Why Nurse Practitioners Have More Momentum than Physician Assistants

Last month we took a look at the number of NPs, PAs and MDs graduating from schools each year. Data showing a decided increase in the number of NP grads over the past five years is interesting, especially compared to that of other healthcare provider professions. Not only are nurse practitioners graduating from programs in growing numbers, scope of practice legislation across the US has also become increasingly favorable for NPs. On the other hand, physician assistants don't seem to be making the same strides as NPs. Why?

In practice, NPs and PAs have very similar jobs. In fact, in most cases they may even be hired for the same jobs. Despite their similarities in the clinical setting, as a profession NPs are taking the cake compared to PAs. This post isn't meant to pin the professions against one another, but rather to point out a few interesting differences among how the two fields have approached professional growth and its impact. Here are a few reasons for notable momentum in the nurse practitioner profession.

Adoption of Online Education 

Nursing schools are on the fast track when it comes to maximizing the online learning model. NP programs in increasing numbers are making their programs available remotely allowing students to complete them at a convenient time and place. Ease of learning not only encourages a higher number of students to enroll in such programs, but also removes physical limitations schools face in regards to their numbers. Online programs are not bound by bricks and mortar buildings. They don't need a physical chair for each member of the student body. Rather, online programs may educate an almost unlimited number of students. 

Physician assistant programs, in contrast, have yet to break the traditional education mold. As such, they have remained almost exclusively on campus programs. Growing campus-based programs requires more resources than it does online and does not allow PA schools to respond as quickly to the increasing need for healthcare providers. 

Lobbying Power

Nurses are a powerful lobbying force and put significant energy and finances behind promoting their agendas. Nursing organizations fight hard to eliminate restrictions placed on nurse practitioners' scope of practice. As nurse practitioners are allowed to work under fewer restrictions, they become more attractive to employers. Clinics and hospitals don't need to jump through as many hoops to use NPs as providers - it's simpler for employers to use nurse practitioners rather than physician assistants. Ultimately, more favorable scope of practice regulations open up more jobs for NPs compared to PAs giving the nurse practitioner profession an optimistic outlook. 

Professional Regulation

Healthcare providers are regulated by a particular state board. Nurse practitioners are regulated by state boards of nursing. Physician assistants are regulated by state boards of medicine. While this may not seem like an important factor, it has significant implications. On the regulatory hierarchy, PAs fall beneath physicians as far as boards of medicine are concerned. Nurse practitioners, however, may have achieved the highest level of education in their field. NPs are leaders in the nursing profession. So, they have more influence on the manner in which they're regulated and are viewed in a different light by regulatory boards. There's no one above NPs on the professional ladder limiting their potential for professional growth and expansion. 

Do you think the nurse practitioner profession has more momentum than the physician assistant profession?

 

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Comments

This is a very biased article. There happens to be more nurse practitioners in different areas. They can’t simply be compared side by side and statistically it is much easier to get into nurse practitioner school than any other medical professional school.

Robert Stypa

In the geographical location where I work, no NPs are unionized! Also, while some NPs do work in a hospital based setting, most NPs work in primary care, therefore at the end of the day, there is NOT another NP to "step into his/her shoes" at the end of the shift. One completes their day when patients are seen, documentation is completed, and labs/diagnostic testing is reviewed. Advanced Practice Nurses (APNs), such as Clinical Nurse Specialists, CRNAs, or Certified Nurse Midwives may work in the OR/floor as stated above, however, these APNs are NOT Nurse Practitioners! There is a difference, so please educate yourself before lumping all APNs in one category. As for the comment on PAs being better educated and better prepared...it sounds ignorant and is unprofessional. Before starting my NP program, I had 16 years of experience as an RN in ER, ICU, cath lab, and chronic disease management, so saying a new PA is better prepared than I was as a new NP is preposterous.

BSB

Don't forget the fact that nurses belong to UNIONS that protect them from the kinds of abuses PAs are subjected to in terms of scheduling, hours, and pay. An NP knows that another nurse will step into his or her shoes at the end of 8 hours (or 10 or 12, based on shift), whether on the floor or in the OR, and have a protected sign-out at the end of each shift that not even attendings are allowed to interrupt. Nurses take care of their own. So not only are PAs limited in the ways described in the article - although there is no doubt we are better educated and better prepared to practice medicine - we are vulnerable to being taken advantage of in the way NPs are not, and now, on top of it, we are being outpaced.

PAs need to be UNIONIZED to have pay protection and to be protected from the kind of hiring and shift abuses we are subjected to. We remain at risk of being FIRED if we do not comply. And don't think that just because we work "like doctors" we will be rewarded "like doctors". We will not. Unless you consider burnout a reward....

Kittredge White