What’s a Better Career Path for the EMT… Physician Assistant or Nurse Practitioner?

You’ve done the EMT gig, you’ve done medic or nursing but you want a little more. More pay, more scope, more experience in definitive treatments. But what do you do?

With your experience and loads of patient hours, you could go to medical school. However, spending $500,000 of money that you don’t have doesn’t, to go to school for literally more than a decade, just to be overworked doesn’t sound all that appealing to you.

If you are coming from a nursing background, you may be inclined to continue on that track and get your nurse practitioner license (NP). Coming from a pre-med background you may lean more towards the PA route. But, how do they compare? Before taking a jump into one or the other, here are a few differences between the two.

Education:

NP: You must complete at least a master’s level nursing program, apply for the NP certification, and pass the exam. However, organizations are pushing for the doctorate of Nurse Practioner (DNP) to be the new minimum standard to improve the caliber of medical providers (1). Depending on whether you already have your RN, you may be able to take an online MSN and DNP program.

PA: These students must complete an intense master’s level program. But do not let the “masters” as oppose to “doctorate” fool you. Instead of the 500 didactic and 500 clinical hours an average MSN gives you, a PA program averages 1,000 didactic hours and 2,000 clinical hours (2). There is no way for you to take this kind of program online, due to the intense hands on training involved.

Philosophy of your education:

NPs go to nursing school. They have a patient-centered model of learning, and focus on health education, promotion, and prevention.

PAs go to medical school. They have a disease-centered model of learning, with an emphasis on biological and pathological aspects of health, assessment, diagnosis, and treatment (2).

Scope of Practice:

NPs can prescribe medication, order diagnostic testing, and diagnose diseases. For the most part, NPs practice under the direct guidance of a physician. However, there are many states that grant NPs the ability to practice autonomously (3).

PAs can also prescribe medication, order diagnostic testing, and diagnose diseases. PAs cannot work independently. The supervising physician is responsible for all medical services provided by a PA under his/her supervision, and for following each patient’s progress (4). This is not necessarily a bad thing. This means much less malpractice insurance, less liability, and a second pair of eyes to watch your, and your patients’, backs.

This scope of practice, for either NPs or PAs, can be widened further with specialization.

Specialties:

NP: Generally, NPs will specialize in some sect of family medicine, whether it be pediatrics, rehab, urgent care, etc. But, they may also continue with further education to work as a nurse anesthetist, and some have even became a surgical first assist (4).

PA:  Nearly 1/4 work in family practice. Yet, whatever area a physician can specialize or sub-specialize in, so can a PA.  Want to be a flight surgeon in the military? No problem. Want to be in the ER? You got it. What about family practice? Yep that too! Cardio-thoracic surgery? It’s yours. Also worth noting: the PA’s education seems to fit more naturally than an NP’s when it comes to the surgical setting (5).

Experience / Ability:

The time I’ve spent going to PA school interviews, conversing with nurses and NPs, and researching these fields I come to believe the NP falls a little short of the PA program.

According to physicians I’ve spoken with, PAs come out of school more prepared, more confident in their work, and more comfortable around their patients. This goes hand in hand with some of the NP students I’ve talked to who complained about how theory heavy their curriculum was, yet, lacked in procedural and diagnostic skills. Instead of hands on work with patients, they wrote essay after essay on theory. “Diagnosis, treatment, patho, and pharm were completely  de-emphasized,” wrote one disgruntled student (6).

What field are you leaning towards? Why?

Citations

  1. “Here’s What You’ll Study in a Nurse Practitioner Degree Program.” Nurse Practitioner Degrees. Accessed August 08, 2016. http://www.allnursingschools.com/nursing-careers/nurse-practitioner/degrees/.
  2. “Nurse Practitioner vs Physician Assistant.” Nurse Practitioner Schools. Accessed August 08, 2016. http://www.nursepractitionerschools.com/faq/np-vs-physician-assistant.
  3. “Nurse Practitioner Scope of Practice.” How to Become a Nurse Practitioner. Accessed August 08, 2016. http://www.graduatenursingedu.org/nurse-practitioner-scope-of-practice/.
  4. “Nursing Programs by Advanced Practice – NP Specialties.” Nurse Practitioner Schools. Accessed August 08, 2016. http://www.nursepractitionerschools.com/programs.
  5. “Frequently Asked Questions about Supervising Physician Assistants – Physician Assistant Board.” Department of Consumer Affairs Physician Assistant Board. Accessed August 08, 2016. http://www.pac.ca.gov/supervising_physicians/faqs.shtml.
  6. Grnrn. “Frustrated with “fluff” in My NP Program.” Answers Articles and Jobs for Nurses and Nursing Students RSS. May 22, 2010. Accessed August 08, 2016. http://allnurses.com/nurse-practitioners-np/frustrated-with-quot-481146.html.
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Tim Cheves
Born in Tucson, AZ, Tim received a B.S. degree in Physiology (Pre-Med) with a minor in Pre-law at the University of Arizona. Here, he co-founded two UA chapter medical outreach clubs, served as a pre-health ambassador, became an R&D researcher, competed on UA's triathlon team, received the “Physiology Wildcat Award” in 2012, and graduated with honors.

In addition to three separate associates degrees, Tim became a nationally certified EMT in 2008 and continues to use his certification to this day. His work experience spans from physical therapy and nursing tech to the ER, donor organ procurement, and Search and Rescue.
As a self proclaimed grease monkey and gym rat, Tim enters his self re-built cars into shows and competes in bodybuilding competitions for fun.

Tim has been an instructor for EMS University since 2014, works at the UA as a biosafety officer, and now sets his sights on becoming a Physician Assistant.