PA vs. NP

sandboxmedic

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Hello all, hope this email finds everyone safe and doing well,on the streets, in the box, or my crew overseas.

Physician Assistant Vs. Nurse Practitioner?
I think I'm done with the sandbox work, and I'm looking for a program. I've done some research on both, and I've come to the conclusion that PA is still a glorified Paramedic with (mother-may-I) responsibilities to the attending physician(s). Nurse Practitioner however, apparently, you can open your own practice or be contracted by an office. I'd like to go to MED school really, but at 33 YOA don't see it happening.
Can't tell you the countless times ive enjoyed punking down MD residents on poor assessments and I know I could do as good if not a better job. HELL, any medic on here would SMOKE most ER residents at a difficult airway, ACLS,PALS,......hahah.
Anyone else looking at this? any comments or info appreciated, Much Thanks!!
 

JPINFV

Gadfly
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Can't tell you the countless times ive enjoyed punking down MD residents on poor assessments and I know I could do as good if not a better job. HELL, any medic on here would SMOKE most ER residents at a difficult airway, ACLS,PALS,......hahah.

Most attendings can destroy most medic students as well, since we want to compare apples to oranges. Does your life really revolve around putting down people who are learning a specialty?
 

rmellish

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Being in the PA program, one could say I'm a bit partial.

That said, my experience dealing with PAs is that they come out of school better able to function as providers. Their training includes EKG, lab and radiology interpretation, something most NPs at my local ER needed to learn once they began working.

PA-Cs are now able to prescribe medications in every state.

PA-Cs function under the auspices of a physician's license, which I believe is also true for NPs.

Does the military have a NP program? I know they have a PA school or two. As far as I can tell a military PA transfers directly to a civilian PA-C.

PA tends to be a shorter course of study since it rarely requires previous medical certification (RN), however prior medical experience is very helpful when applying.
 

LucidResq

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I'm pursuing the Nurse Practitioner route. What you've said is sorta-kinda-true, and it depends on where you would be practicing. Some states give PAs more freedom, and others give NPs more.

Really though, the core difference between the two routes are their philosophies. Medicine and nursing are not really the same thing. Medicine focuses on diagnosis, the biological concept of disease and the treatment of it, primarily with medications and surgery. Nursing tends to take a more holistic approach that focuses on improving the quality of life of people as a whole, including their activities of daily living, families, social life, and so forth. While these two definitions are obviously not cut and dry and there's some blending of nursing and medicine nowadays, there is a definite difference.

Keep in mind that, in general, NPs do not assist with surgery while PAs can.
 

firecoins

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I am considering PA heavily although I may get my RN and pursue CRNA.
 

BruceD

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...Can't tell you the countless times ive enjoyed punking down MD residents on poor assessments and I know I could do as good if not a better job. HELL, any medic on here would SMOKE most ER residents at a difficult airway, ACLS,PALS,......hahah.

Hmmmm, You're obviously smart enough. Why not just hang out a shingle and start practicing as a MD?

No need to bother with that 4 yrs college, 4 yrs med school, 3 yrs residency, and countless exams crap, jump right in get your hands dirty and show all those stupid residents how it's done.
 

Ridryder911

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As one that has been enrolled in both, I may be able to help distinguish between the two. Both are considered physician extenders. P.A. programs are based upon the medical model (condensed medical school) and NP are based upon the nursing model.

P.A. are taught general medicine within about 2 or 3 yrs. most are now graduate level, there are still some associate degree and diploma P.A. programs. They have to retake the boards every 6 yrs. and as well be either within physical contact or verbal (telephone) and have medical directive in a timely manner. One can have a basket weaving degree and still be able to enter a P.A. program, not all programs require prior medical experience. Most prefer B.S., but not all require such.

NP are at the least a minimum of graduate level, and require a BSN with years experience as a RN. Usually, one has to be in the upper percentage and GRE examination. One must also specialize in a specific area. For example neonate can only work on neonate, acute care- ICU/CCU/ER , Psych-psych, etc. each state Board of Nursing determines upon the specifics. Yes, some states do NOT require physician attachment or guidance. Most choose for malpractice and safety. Therefore they can bill for their own services. As well by the year 2012 will require either a PhD or Doctoral in Nursing Science. They too have a prescription rights, dependent upon their speciality. They are becoming more and more attractive to physician groups due to less or no liability to the physicians since they work upon their own license, and carry their own malpractice.

I performed a detailed thesis in comparison. Bottom line their is very little to no differences in care provided. NP's appeared to have a higher client/patient satisfaction and less labs/medicine ordered. A more holistic and personal interaction appeared to be the difference. Both are commonly used in more rural areas, but both are increasing in numbers in metro areas now.

Both are offered per military, after discussing with several in Iraq, NP's have now become very popular.
R/r 911
 
OP
OP
sandboxmedic

sandboxmedic

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Pa vs.NP

Most attendings can destroy most medic students as well, since we want to compare apples to oranges. Does your life really revolve around putting down people who are learning a specialty?

Ok, obviously my humor didnt completely transfer over.
 
OP
OP
sandboxmedic

sandboxmedic

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To all those who helped clear up a few questions i had Thanks Much !!! (Ridryder,lucid,mellish). Since a few of you are alrady involved in programs i may hit ya up for some other info.
As far as "playing" with the residents, its usually several that I know pretty well and its all in fun. So NO, I dont intentionally seek out opportunities to do that, It was a joke.
 

BruceD

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Ok, obviously my humor didnt completely transfer over.

Yep, missed the humor.

Choose the path based on how you like to deal with patients most. Both careers will be in increasingly higher demand.
 

mikeylikesit

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if you are a medic who is just keeting out of the sand then i say gop with NP. it seems to be the choice for most military medics because they like the pace more.
 

VentMedic

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NP are at the least a minimum of graduate level, and require a BSN with years experience as a RN. Usually, one has to be in the upper percentage and GRE examination. One must also specialize in a specific area. For example neonate can only work on neonate, acute care- ICU/CCU/ER , Psych-psych, etc. each state Board of Nursing determines upon the specifics. Yes, some states do NOT require physician attachment or guidance. Most choose for malpractice and safety. Therefore they can bill for their own services. As well by the year 2012 will require either a PhD or Doctoral in Nursing Science. They too have a prescription rights, dependent upon their speciality. They are becoming more and more attractive to physician groups due to less or no liability to the physicians since they work upon their own license, and carry their own malpractice.


Interesting article:
Making Room For "Dr. Nurse"

http://encarta.msn.com/encnet/Departments/eLearning/?article=MakeRoomDrNurse&GT1=27001
 

JPINFV

Gadfly
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^
I think that article paved the way for one of the truely epic DNP v PA v Physician threads on SDN.

Edit: Linky

If you think the ALS v BLS or volly v paid threads can turn into flame wars, there's nothing like a good ol'fashion MD v DO or PA v NP thread on Student Doctor Network.
 
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Ridryder911

EMS Guru
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^
I think that article paved the way for one of the truely epic DNP v PA v Physician threads on SDN.

Edit: Linky

If you think the ALS v BLS or volly v paid threads can turn into flame wars, there's nothing like a good ol'fashion MD v DO or PA v NP thread on Student Doctor Network.

Hence the reason I never participate on that forum. Usually filled with early 20 year olds that have never touched a real patient. If they have, they whine about their residency and lack of pay.. although in a couple of years it will be in the hundred of thousands of dollars. I know of at least three active members, that are still pre-med after five years.

In regards to the article I found it to be misleading. It described that it is a 2 year program. Technically, it is more like a three year program after BSN, MSN, then you can apply for a Doctoral. So really it is an 8-10 year program. Unlike some MD's and DO programs that do not even require a B.S. Yes, there are some left as long as you have a great MCAT and interview skills, and then met the requirements (some require an agreement that you will have completed a B.S. or be in good standing). I have several MD and DO friends that as of yet do NOT have a B.S. or B.A.. In fact three went from Paramedic AAS to medical school.

Ironically, many articles have done comparison between several "physician extenders". PA's are very similarly educated but unfortunately along with this medical model, they are limited in holistic medicine. This is where the NP appears to excel. To treat the patient as a whole in lieu of s/s. It does no good to treat for hypokalemia if the patient has poor dietary habits...treat the cause, not just the effect.

R/r 911
 
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JPINFV

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I love how I completely forgot to put a link in.

Edit: Linky

http://forums.studentdoctor.net/showthread.php?t=289278

Hence the reason I never participate on that forum. Usually filled with early 20 year olds that have never touched a real patient. If they have, they whine about their residency and lack of pay.. although in a couple of years it will be in the hundred of thousands of dollars. I know of at least three active members, that are still pre-med after five years.

There's generally 3 forums I visit because of that. Post-bacc (because I'm in one right now and normally to answer questions about the program I'm in), pre-hospital (generally very slow), and the EM-residency thread (generally well moderated). Clinicians, pre-allo, and pre-osteo, on the other hand, is generally a wasteland of stupidity and trolls.

Unlike some MD's and DO programs that do not even require a B.S. Yes, there are some left as long as you have a great MCAT and interview skills, and then met the requirements (some require an agreement that you will have completed a B.S. or be in good standing).
[I'm sure you know most of the following, but for the rest of the forum's sake]
I'm willing to bet that they're the exception, though, and not the rule (not counting the BS/MD combined programs, but those spots are rare as well). The pre-reqs for medical school are completely different (physiology, for example, is not a pre-req) than for other health care providers since the base education (nutrition, physiology, anatomy, etc) is done in house instead of as a prereq. Similarly, the post medical school situation is vastly different as well. It's not good enough to simply pass the USMLE a la EMS or nursing (unless I'm missing something with nursing) because the USMLE scores are also used by residency when developing their match list.* Furthermore, a lot of the more practical education and training happens during the residency where a 60-80 hour week (not including study time) is the norm. I feel that a lot of the prereqs for medical school (e.g. O-Chem, which I honestly enjoyed) are in place because medical schools can require them, not because they are necessarily useful. It's a lot easier to be picky when there's twice the number of applicants than there are seats.


*Medical students are sorted into specialties and residencies through the Match. Essentially following interviews for residencies, each medical student makes a rank order list of residences s/he would like to go to and each residency program makes a list of applicants that they would like to accept. A computer program sorts through and 'matches' students to residencies based on the preferences of the students and residences. Anyone who doesn't match then "scrambles" to fill in any unmatched residency spots.
 
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