Psychiatric NP vs Psychiatric PA?

[InfoNerd101]

What is the difference between them? Can they both apply for the same jobs?

---

Members don't see this ad.

 

[pamac]

Infotroll101.

 

[InfoNerd101]

Infotroll101.

Mind your own business, you have no clue why I am hear or anyone for that matter asking the questions that I am. I'm curious! To be quite honest u seem to be the troll making a point to go out of your way to come on each of my forms to write "troll." If u have nothing worthwhile to contribute to a post other than your snide condescending remarks do me a favor and shut your mouth and don't respond. It's arrogant practitioners like your that think because you have a specific credential behind your name that you are all superior that make me not want to see u or ever send a family member to them.

 

[Mad Jack]

In most fields, I'd say go PA, but for psych, the specialty-focused training you get as a PMHNP makes a difference. In this particular case, NP.

 

[InfoNerd101]

In most fields, I'd say go PA, but for psych, the specialty-focused training you get as a PMHNP makes a difference. In this particular case, NP.

Thank you for the reply, but what is the difference between scope of practice and what each can do in psychiatry?

 

[Mad Jack]

Thank you for the reply, but what is the difference between scope of practice and what each can do in psychiatry?

In most states, PMHNPs can act independently, which is a bonus. They get more training in therapy, something PAs get basically none of- a PA gets 6 weeks of psych rotations and a cursory knowledge of psychiatric conditions and drugs throughout their entire education. PMHNPs have an entire education that is about nothing but psychiatric care, so they know the diseases better, the drugs better, and have training in therapy. The only advantage a PA might have is a better ability to rule out medical issues as a cause of psychiatric symptoms, but other than that, the PMHNP wins. There's a reason that there are very few PAs in psychiatry compared to NPs, and that NPs have much higher demand by those looking to hire someone onto their psych practice.

 

[Makati2008]

Keep it professional guys


Sent from my iPhone using SDN mobile app

 

[InfoNerd101]

In most states, PMHNPs can act independently, which is a bonus. They get more training in therapy, something PAs get basically none of- a PA gets 6 weeks of psych rotations and a cursory knowledge of psychiatric conditions and drugs throughout their entire education. PMHNPs have an entire education that is about nothing but psychiatric care, so they know the diseases better, the drugs better, and have training in therapy. The only advantage a PA might have is a better ability to rule out medical issues as a cause of psychiatric symptoms, but other than that, the PMHNP wins. There's a reason that there are very few PAs in psychiatry compared to NPs, and that NPs have much higher demand by those looking to hire someone onto their psych practice.

So why don't PA's have the ability to specialize in psych and learn therapy and stuff like their NP counterparts to stay competitive with them?

Or do they just figure that if they want to additionally learn to do extensive therapy or what not, that they can go get a second masters in MSW or counseling or whatever?

Again, not trolling, just very curious.

 

[Mad Jack]

So why don't PA's have the ability to specialize in psych and learn therapy and stuff like their NP counterparts to stay competitive with them?

Or do they just figure that if they want to additionally learn to do extensive therapy or what not, that they can go get a second masters in MSW or counseling or whatever?

Again, not trolling, just very curious.

Because PA education has a set of required stuff to do during your clinical years. There is not time to specialize, and there are rarely, if ever, any electives (not that an elective or two would even make a difference). PA training, post-graduation, is typically done in an on-the-job format. Certain fields are more conducive to this than others- medicine, surgery, and other fields where you can watch and learn and pick things up as you go with a lot of support and people around. Therapy and psychiatry generally aren't like that, particularly on the outpatient side of things. It is a one-on-one field, so teaching a PA the ropes would require a psychiatrist to completely drop what they were doing and devote a large amount of their time to teaching the PA how everything works by having them see patients together. Basically no one wants to do that, as it's a MASSIVE waste of time and money for the physician, so hiring an NP who has already gone through formal psychiatric training just makes sense.

 

[InfoNerd101]

Because PA education has a set of required stuff to do during your clinical years. There is not time to specialize, and there are rarely, if ever, any electives (not that an elective or two would even make a difference). PA training, post-graduation, is typically done in an on-the-job format. Certain fields are more conducive to this than others- medicine, surgery, and other fields where you can watch and learn and pick things up as you go with a lot of support and people around. Therapy and psychiatry generally aren't like that, particularly on the outpatient side of things. It is a one-on-one field, so teaching a PA the ropes would require a psychiatrist to completely drop what they were doing and devote a large amount of their time to teaching the PA how everything works by having them see patients together. Basically no one wants to do that, as it's a MASSIVE waste of time and money for the physician, so hiring an NP who has already gone through formal psychiatric training just makes sense.

Right and that makes total sense, so why don't they have a specific or seperate psychiatric tract in PA school or as like a post grad certificate just like with NP's?

 

[Makati2008]

Right and that makes total sense, so why don't they have a specific or seperate psychiatric tract in PA school or as like a post grad certificate just like with NP's?

If I remember correctly there maybe a few postgrad psych fellowships for PA


Sent from my iPhone using SDN mobile app

 

[Mad Jack]

Right and that makes total sense, so why don't they have a specific or seperate psychiatric tract in PA school or as like a post grad certificate just like with NP's?

Because the PA profession is committed to being a generalist profession whose members are free to pursue whatever postgraduate training they like after graduation. The idea of specialist pathways has come up in the past, and, aside from the Anesthesiologist Assistant pathway that was founded simultaneously with the PA profession, all ideas in regard to specialist training programs have been denied to be the direction that the profession wants to go in by the APA. They view themselves as having training to compliment that of a physician, something that they would lose if they were to give up their generalist background and foundation in a broad swath of medicine.

 

[AnnoyedByFreud]

If I remember correctly there maybe a few postgrad psych fellowships for PA


Sent from my iPhone using SDN mobile app

They do exist, but are confined to learning how to manage meds in an acute setting, from what I can tell. I was curious, but when I looked at psych PA fellowships, I was utterly disappointed by the lack of therapy training. It seemed more like it was a money grab from inpatient facilities to get free, cheap labor rather than actually teaching in-depth psychiatry.

 

[InfoNerd101]

They do exist, but are confined to learning how to manage meds in an acute setting, from what I can tell. I was curious, but when I looked at psych PA fellowships, I was utterly disappointed by the lack of therapy training. It seemed more like it was a money grab from inpatient facilities to get free, cheap labor rather than actually teaching in-depth psychiatry.

Are you a PA yourself? And it seems the profession of psychiatry as a whole has moved away from psychotherapy.

I might be wrong and my word certainly doesn't mean everything but I think that there should be more of a balance... medical psychiatric providers should be able to pursue more training do more therapy and likewise medical psychologists who choose to should be allowed to go get additional training to prescribe a limited set of psychiatric drugs.

 

[d2305]

NP have psych covered with an occasional PA in the field.

 

[hamstergang]

In most states, PMHNPs can act independently, which is a bonus. They get more training in therapy

I have been led to believe that PMHNPs get minimal psychotherapy training, and very little if any supervised therapy cases during their training. I know that as a psychiatry resident, the therapy training I had was just enough for me to know that a lot more is needed to do it well a real level of competence, so I worry a ton about PMHNPs thinking they should even consider doing psychotherapy. Have I been misled?

 

[AnnoyedByFreud]

I have been led to believe that PMHNPs get minimal psychotherapy training, and very little if any supervised therapy cases during their training. I know that as a psychiatry resident, the therapy training I had was just enough for me to know that a lot more is needed to do it well a real level of competence, so I worry a ton about PMHNPs thinking they should even consider doing psychotherapy. Have I been misled?

It depends on the program. My program had four separate therapy courses (adult, child, group, family) + supervised clinical hours, though undoubtedly the training is not as long or in depth as the training psychiatrists or psychologists get. However, it is a lot, lot more than what the average PA gets.

 

[Mad Jack]

I have been led to believe that PMHNPs get minimal psychotherapy training, and very little if any supervised therapy cases during their training. I know that as a psychiatry resident, the therapy training I had was just enough for me to know that a lot more is needed to do it well a real level of competence, so I worry a ton about PMHNPs thinking they should even consider doing psychotherapy. Have I been misled?

That is correct. But PAs get exactly zero, so PMHNPs still take the lead.

 

[pamac]

Mind your own business, you have no clue why I am hear or anyone for that matter asking the questions that I am. I'm curious! To be quite honest u seem to be the troll making a point to go out of your way to come on each of my forms to write "troll." If u have nothing worthwhile to contribute to a post other than your snide condescending remarks do me a favor and shut your mouth and don't respond. It's arrogant practitioners like your that think because you have a specific credential behind your name that you are all superior that make me not want to see u or ever send a family member to them.

There's a theme that comes up with your past posts, but oh well.... I'll play along.

One of the things you are interested in is psychologists/therapists getting into the role of prescriber. The problems with that are legion, but some of the same arguments are used by folks who don't like to see PAs and NPs have more independence in their roles...namely that patients would be underserved by seeing anyone with less training than a physician. I guesse it comes down to where you place the threshold for the necessary experience to be an adequate provider. Personally, what stands out to me very quickly is how a psychologist would be ill suited for understanding medical comorbidities that their psyche patients would be dealing with. It may seem reasonable to allow prescribing powers for a limited range of meds (and some places are trying this), you have to wonder how wise it would be to limit these people to a provider that can only focus on that slate of meds. What if they could benefit from meds not on the approved slate, and could you trust a psychologist to know when to refer out? They would tend to see those meds as the solution to most problems. It's disconcerting to think that med management could be farmed out to folks that really only have a grasp of medications as a side note to what their real focus is, and that is behavioral techniques. I'm not sure that extra training would alleviate my concern. I feel that way about pharmacists getting into administering treatment regimens and assessing, and wonder if it's wise to take them out of the realm where they are undoubtably experts, and putting them in a foreign role.

 

[future psych NP]

I know all programs are different but in mine we follow both individual patients and families in psychotherapy for 2 semesters each and also get two semesters of didactic and clinical training in psychopharm. We also do group work for a semester. It's seven semesters total of psych with some general pharm and physical assessment thrown in.

 

[Cranjis McBasketball]

9 semesters here pretty much exclusively focused on evaluation and medication management with a smattering of nurse fluff and the single episode of individual/group therapy

Am I able to PM you with some questions?


Sent from my iPhone using SDN mobile