicine.

2. If you are actively campaigning in a state to eliminate any language that even alludes to physician supervision or collaboration, isn't that an attempt to become autonomous!? Further, in many states they have debated how "collaborating physician" should be defined in favor of less oversight.

3. It is also my understanding that the NP organization has actively criticized the PA profession and compared them on many levels as being inferior to NP's. I'm obviously biased towards PA's, but it's because of their education. However I'm not a PA! I'm just amazed that PA's would simply sit back and just take whatever they get regardless if it's less than they deserve. Being an "outsider", I can't debate with you about being ignorant personally, but I might consider questioning some of the efforts of the NP organization.

Sorry if I seemed obnoxious.
 
lawguil

I just dont have any idea what your modus-operandi is here. From my perpective you are being a Troll. I am neither pro NP or PA and have no interest in either. I decided to do medical school instead. You, however, are an outsider with absolutely no idea of what even happens in a hospital let alone the differences between PA and NP.

Though some may think differently, there is considerable difference between the person who enters PA school cold from being a candy striper in the hospital with absolutely no healthcare experience and the critical care RN who enters (as emdpa mentioned).

The evidence is really in the care provided. There are many patients managed by PA's and NP's who are very happy with that care and are managed appro[riately. There are certainly not a disproportionate difference in mismanagement or lawsuits between the two (or you can bet we would all have heard of it) ergo: either path is preparatory for the job.

As far as autonomy = wanna be doctors. Thats simply your read of it. I see autonomy as an evolutionary part of a profession. This is evidenced by nursing itself, from as* wipers and chart handers to the current level of autonomy existing in the profession. NP's are, from my opinion, looking to step away from physician oversight as a way of differentiating themselves from physicians not becomming them.

In anycase, alot of that will be simply how you see it personally. However, NP's (or PA's for that matter) will never be without some form of physician oversight since medicine is a hierarchical entity.

As for the difference in training between NP/PA it is also important to look at the structure of each. PA's exit the program able to basically do anything the physician delegates and feels comfortable with. With NP's this is NOT the case. There are psych NP's, Neonatal NP's etc etc who cannot step outside their specialty in ANY situation as their liscence prevents it. My undertsanding is PA's can basically transition from one to another at will. This creates a need for a more general program to prepare for basics in any situation. Somewhat different.
 
You don't seem obnoxious, lawguil...you are obnoxious.

As Mike said, you are no better than Cyndee (who could write the playbook on how to alienate an entire BB in one post). You make claims that are not substantiated by any facts; hate to say it, but "It's my understanding..." isn't much more than an opinion until you can cite a source to back up your statement.

Most of the NPs I know work well with the docs and PAs in group practices. I don't understand all the runaway paranoia going on. Maybe when you've been in the real world for a while and actually work collaboratively with others you'll have a better idea of what things are really like.
 
http://www.amcollege.org/

I think it costs about 40 dollars to at least take a 'step' towards unity.
It is also intersting that the people who are actually working as NP's and PA's, side by side are not feeling the conflict that has been exhibited on this post from those who are neither.
 
................................
 
acutecarenp said:
Two more words:

Responses like that are one of the reasons why most efforts, to date, to form an alliance between NPs and PAs (such as National mid level practitioner organizations) have been nothing more than futile.

Keep up the good work!

P.S. Another difference is that you cannot be an NP without a Masters Degree.
Click to expand...

There are many NPs out there without master's degrees, just as there are PAs. There is still a woman's health NP program out there that does not award a degree of any sort.

The more important question is what constitutes medical knowledge (PA) and what constitutes advanced nursing knowledge (NP)? What does the practice need to care for its patients? Answer those questions and you have the answer, whether PA or NP.

Mike
 
guetzow said:
................................
Click to expand...
Joining what? She's been banned. ;)
 
O'K, now that we are all enlightened, and get it: NP=bad, PA=good :smuggrin: can't we all get alone? And while at it...Let this freaking thread DIE already
Thanks :smuggrin: :rolleyes:
 
beatingthehorse.gif
 
I cant believe you paople are still batting this crap around.

Student==idiot

practicing profession===good

everyone grow up and get to gettin`

I see this as a common thread for MD/DO/NP/PA/ PT/pharm, RN---everyone has their opinions all are worthless untill you get out and work
 
Bandit said:
I cant believe you paople are still batting this crap around.

Student==idiot

practicing profession===good

everyone grow up and get to gettin`

I see this as a common thread for MD/DO/NP/PA/ PT/pharm, RN---everyone has their opinions all are worthless untill you get out and work
Click to expand...

Thank you Bandit! There's nothing like the simple truth! :D

Just a workin' PA.. ;)
 
So much crap, really, just wait till you're actually done with your program and thrown out into the wilderness of actual practice.

All I can say is thank goodness for the NPs I work with, they have been nothing but helpful, approachable and knowledgeable to this PA.
 
..................................
 
niko327 said:
So much crap, really, just wait till you're actually done with your program and thrown out into the wilderness of actual practice.

All I can say is thank goodness for the NPs I work with, they have been nothing but helpful, approachable and knowledgeable to this PA.
Click to expand...

So true. This NP has PA buddies that we all bitch to each other about the BS we all have to deal with. Even some of my patients are PAs ( :eek: ) and we get along great. That's the real world...
 
Does PA education now mandate a Masters?
 
niko327 said:
So much crap, really, just wait till you're actually done with your program and thrown out into the wilderness of actual practice.

All I can say is thank goodness for the NPs I work with, they have been nothing but helpful, approachable and knowledgeable to this PA.
Click to expand...

Isn't it funny, the people who are actually out there working in practices with NPs and PAs seem to have few problems.

I'm glad you work in that sort of practice, niko.

Guetzow, I must say, it takes incredible chutzpah/moxie/whatever for you to say "can't we all just get along?" Yours has been one of the most uninformed and divisive voices in this forum.
 
"chutzpah"


wow, hmmm is that how that ius spelled???? I would have never guessed
 
No. Just like NPs do not. "Content" is more relevant. At present their is no consensus regarding what a Mid-Level Masters program should be.
 
emedpa said:
pa's are clinicians. they see pts,perform histories and physical exams, order tests, interpret them,perform procedures, write prescriptions, and arrange follow up and referals.
nurses follow orders written by pa's/md/do/np folks and do not have any authority on their own to order medications or interpret studies.
both roles are important and needed for a facility to run.

most pa programs are graduate level programs taken by folks with prior degrees and experience as paramedics, nurses, resp. therapists and other health care professionals. for general info on the pa profession see www.aapa.org

as an aside pa's do work in canada in your armed forces as well as in manitoba in the civilian sector. I think they call them clinical associates or something similar in manitoba but they are the same creature.
Click to expand...

Nurses are clinicians also. Just a different breed. And in Illinois, you cannot be an NP with out a masters program. It may be differnent in other states, but my home state says that np=masters program, even post-masters.

however, you can get a certificate program for a PA from certain programs. The one I am thinking of is the Cook County program. And I would think that coming out of Cook County you'd be prepared to handle just about anything.
 
NoAngel said:
... And in Illinois, you cannot be an NP with out a masters program. It may be differnent in other states, but my home state says that np=masters program, even post-masters...
Click to expand...

WRONG...
I'm From Chicago...
Illinois, like many/most states depend upon the national certification test to license NPs...
As such... you have to have a Masters to sit for the exam... Not to take a NP course. But if you took a NP course of study before 1/1/00 and passed... even without a masters... you can be licensed in Illinois!

ALL NPs that took the test before 1/1/00 were/are "grand-fathered" in!!!

DocNusum, FNP, PA-C
 
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