Nov 18, 2010
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Hi Everyone,

I am currently a Senior in undergrad., graduating this Spring. I am in a position where I can either go to PA school or NP school. I understand that these are two different professions, that undergo very different training. However, they are both midlevels and have similar salaries. Grades/GRE scores are not an issue. I could get into whichever I choose.

Heres the thing:
1. I could go to PA school and be done in around 24 months for about 70k+plus in student loans. This route is shorter and I would have much more employment opportunities (switching specialties easier than an NP).

or

2. I could go to a Direct Entry NP program which would take 3 full years, for about 60k (in state). Becoming an RN in the first year, and then an NP in the last two. And, become an Independent Practitioner in the end. (however, may have to continue school if the DNP becomes the standard)

(I am paying for graduate school myself, which is why I am taking tuition costs into account so much.)

I know that many people are going to reply saying "well it depends on what you want to go into..." blah blah blah. "Nursing and PA are very different." yes I know this. I'm still unsure as to which specialty I like most. I have shadowed Primary Care NP, Critical Care NP, Neuro PA, and Ortho PA and I enjoyed all of them.

Also, please don't turn this into an NP vs. PA battle. I just want your opinions about my situation.


Thanks for any advice you have. :D

Boston PreMed
 

emedpa

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do you have any prior health care experience?
quality pa programs require this...
if not np would actually be the faster route.
 

Dwindlin

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Hi Everyone,

I am currently a Senior in undergrad., graduating this Spring. I am in a position where I can either go to PA school or NP school. I understand that these are two different professions, that undergo very different training. However, they are both midlevels and have similar salaries. Grades/GRE scores are not an issue. I could get into whichever I choose.

Heres the thing:
1. I could go to PA school and be done in around 24 months for about 70k+plus in student loans. This route is shorter and I would have much more employment opportunities (switching specialties easier than an NP).

or

2. I could go to a Direct Entry NP program which would take 3 full years, for about 60k (in state). Becoming an RN in the first year, and then an NP in the last two. And, become a danger to my patients in the end. (however, may have to continue school if the DNP becomes the standard)

(I am paying for graduate school myself, which is why I am taking tuition costs into account so much.)

I know that many people are going to reply saying "well it depends on what you want to go into..." blah blah blah. "Nursing and PA are very different." yes I know this. I'm still unsure as to which specialty I like most. I have shadowed Primary Care NP, Critical Care NP, Neuro PA, and Ortho PA and I enjoyed all of them.

Also, please don't turn this into an NP vs. PA battle. I just want your opinions about my situation.


Thanks for any advice you have. :D

Boston PreMed
Fixed that for you...

Go the PA route, even if it means getting some experience first.
 

Narnian

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Why not do 4 years and a residency and go MD/DO?

Take out a MedCAP loan!

https://www.wellsfargo.com/student/loans/professional/medschoolloan

Or are you old school and you do not believe in credit...:laugh:

My grandpa said "If you cant buy it with cash then do not buy it!"

Just wondering! If your heart is set on midlevel though go for either. If you do not have 2 years of HCE then NP would be shorter. If you have been like a CNA or EMT for two years then go PA.
 
Jul 24, 2009
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Hi Everyone,

I am currently a Senior in undergrad., graduating this Spring. I am in a position where I can either go to PA school or NP school. I understand that these are two different professions, that undergo very different training. However, they are both midlevels and have similar salaries. Grades/GRE scores are not an issue. I could get into whichever I choose.

Heres the thing:
1. I could go to PA school and be done in around 24 months for about 70k+plus in student loans. This route is shorter and I would have much more employment opportunities (switching specialties easier than an NP).

or

2. I could go to a Direct Entry NP program which would take 3 full years, for about 60k (in state). Becoming an RN in the first year, and then an NP in the last two. And, become an Independent Practitioner in the end. (however, may have to continue school if the DNP becomes the standard)

(I am paying for graduate school myself, which is why I am taking tuition costs into account so much.)

I know that many people are going to reply saying "well it depends on what you want to go into..." blah blah blah. "Nursing and PA are very different." yes I know this. I'm still unsure as to which specialty I like most. I have shadowed Primary Care NP, Critical Care NP, Neuro PA, and Ortho PA and I enjoyed all of them.

Also, please don't turn this into an NP vs. PA battle. I just want your opinions about my situation.


Thanks for any advice you have. :D

Boston PreMed
You say you qualify for either
If you have the science background
Can go to school full-time for 2.5 years
Go PA

PA is shorter in time (assuming you have quality experience)
NP is much shorter in content (No matter how you look at it)
 

silas2642

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Why not do 4 years and a residency and go MD/DO?

Take out a MedCAP loan!

https://www.wellsfargo.com/student/loans/professional/medschoolloan

Or are you old school and you do not believe in credit...:laugh:

My grandpa said "If you cant buy it with cash then do not buy it!"

Just wondering! If your heart is set on midlevel though go for either. If you do not have 2 years of HCE then NP would be shorter. If you have been like a CNA or EMT for two years then go PA.
Because becoming an MD requires taking the MCAT and perhaps additional/different pre-requisites, 4 years of med school, and at least 3 years of residency.
 

Narnian

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Because becoming an MD requires taking the MCAT and perhaps additional/different pre-requisites, 4 years of med school, and at least 3 years of residency.
True... it is the much longer, arduous pathway. I guess not everyone thinks the juice is worth the squeeze. :laugh:
 

facetguy

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True... it is the much longer, arduous pathway. I guess not everyone thinks the juice is worth the squeeze. :laugh:
Let's say the OP were 40 years old. Med school or PA/NP in that scenario? Almost certainly PA/NP, no?
 

cecilia

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IF you get accepted to a PA school then got to PA school, if not then go NP.
And I think it is a mistake to think that NP are completely independent practitioners. Unless someone can correct me. NPs need an MD for collaboration.
 

Dr Oops

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IF you get accepted to a PA school then got to PA school, if not then go NP.
And I think it is a mistake to think that NP are completely independent practitioners. Unless someone can correct me. NPs need an MD for collaboration.

some states they don't

l agree though PA or bust

If independent practice is really that important to you, you should go MD/ DO
 
Oct 11, 2010
183
1
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Other Health Professions Student
Hi Everyone,

I am currently a Senior in undergrad., graduating this Spring. I am in a position where I can either go to PA school or NP school. I understand that these are two different professions, that undergo very different training. However, they are both midlevels and have similar salaries. Grades/GRE scores are not an issue. I could get into whichever I choose.

Heres the thing:
1. I could go to PA school and be done in around 24 months for about 70k+plus in student loans. This route is shorter and I would have much more employment opportunities (switching specialties easier than an NP).

or

2. I could go to a Direct Entry NP program which would take 3 full years, for about 60k (in state). Becoming an RN in the first year, and then an NP in the last two. And, become an Independent Practitioner in the end. (however, may have to continue school if the DNP becomes the standard)

(I am paying for graduate school myself, which is why I am taking tuition costs into account so much.)

I know that many people are going to reply saying "well it depends on what you want to go into..." blah blah blah. "Nursing and PA are very different." yes I know this. I'm still unsure as to which specialty I like most. I have shadowed Primary Care NP, Critical Care NP, Neuro PA, and Ortho PA and I enjoyed all of them.

Also, please don't turn this into an NP vs. PA battle. I just want your opinions about my situation.


Thanks for any advice you have. :D

Boston PreMed
Frankly, I say don't go to PA nor NP school. Let's face it there is a reason why so many of the PA jobs you see advertised are vacant. A lot of them are high stress positions requiring the PA to see lots of patients etc. Can you really see yourself working one of these jobs on a daily basis for the rest of your life?

If your answer is yes, I say get your RN license and go directly to nurse anesthetist school. Get it over with. Don't play games.

Why get 2 years of hospital experience to go to PA school for 24 months full time, when you could get your RN and go to nurse anesthetist school full time?

As a second choice, if you are able bodied (young) and have a strong science background I say go to pharmacy school.

Trust me, if you don't make the right choice now you will be kicking yourself later.
 
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Oct 11, 2010
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some states they don't

l agree though PA or bust

If independent practice is really that important to you, you should go MD/ DO
As an NP, if independent practice is what you are seeking it may be possible.


"States Permitting Fully
Independent Practice
AK, AZ, DC, IA, ID, MT, NH, NM, OR, WA
States with Light Regulation
AR, CO, CT, DE, HI, IL, KS, KY, LA, MD, ME, MI, MN,
MS, ND, NE, NJ, NV, OK, RI, TN, UT, VT, WI, WV, WY
States with Moderate Regulation
AL, CA, IN, MA, NC, NY, OH, PA, SD, VA
States with Heavy Regulation
FL, GA, MO, SC, TX
Sources: Rules and regulations for each state's board of nursing; Phillips
SJ.2007. A comprehensive look at the legislative issues aff ecting

advanced nursing practice. "The Nurse Practitioner," 32(1):14-7."
 
Jan 14, 2010
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If you have the grades, experience, and desire to be a midlevel, go to PA school. If you can't for whatever reason get into PA school, NP will always be an option.

Frankly, I say don't go to PA nor NP school. Let's face it there is a reason why so many of the PA jobs you see advertised are vacant. A lot of them are high stress positions requiring the PA to see lots of patients etc. Can you really see yourself working one of these jobs on a daily basis for the rest of your life?

If your answer is yes, I say get your RN license and go directly to nurse anesthetist school. Get it over with. Don't play games.

Why get 2 years of hospital experience to go to PA school for 24 months full time, when you could get your RN and go to nurse anesthetist school full time?

As a second choice, if you are able bodied (young) and have a strong science background I say go to pharmacy school.

Trust me, if you don't make the right choice now you will be kicking yourself later.
I see PA and NP both doing a lot of scut work. I would imagine that the work load would be about the same regardless. Though, the training would certainly be different.

As for going to CRNA school, they requires a BS (usually nursing) and atleast 1 year of ICU/CVICU experience. It is much more competitive/hard to get into than APN. The APN program in my state doesn't even make you interview. You just apply and they let you it. It's a bit of a joke. Where as CRNA programs everywhere require that you have a strong foundation in critical care and can demonstrate it via an in depth interview and sometimes written test.
 
Jul 24, 2009
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As an NP, if independent practice is what you are seeking it may be possible.


"States Permitting Fully
Independent Practice
AK, AZ, DC, IA, ID, MT, NH, NM, OR, WA
States with Light Regulation
AR, CO, CT, DE, HI, IL, KS, KY, LA, MD, ME, MI, MN,
MS, ND, NE, NJ, NV, OK, RI, TN, UT, VT, WI, WV, WY
States with Moderate Regulation
AL, CA, IN, MA, NC, NY, OH, PA, SD, VA
States with Heavy Regulation
FL, GA, MO, SC, TX
Sources: Rules and regulations for each state’s board of nursing; Phillips
SJ.2007. A comprehensive look at the legislative issues aff ecting

advanced nursing practice. “The Nurse Practitioner,” 32(1):14-7."
My understanding:

NP's have "independent practice" in the states above, but not really....independent practice means no prescription privilages, no hospital privilages and an even more limited scope of practice.


If you want independent practice...go to medical school

Otherwise, PA school.
 

cbrons

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My understanding:

NP's have "independent practice" in the states above, but not really....independent practice means no prescription privilages, no hospital privilages and an even more limited scope of practice.


If you want independent practice...go to medical school

Otherwise, PA school.
Your understanding is incorrect young grasshopper.

Mid-levels have a certain degree of prescriptive authority in every state. This goes for Advanced Nurse Practitioners, Doctor (that's a scream) of Nurse Practice, Midwives, CCRNAs and PAs.
 
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Frankly, I say don't go to PA nor NP school. Let's face it there is a reason why so many of the PA jobs you see advertised are vacant. A lot of them are high stress positions requiring the PA to see lots of patients etc. Can you really see yourself working one of these jobs on a daily basis for the rest of your life?

If your answer is yes, I say get your RN license and go directly to nurse anesthetist school. Get it over with. Don't play games.

Why get 2 years of hospital experience to go to PA school for 24 months full time, when you could get your RN and go to nurse anesthetist school full time?

As a second choice, if you are able bodied (young) and have a strong science background I say go to pharmacy school.

Trust me, if you don't make the right choice now you will be kicking yourself later.
The OP asked about NP vs PA school - not pharmacy or CRNA
Pharmacy has limitations with respect to patient care as compared to PA and NP.....and if you have an interest in practicing medicine - PA is the closest in training to a physician.

My understanding: there is approximately 4 PA jobs for every practicing PA....thats more likely the reason for all the vacancies you eluded too.

I think it's time to disappear again, PSYCHNP.
 
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Your understanding is incorrect young grasshopper.

Mid-levels have a certain degree of prescriptive authority in every state. This goes for Advanced Nurse Practitioners, Doctor (that's a scream) of Nurse Practice, Midwives, CCRNAs and PAs.
You don't seem to get what I was saying.....but perhaps I have heard wrong

In these states that allow "independent practice", the NP needs an agreement with a physician if they want Rx privalages ect...

Which is not independent practice.

***Edit: You called me on it - I am indeed a young grasshopper and will spend more time taking notes before making uninformed statements. My best, cbrons!
 
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emedpa

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You don't seem to get what I was saying.....but perhaps I have heard wrong

In these states that allow "independent practice", the NP needs an agreement with a physician if they want Rx privalages ect...

Which is not independent practice.
my understanding is that 12 states have true independent practice for np's; no collaboration AND independent rx rights....
 
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my understanding is that 12 states have true independent practice for np's; no collaboration AND independent rx rights....
F'ing scary
Does this mean a newly minted NP can practice without any supervision in these states?

How does this affect hospital privilages?

Guess I don't know what I'm talking about

SCARY
 
Oct 11, 2010
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my understanding is that 12 states have true independent practice for np's; no collaboration AND independent rx rights....
Thanks for the clarification EMED. I believe you are 100% right.

With the public's satisfaction with such ventures as Minute and Take Care Clinics I believe this will become more common for both NPs and PAs alike.
 

Dr Oops

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F'ing scary
Does this mean a newly minted NP can practice without any supervision in these states?

How does this affect hospital privilages?

Guess I don't know what I'm talking about

SCARY
it means don't get sick in those states
 

emedpa

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hospitals or groups can still add their own requirements. for example I work in a state where np's are "independent" but their charts are still reviewed at my facility because the medical director(md) says so...
"independence" has more to do with the outpt setting. it means an np in these states can hang a shingle that says:
jane doe, np
family practice

and work solo.....
 

Dwindlin

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it means don't get sick in those states
This. Frightening what they'll let nurses with a watered down masters do. . .
 
Oct 11, 2010
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hospitals or groups can still add their own requirements. for example I work in a state where np's are "independent" but their charts are still reviewed at my facility because the medical director(md) says so...
"independence" has more to do with the outpt setting. it means an np in these states can hang a shingle that says:
jane doe, np
family practice

and work solo.....
EMED that's a beautiful thing. Since so many of the jobs we do as healthcare providers are so stressful, often times bureaucracy and management only makes matters worse. I can see why so many of the PA jobs go unfilled.
 
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I agree with a statement one of the students posted earlier, that being a PA is like always being a resident.
 
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facetguy

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hospitals or groups can still add their own requirements. for example I work in a state where np's are "independent" but their charts are still reviewed at my facility because the medical director(md) says so...
"independence" has more to do with the outpt setting. it means an np in these states can hang a shingle that says:
jane doe, np
family practice

and work solo.....
With the MD-family practitioner shortage likely to get worse, can we assume that PAs will eventually be afforded this same ability?

And speaking of solo practice, do incomes go up in these scenarios, or is it just more about independence?
 

Denatured

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With the MD-family practitioner shortage likely to get worse, can we assume that PAs will eventually be afforded this same ability?

And speaking of solo practice, do incomes go up in these scenarios, or is it just more about independence?
That will never happen for PAs as long as they are under the BOM.

Very few NPs practice solo. They are given independent practice rights really to prevent state laws from hindering facilities using them as they desire. As stated before, facilities can have their own restrictions.

As for money, well that is all dependent on the insurance.
 

Dr Oops

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The duplicity & hypocrisy in nursing pretty ridiculous. Nurses claim they are practicing advanced nursing but then in the same breath say they do the exact same thing as physicians and should get paid the same, if that's true then they should be regulated by BOMs. but they would fight this tooth and nail because it would limit the amount of B.S. they could get away with
 

zenman

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That will never happen for PAs as long as they are under the BOM.

Very few NPs practice solo. They are given independent practice rights really to prevent state laws from hindering facilities using them as they desire. As stated before, facilities can have their own restrictions.

As for money, well that is all dependent on the insurance.
Insurance? What is insurance? I'll go in tomorrow, see 6 patients at $125 an hr in cash, and you want me to even consider insurance? :laugh::laugh::laugh::laugh::laugh:
 
Oct 11, 2010
183
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Hi Everyone,

I am currently a Senior in undergrad., graduating this Spring. I am in a position where I can either go to PA school or NP school. I understand that these are two different professions, that undergo very different training. However, they are both midlevels and have similar salaries. Grades/GRE scores are not an issue. I could get into whichever I choose.

Heres the thing:
1. I could go to PA school and be done in around 24 months for about 70k+plus in student loans. This route is shorter and I would have much more employment opportunities (switching specialties easier than an NP).

or

2. I could go to a Direct Entry NP program which would take 3 full years, for about 60k (in state). Becoming an RN in the first year, and then an NP in the last two. And, become an Independent Practitioner in the end. (however, may have to continue school if the DNP becomes the standard)

(I am paying for graduate school myself, which is why I am taking tuition costs into account so much.)

I know that many people are going to reply saying "well it depends on what you want to go into..." blah blah blah. "Nursing and PA are very different." yes I know this. I'm still unsure as to which specialty I like most. I have shadowed Primary Care NP, Critical Care NP, Neuro PA, and Ortho PA and I enjoyed all of them.

Also, please don't turn this into an NP vs. PA battle. I just want your opinions about my situation.


Thanks for any advice you have. :D

Boston PreMed
Back to the issue at hand. If you reside in one of the 12 states that allow NPs to practice independently becoming an NP is the way to go. It's a no-brainer.

And yes, Advance for Nurses wrote that practitioners with a private practice do have a greater earning potential.
 
Last edited:
Oct 11, 2010
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Hi Everyone,

I am currently a Senior in undergrad., graduating this Spring. I am in a position where I can either go to PA school or NP school. I understand that these are two different professions, that undergo very different training. However, they are both midlevels and have similar salaries. Grades/GRE scores are not an issue. I could get into whichever I choose.

Heres the thing:
1. I could go to PA school and be done in around 24 months for about 70k+plus in student loans. This route is shorter and I would have much more employment opportunities (switching specialties easier than an NP).

or

2. I could go to a Direct Entry NP program which would take 3 full years, for about 60k (in state). Becoming an RN in the first year, and then an NP in the last two. And, become an Independent Practitioner in the end. (however, may have to continue school if the DNP becomes the standard)

(I am paying for graduate school myself, which is why I am taking tuition costs into account so much.)

I know that many people are going to reply saying "well it depends on what you want to go into..." blah blah blah. "Nursing and PA are very different." yes I know this. I'm still unsure as to which specialty I like most. I have shadowed Primary Care NP, Critical Care NP, Neuro PA, and Ortho PA and I enjoyed all of them.

Also, please don't turn this into an NP vs. PA battle. I just want your opinions about my situation.


Thanks for any advice you have. :D

Boston PreMed
Boston PreMed it seems as though you are a pre-med major and may not want to go back and get your RN license.

Furthermore, you may not want to invest the many years to study pharmacy.

Did you look into podiatry school? I believe the admission requirements are less than MD/DO school.

Besides, podiatry would be a way better career choice than being a physician's assistant.

Maybe you should start a thread on the podiatry forum.
 
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Boston PreMed it seems as though you are a pre-med major and may not want to go back and get your RN license.

Furthermore, you may not want to invest the many years to study pharmacy.

Did you look into podiatry school? I believe the admission requirements are less than MD/DO school.

Besides, podiatry would be a way better career choice than being a physician's assistant.

Maybe you should start a thread on the podiatry forum.
PsychNP, you have no thought process. The OP only asked between PA & NP.

You are saying admission is easier for podiatrists then MDs? Well, he made no indication that his grades were low, and he further said "Grades/GRE scores are not an issue. I could get into whichever I choose. "

pharmacy? he asked should i do NP or PA, and you say pharmacy?!


Personally, I would be a pa over a pod anyday. Pharm definetely has its drawbacks (saturation, limited clinical scope, lack of 'provider status')

Also the title is Physician Assistant, not a physician's assistant

what happend to your hiatuses?!?
 

Bernoull

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OP, carefully consider the curriculum of both programs, NP & PA. Honestly, it's not even a fair comparison. If you want a firm scientific foundation for your subsequent practice, go PA. Generally, I find DNP, MSN NP programs to be severely deficient in basic sciences and even clinical sciences and heavy "filler" courses.

Gdluck
 

keregg228

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The NP program may give u a higher earning potential (depending on specialty. A PA in a surgical specialty will prob make the most)

I have traveled a bit as a RRT till I start my medical education. Most the hospitals I work at do not hire NP’s outside of hospice and as Case managers. PA’s only.

Correct me if I am wrong but CMS only reimburses for PA surgical first assistants? So if surgery is your interest go PA.

The NP’s in my town work all outpatient seeing tons of patients to make the Doc’s rich. I do know a couple that are almost independent that make a killing though. They live in work out in the middle of nowhere. Not all patients will accept seeing a NP (or a PA).

I personally will never let a NP touch me after I shadowed a doctor and watched the NP leave the patients room go to the computer and look up everything for every patient on Wikipedia. I know not every NP is like this. I know there are plenty of good ones. I just don’t want to find out which type I have.
 
Oct 11, 2010
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The NP program may give u a higher earning potential (depending on specialty. A PA in a surgical specialty will prob make the most)

I have traveled a bit as a RRT till I start my medical education. Most the hospitals I work at do not hire NP's outside of hospice and as Case managers. PA's only.

Correct me if I am wrong but CMS only reimburses for PA surgical first assistants? So if surgery is your interest go PA.

The NP's in my town work all outpatient seeing tons of patients to make the Doc's rich. I do know a couple that are almost independent that make a killing though. They live in work out in the middle of nowhere. Not all patients will accept seeing a NP (or a PA).

I personally will never let a NP touch me after I shadowed a doctor and watched the NP leave the patients room go to the computer and look up everything for every patient on Wikipedia. I know not every NP is like this. I know there are plenty of good ones. I just don't want to find out which type I have.
Very good point. I believe the PA profession was designed to be the assistant to the physician. That is why what a PA can or cannot do is contingent upon his or her's supervising physician. Therefore, they are often used in surgical specialties by the physician. No matter how long a PA works in surgery he or she would never be a surgoen.

Many of the Minute Clinics in our area are staffed by Family NPs. I also see NPs doing more "freelance/solo" type work in our area.

Another factor one must consider is the median age of NPs as opposed to PAs. I believe most NPs are typically older than PAs, thus are at a different stage in their lives (past prime earning years of life). Many NPs have already worked several years as professional registered nurses.

Not to mention that many NPs get their advanced certification/MSN and still work as nurse IIIs, as clinical educators, or in nursing administration. They do not bother to go through the learning curve/change in role.
 
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Median NP salary is lower than median PA salary.

Median PA salary is way lower than median CRNA salary. For two years of "full time" and "superior" training why not just be a CRNA and get it over with.
 

emedpa

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Median PA salary is way lower than median CRNA salary. For two years of "full time" and "superior" training why not just be a CRNA and get it over with.
or an AA and skip the whole nursing thing entirely.
AA's do the same job as crna's and in practices that use both they are used interchangeably.
anesthesiologists and surgeons prefer to work with AA's and there are new programs opening every yr and new states allowing AA practice( up to 18 or so now). JWK , a frequent poster here, is an AA and the chief anesthetist in his group which includes both AA's and crna's.
 
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Median PA salary is way lower than median CRNA salary.
This is true. Anyhow NP median isn't that much lower that PA median (what, something around 5 or 10K, ooooo). And like you said, it probably all depends on the specialty and level of experience.

For two years of "full time" and "superior" training why not just be a CRNA and get it over with.
CRNA takes additional training outside of and after RN training, is that correct?
 
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Oct 11, 2010
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or an AA and skip the whole nursing thing entirely.
AA's do the same job as crna's and in practices that use both they are used interchangeably.
anesthesiologists and surgeons prefer to work with AA's and there are new programs opening every yr and new states allowing AA practice( up to 18 or so now). JWK , a frequent poster here, is an AA and the chief anesthetist in his group which includes both AA's and crna's.
Emed I see your point. It is a good one. The reason you can't just skip the whole nursing thing is because the PA and AA are designed to be the assistant to the physician. Not a physician trained in half the time. Not a master's level physician ect.

PA training is not equivalent to that of the MD/DO period. I don't even know if the PA profession has all of the elements of a true profession. One of which is autonomy. Take the time and look up the elements of a true profession folks.

PAs were brought about to assist physicians and nothing more. That is why they can work in every subspecialty. If they desire to be MDs they need to go to MD school. Just like if a FMG cannot pass his or her boards they need to go to nursing school from the very beginning, if they desire to be advanced practice nurses (have the ability to practice independently in 12 states).

I agree with Kaushik on this. The PAs and AAs are not MDs and if they desire the priveleges they must attend med school. Case closed.
 
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Oct 11, 2010
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This is true. Anyhow NP median isn't that much lower that PA median (what, something around 5K, ooooo). And like you said, it probably all depends on the specialty and level of experience.



CRNA takes additional training outside of and after RN training, is that correct?
Starpower I respect your posts. You seem to be highly ambitious. I wish you much success in your career.
 

emedpa

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pa's are autonomous but not independent. that is the difference. I work the majority of my shifts solo. that's pretty good autonomy don't you think? sure, my charts are reviewed after the fact(just like those of the 1 np in our group) but it's more about quality assurance than anything else because the pts are long gone by then so the doc can't say switch this abx or get this consult because they are reviewing, not precepting.
 

Denatured

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Keregg, NPs can bill as first assist. Either way a PA is better if you want to do surgery as they are utilized more here.

Emed, I don't think you can say that AA (or CRNA) is preferred. There is no data to support this. Just being unbiased about it. You are correct that places that use both of them they are interchangeable, but in full disclosure they are not capable of being used in all practices. Many practices have the CRNAs cover OB independently which an AA (legally not, not a slight against their skills) cannot do. If someone wanted to practice in medically directed/ACT only and didn't want to be an RN then I agree AA is the way to go.

PsychNP, I wish you would stop speaking. A PA is not "assisting" a physician unless you call decreasing his case load assisting, which would mean the same thing for a NP.

Starpower, yes, a CRNA receives additional training. They are very much analogous to a PA with 2-3 years (depending on school, average is 28months) of education after undergrad and after practicing one year as a critical care RN. Some are integrated doing clinical and didatics together, but many are like PA school where they do full time of 24 months didatic (gross anatomy, physiology, pathophysiology, typically 3 principle of anesthesia classes [analogous to principles of clinical medicine classes], 3 pharm classes, physical assessment, stats/research, and skills classes) and then the rest is clinical with "seminar" classes to discusses literature and cases and with exams analogous to "shelf" exams, except they are based in different anesthesia subjects like thoracic/laproscopic/trauma/ob/etc instead of psych/internal med/em/etc
 
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Starpower, yes, a CRNA receives additional training. They are very much analogous to a PA with 2-3 years (depending on school, average is 28months) of education after undergrad and after practicing one year as a critical care RN. Some are integrated doing clinical and didatics together, but many are like PA school where they do full time of 24 months didatic (gross anatomy, physiology, pathophysiology, typically 3 principle of anesthesia classes [analogous to principles of clinical medicine classes], 3 pharm classes, physical assessment, stats/research, and skills classes) and then the rest is clinical with "seminar" classes to discusses literature and cases and with exams analogous to "shelf" exams, except they are based in different anesthesia subjects like thoracic/laproscopic/trauma/ob/etc instead of psych/internal med/em/etc
Thanks Denatured!
 

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Hawkeye
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Thanks Denatured!
You are welcome. I've studied PA programs and CRNA prrograms like it was going to be an exam, haha. I have great respect for both. Though I do have problems with both of their national associations, but that is another thread.
 
Oct 11, 2010
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Keregg, NPs can bill as first assist. Either way a PA is better if you want to do surgery as they are utilized more here.

Emed, I don't think you can say that AA (or CRNA) is preferred. There is no data to support this. Just being unbiased about it. You are correct that places that use both of them they are interchangeable, but in full disclosure they are not capable of being used in all practices. Many practices have the CRNAs cover OB independently which an AA (legally not, not a slight against their skills) cannot do. If someone wanted to practice in medically directed/ACT only and didn't want to be an RN then I agree AA is the way to go.

PsychNP, I wish you would stop speaking. A PA is not "assisting" a physician unless you call decreasing his case load assisting, which would mean the same thing for a NP.

Starpower, yes, a CRNA receives additional training. They are very much analogous to a PA with 2-3 years (depending on school, average is 28months) of education after undergrad and after practicing one year as a critical care RN. Some are integrated doing clinical and didatics together, but many are like PA school where they do full time of 24 months didatic (gross anatomy, physiology, pathophysiology, typically 3 principle of anesthesia classes [analogous to principles of clinical medicine classes], 3 pharm classes, physical assessment, stats/research, and skills classes) and then the rest is clinical with "seminar" classes to discusses literature and cases and with exams analogous to "shelf" exams, except they are based in different anesthesia subjects like thoracic/laproscopic/trauma/ob/etc instead of psych/internal med/em/etc
Thanks for the clarification Denatured, but let's not pacify these PA enthusiasts. The educational preparation of PA is not analogous to that of a CRNA. The PA typically has to have 1-2 years of previous healthcare experience (i.e. nurse's assistant etc.). On the other hand, the CRNA must get her RN, BSN (i.e. with practical med/surge, client assessment, Peds, OB, Psych, community health etc.) class content and also have worked in the ICU for several years as a professional. Why do you think the pre-med students are avoiding the nursing route?

That is why the NP must have his or her RN and work experience prior to being admitted to the program. It is part of the educational track of the advanced practice nurse.

The PA was designed from it's inception to be the assistant to the physician. It's the law as set by the BOM. If you disagree write your local boards.

Studies show that it takes 10-15 years to become an expert. Imagine a PA working independently jumping from subspeciatly to subspecialty. How unsafe is this for the clients we all serve?

That is why the nursing profession has CRNAs, midwives, acute care NPs ect.
 
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Dwindlin

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That is why the nursing profession has CRNAs, midwives, acute care NPs ect.
That are all woefully under trained, and in states that grant unsupervised practice much more dangerous than a PA who decides to switch specialties every so often. . .
 
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The reason you can't just skip the whole nursing thing is because the PA and AA are designed to be the assistant to the physician. Not a physician trained in half the time. Not a master's level physician ect.
I hate this nursing two-sidedness. You first say PAs are more rigorously trained then NPs. Then say but they're 'assistants', so NPs (who you earlier claimed are less trained), are better since they are 'practitioners'. Then you imply an NP is a physician trained in "half the time."

The truth is that obviously neither PA nor NP is ever a physician, unless they go to med school. But, looking at amount of training they each recieve, NPs should be 'assisting' even PAs as far as im concerned, sorry.
 

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PsychNP, if NPs actually had to have nursing experience to go to NP school, it might be different, but I doubt my opinion would change. Many NPs have no experience. Furthermore, many PAs were formerly medics in the military, paramedics, RRTs, and many even nurses.

I do feel that the education between PA and CRNA are very analogous. They both believe in prior HCE, with some schools putting more emphasis than others, and they both believe in full time hard science courses. They also both believe in substantial, full time clinical hours. The only difference is a CRNA focuses only on anesthesia and subjects in relation to it and PAs study all aspects of medicine.

BTW, PA was designed from it's inception based on accelerated physician training during WWII. They were never meant to be a "physician's assistant," (some ignorant people use the apostrophe) but a physician associate, which was there original name.

And as for the "unsafe" comment about PAs, get off your high horse. You think NPs don't switch specialties either? I've seen plenty of NPs go froth Ortho to cardiac, etc.