Physician Assistant and Nurse Practitioner career comparison

Physician Assistant vs Nurse Practitioner [Which Differences Matter?]

In the end, physician assistants and nurse practitioners do a very similar job. Nearly identical.

But there are a few key differences to know about, if you’re thinking about pursuing one of these careers.

In this post I’ll explain the differences that are worth knowing about between PA’s and NP’s (and the similarities).

Let’s dive in.

How You Become a PA or NP (Education)

One of the biggest differences between physician assistants and nurse practitioners is how you become one. 

To become a nurse practitioner, first you have to work as a nurse

Typically, a nurse practitioner has worked as a nurse for a year or two, and then does an additional master’s or doctorate program to become a nurse practitioner. Nurses often do these programs online, while they continue to work.

To become a physician assistant, you generally need to have some type of healthcare experience, as well as a bachelor’s degree (with various prerequisite classes). Then you go to PA school to get a master’s degree in physician assistant studies.

physician assistant students in school

So while the education track is a bit different, overall it may take about the same amount of time to become an NP or PA. 

Here’s one key takeaway:

If you’re already a nurse, then it probably makes sense to become a nurse practitioner. But if you’re not a nurse, it probably makes more sense to become a PA.

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Job Opportunities for PA’s and NP’s

Overall, the job opportunities for physician assistants and nurse practitioners are quite similar. 

That’s because we basically do the same job as each other. So there is very little difference.

However, there are a couple of caveats:

Depending on your education track as an NP, you may occasionally be limited to only working with certain age groups (like adults or kids). 

For example, I’ve worked with some nurse practitioners in the emergency room who could not treat pediatric patients because of their specific degree and certification.

That would be something to pay attention to if you’re thinking about becoming a nurse practitioner. Look at the different options of what type of NP you will become, keeping in mind what type of job you want to get down the road.

On the other end of the spectrum, occasionally there are situations where someone will hire an NP but not a PA. This could be because they want to take advantage of the NP’s legal ability to work “autonomously”, without a supervising physician. 

Speaking of which…

Job Autonomy

In essence, PA’s and NP’s do exactly the same job. So there’s no rational reason why one should have more autonomy for opportunities than the other.

But in practice, nurse practitioners have more lobbying power than physician assistants. Or at least that’s what it seems like.

As a result, some state laws give nurse practitioners the ability to practice without a supervising physician. In contrast, physician assistants are always required to have a supervising physician (as far as I know).

That doesn’t mean they always have to have a doctor with them on the job. But it means they need to have someone contracted with them to be able to review some of their charts, discuss cases as needed, etc.

So in some cases, someone may set up a business where they don’t want to have to worry about supervising physicians. As a result, that business would be looking for nurse practitioners rather than PA’s.

But most of the time, in most places, this doesn’t really matter. And it has little or no impact on how you do your job as a PA or an NP.

Job Responsibilities for PA’s and NP’s

As I’ve alluded to above, PA’s and NP’s pretty much do exactly the same job.

Overall, there’s very little difference between being a PA versus being an NP.

For example, I work in the emergency room as a physician assistant, and a lot of my coworkers are both PA’s and NP’s.

We literally do exactly the same job; there is absolutely no difference.

physician assistant treating a patient in the hospital

You only run into differences occasionally in job settings where an NP is unable to take care of pediatric patients (as mentioned above), or a PA doesn’t get hired because the business doesn’t want to worry about supervising physicians (as also mentioned above), or other bureaucratic nuances like that.

Overall, any little quibbling about differences between the careers is kind of silly. It’s pretty much the exact same job. There are just some logistical issues that you run in from time to time.

PA Pay vs NP Pay

Where I work, PA’s & NP’s get paid exactly the same amount. Because we do the same job, and have the same responsibilities.

And as far as I understand, this generally holds true around the country. Most clinics or hospitals would pay an NP the same amount as a PA.

I’m sure there are some exceptions, but those would be rare, and it doesn’t really make sense for there to be any difference in the job compensation for these two careers.

Summary: Physician Assistants vs Nurse Practitioners

In the end, PA’s and NP’s do pretty much the exact same job, with similar job responsibilities, autonomy, and income.

The biggest difference between PA’s and NP’s is how you get there. There are some differences in the type of education that you undertake for each of these careers (see my explanations above).

Ultimately it takes about the same number of years to become a PA versus an NP. And other than a few of the small caveats that I mentioned above, we pretty much do exactly the same job.

So as long as you figure out how to become one or the other, in most cases you can ignore the differences between a physician assistant and a nurse practitioner.