Since both practitioners do similar tasks, who is able to do more in terms of helping patients? From what I understand, they both make the same amount of money and have just about the same amount of schooling. I'm having trouble deciding which of the two I want to go into.
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NP vs PA
Started by mulberry
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Actually, this thread can be closed. I did more research and came across an EXCELLENT site that compared the two.
http://allnurses.com/general-nursing-discussion/nurse-practitioner-physicians-406029-page2.html
Sorry about that.
http://allnurses.com/general-nursing-discussion/nurse-practitioner-physicians-406029-page2.html
Sorry about that.
You do realise the most valid points on that thread were by members of this forum?
Basically you have to decide two things.
(1) Do you want to practice nursing or medicine?
(2) Do you want to work in a specific field (mostly neonatal, family, peds, and women's health) or do you want a lot of lateral mobility to move about specialties and work in surgery?
(1) Do you want to practice nursing or medicine?
(2) Do you want to work in a specific field (mostly neonatal, family, peds, and women's health) or do you want a lot of lateral mobility to move about specialties and work in surgery?
Do you know what PA actually does for "surgery"? 🙂
Here's a youtube video of a NP in action (Minor surgery - not for the faint of heart)
http://www.youtube.com/watch?v=rP5nElmpdSA
No one really knows what a PA actually does in surgery because it varies greatly by the experience, supervising physician, and area of practice. My orthopaedic surgeon has a PA that has been with him for over 20 years and the PA did a fabulous job of repairing my rotator cuff. After 20 years of working in orthopaedic surgery, I'd say it is a safe bet the PA is just as good at routine surgeries as the doc. The PA has actually being working in orthopaedic surgery 13 years longer than his SP.
In other areas, the PA will just do simple vein harvesting. In other situations, the PA may just do suctioning and retracting. I've encountered PAs who are barely allowed to touch the patients to PAs who do routine procedures themselves as the primary surgeon with the supervising physician on hand if needed.
And that makes him a PA, not a surgeon.
If you're betting your PA is just as good as your surgeon at routine surgeries, you must not think much of your surgeon. Even a good PA is not equal to a surgeon.
If that's the case, then you are claiming that medical school trumps any other education and experience?
And both my surgeon and his PA are wonderful. Everyone tried to talk me out of repairing my rotator cuff because they had all had bad experiences - terrible recovery, no improvement, or worsening of the problem. I had a complete tear repaired and my recovery wasn't that bad and I feel amazing.
There are always exceptions. Vivien Thomas never spent a day in medical school (or PA school for that matter) yet he was talented enough at surgery that Johns Hopkins made him an instructor of surgery:
http://www.medicalarchives.jhmi.edu/vthomas.htm
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Even a good PA is not equal to a surgeon.
This is VERY true. I actually really realized that PAs were not equal to doctors as I went from a practicing PA-C to med school. During med school and residency I realized how much I didn't learn as a PA-C. I worked as a PA-C for many years and realized the loopholes in the PA education in comparison to an MD program. Also, there is a reason why residency is so long and not just for 1 year.
Becoming an MD was a very humbling experience. Anyone who thinks PA's are surgeons/doctors are in need of a reality check. It is very sad to see some former colleagues (you even see this on the PA forum) think of themselves as physicians. If they were equal, I wouldn't have gone on to medical school; others wouldn't have either. If one wants to be equal to a surgeon/doctor, he/she needs to go to med school and complete a residency.
This is VERY true. I actually really realized that PAs were not equal to doctors as I went from a practicing PA-C to med school. During med school and residency I realized how much I didn't learn as a PA-C. I worked as a PA-C for many years and realized the loopholes in the PA education in comparison to an MD program. Also, there is a reason why residency is so long and not just for 1 year.
Becoming an MD was a very humbling experience. Anyone who thinks PA's are surgeons/doctors are in need of a reality check. It is very sad to see some former colleagues (you even see this on the PA forum) think of themselves as physicians. If they were equal, I wouldn't have gone on to medical school; others wouldn't have either. If one wants to be equal to a surgeon/doctor, he/she needs to go to med school and complete a residency.
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Excellent movie...Mos Def played Vivien...
"Something the Lord Made"
http://www.imdb.com/title/tt0386792/
We also need to realise these situations are the exception however.
I worry that people who are deciding on a career hear these stories and come away with the message of "if I want to be a surgeon I can just go to PA school and do my own surgeries." That fact that they are a few people out there who have a lot of autonomy in the operating room isn't representative of what the "average" surgical PA does. And if you are a picking a career you should be looking at the average, not the rare top 1%. It'd be like joining the Navy because some people in the Navy become astronauts, or becoming a doctor because some doctors work at the Everest base camp.
One thing I've learned in med school is that "easy" surgeries are easy, with some practice I felt like I could do a basic surgery that I had seen a number of times like a lap chole. But then we had a straight forward lap chole turn really bad, where we thought we had a complication and had to open the patient up. I realized that being a surgeon is about being prepared for those complications by having the training to do a number of other procedures. So being ready to do a colostomy if the bowel is injured, localizing vessels to control bleeding, etc etc. I worry that someone who has been assisting a specialist for awhile could be convinced that they could do the procedure but they haven't had that general surgical training to handle the complications.
From what I've seen some surgical PAs handle only office work, some act as a first assist, some cover the floors and get pulled into surgery when needed. But the PA who "does the case" while the surgeon sits back and watches is something that I think is very rare and shouldn't be the expectation of people entering the field. And the fact that someone on here "knows a guy" who does that shouldn't really change that expectation.
One thing I've learned in med school is that "easy" surgeries are easy, with some practice I felt like I could do a basic surgery that I had seen a number of times like a lap chole. But then we had a straight forward lap chole turn really bad, where we thought we had a complication and had to open the patient up. I realized that being a surgeon is about being prepared for those complications by having the training to do a number of other procedures. So being ready to do a colostomy if the bowel is injured, localizing vessels to control bleeding, etc etc. I worry that someone who has been assisting a specialist for awhile could be convinced that they could do the procedure but they haven't had that general surgical training to handle the complications.
From what I've seen some surgical PAs handle only office work, some act as a first assist, some cover the floors and get pulled into surgery when needed. But the PA who "does the case" while the surgeon sits back and watches is something that I think is very rare and shouldn't be the expectation of people entering the field. And the fact that someone on here "knows a guy" who does that shouldn't really change that expectation.
I completely agree🙂. And we PAs are clearly not equal in clinical education than an MD and should not represent ourselves as such....
Yes. This is why I've asked foreverlaur if he or she knew about the PAs and their roles in "surgery".
Well, if you need surgery, who are you going to get to do your surgery? Yes, medical school does indeed trump other education in the end. It doesn't mean other disciplines aren't necessary, which is what you seem to have inferred. But when it comes down to brass tacks, a doctor does indeed "trump" a PA/NP.
The biggest difference between an NP and a PA is one of them has to work with nursing administration from start to finish and the other one doesn't. Some of the nurses who are going to be in charge of your education are REAL pieces of work...didactic and clinical NP training is less intense than PA training, but if you get the wrong nurse instructor, he/she will add on about 100% more difficulty just for fun.
I see this train of thought constantly. Were you REALLY surprised than an MD's education is more intense than a PA's education? I'm not trying to be rude, but it seems like that's simply a case of mistaken expectations. So many people - RNs, NPs, PAs - end up in med school and are amazed at what they weren't previously taught. Well, duh...you weren't in med school before. That's like a police officer getting all wide-eyed over law school.
I see this train of thought constantly. Were you REALLY surprised than an MD's education is more intense than a PA's education? I'm not trying to be rude, but it seems like that's simply a case of mistaken expectations. So many people - RNs, NPs, PAs - end up in med school and are amazed at what they weren't previously taught. Well, duh...you weren't in med school before. That's like a police officer getting all wide-eyed over law school.
An experienced doctor trumps anyone else in the medical field any day. But if I had to choose between a 4th year orthopaedic surgery resident to do my surgery or a PA who has been practicing in orthopaedic surgery for 20 years, I'd pick the PA. I did it once and it worked out great. No reason why I wouldn't do it again.
A fourth year orthopaedic surgery resident is very involved in the surgery. It is possible (very much so) that an orthepaedic PA of 20 years may have only first assisted. Many years of work experience does not always make up for the lack of training, when the 2 fields are different. This is why I became an MD. The issue still goes back to the PA not being a surgeon. Again, there is a reason why surgical residency is 5 years.
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May have - may have not. The PA/surgeon team I have worked with does not use his PA as simply a first assist. That may be rare and I always do my research before anyone does something that could seriously affect my life - whether it be the nurse, PA, doctor, etc.
Do you have a lot of anger in you?
Many first assistant, I am familiar with this as I worked as a PA-C for many years before going on to a phd and an MD. You have to go by the "average" PA.
Oh, and many people do their research before anything serious is done to them, and many are not healthcare professionals.
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Well, you could play in traffic and not get hit by a car, but that doesn't mean it's safe.
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Not all do a fellowship. A fair amount simply complete their residency and practice as an ortho surgeon. Most PAs work in a major hospital and act as a first-assist. This is the norm. However, some PAs are fortunate enough to work in a much smaller surgical environment where they are paired one on one with a doctor and are given a much more in depth learning experience which can be quite valuable over a 20 year period when you have a mentor like that. Again - this is rare, but possible. I'm definitely not expecting to graduate PA school, walk into a hospital, and expect to be handed cases (or ever). I'm aware that PAs first-assist and I'm good with that.
Quite a bit of them do specialize, however. Yes , it is true that surgical PAs and not just in orthopedics first assist. I know this because I have been a PA-C for a long time, and have also worked as a surgical PA before. In most of my posts I have been saying that surgical PAs generally work as first assistants.
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