Get to Know NPs and PAs

Even though there are an estimated 1.1 million doctors in America, that’s not nearly enough to serve the needs of its population. The American Medical Association warns that there’s a severe MD shortage, and it’s only expected to get worse.

Given this reality, you may have noticed a shift in your health care in recent years. Instead of seeing a doctor in a particular practice, you’ve likely been treated by a different sort of PCP: a nurse practitioner or physician associate. Get to know these essential medical personnel better so you can feel more prepared for your next appointment.

Commonalities

Considering their respective titles, it’s no surprise that these professionals are similar in many ways. Here’s a summary of how their respective training and responsibilities overlap. Both:

• Must have, at minimum, a master’s degree as well as field-specific certifications, which they must maintain
• Work in a variety of settings, such as doctor’s offices and hospitals
• Can examine, diagnose, and treat patients, interpret test results, and, in many cases, prescribe medicine

Beyond these general descriptions, however, the jobs of nurse practitioner and physician associate vary greatly in several ways. A deeper dive into each reveals their distinct duties along with the roles they play in their patients’ well-being.

Nurse practitioners (NPs)

History and prevalence
The first nurse practitioner program was established in 1965, but the profession didn’t go national until the following decade—per the American Association of Nurse Practitioners (AANP), there were around 15,000 NPs in the United States by the end of the 1970s. As the twentieth century ended, that number ballooned to over 68,000, and today there are over 385,000 NPs across America, who conduct over one billion visits per year.

Training and duties
As the name indicates, a nurse practitioner has a nursing-based, patient-focused foundation. There’s a general four-step process to becoming an NP, the first of which is to earn a bachelor of science in nursing. After completing their initial postsecondary education, individuals must pass their state’s RN exam to become a registered nurse and then get at least a master’s degree in nursing from an accredited program. Finally, they must pass a nationally board-certified exam to get their nurse practitioner license.

Once they’ve met all their professional requirements, NPs can, in the majority of states, treat patients independently without any supervision. Typically, they work in specific disciplines, such as elderly care or neonatal care, that require specialized certifications. This means they would need to be retrained if they were to switch their focus population.

Fun facts

• Write it up 
  Over 96 percent of NPs can prescribe medicine; in fact, they average around twenty-one prescriptions per day, per the AANP.
• Room to grow
  The number of NPs in America skyrocketed over 300 percent from 2007 to 2023.
• A clean sweep
  U.S. News & World Report named nurse practitioner its number one health-care job (followed by physician associate), best STEM job, and best overall job of 2024.

Physician associates (PAs)

History and prevalence
The physician associate occupation originated shortly after its NP counterpart upon the graduation of the first class of PAs in 1967. These trailblazers were navy Vietnam vets who wanted to translate their corpsman experience to practical use in the civilian world. The AMA officially recognized the profession in 1971, and there are currently over 168,000 PAs helping patients in all fifty states, conducting over 500 million patient visits each year.

Training and duties
To become a physician associate, students must earn an undergraduate degree and complete basic and behavioral science classes as a prerequisite. They must also gain about 3,000 hours of direct patient contact experience, such as through working as paramedics, athletic trainers, or medical assistants, prior to attending a PA program. These graduate-level programs are approximately twenty-seven months and include classroom instruction and more than 2,000 hours of clinical rotations. Upon completion of this education, they need to pass the national PA exam to get their state license.

All this effort allows PAs to seamlessly work in different disciplines; they can even perform some procedures and take part in surgeries. Unlike NPs, though, they normally report to a superior, such as a doctor or surgeon.

Fun facts

• Ka-ching!
  According to the American Academy of Physician Associates (AAPA), 75 percent of PAs receive multiple job offers as soon as they graduate.
• What’s in a name? 
  In 2021, the AAPA initiated a slight alteration to the profession’s name, from physician assistant to physician associate, to reflect the importance and collaborative aspect of the job.
• Valued and vital
  Nine out of ten people surveyed in a 2023 Harris Poll considered PAs trustworthy medical professionals as well as a critical component to filling the ever-widening health-care provider gap.

Often the first, and sometimes only, line of defense against medical issues, both nurse practitioners and physician associates play essential roles in patients’ well-being. By better understanding who they are and the services they provide, you can breathe easier during your medical visits knowing you are in good hands with these rigorously trained and skilled individuals.