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Nurse Practitioner vs. Physician Assistant

Sunday, January 9, 2011; 9:00 AM

Nurse practitioners (NPs) work in a variety of settings. So do physician assistants (PAs). They can both be found in hospitals and clinics, from rural to urban practices. PAs care for a variety of conditions. So do NPs. They both treat illnesses, provide patient teaching and prescribe medications, often acting as the primary care provider.

But there is a difference.

"When the patient asks me what the difference is between a PA and an NP, the difference is really in our training and our background," said Physician Assistant Patrick Killeen, president of the American Academy of Physician Assistants (AAPA). "Both are important members of the health care team┬┐To the patient, it may or may not matter, but to the provider, it may make a difference as to how that medical knowledge has been obtained."

PAs follow a medical type of model for training. Most PAs have a master's degree. They attend programs that focus on the medical aspects of health care, training them to be general practitioners, though PAs can specialize in everything from primary care to pediatrics and general surgical care. Nine to 15 months of the program is spent in supervised clinical training, according to the Physician Assistant Education Association and the AAPA.

Similarly, NPs also hold advanced degrees┬┐either master's or doctorate degrees.

Nurse practitioners have, on average, over 10 years of nursing experience before they go into their practitionership," said Nurse Prac-titioner Mary Jo Goolsby, director of research and education at the Ameri-can Academy of Nurse Practitioners (AANP). "We're a little bit different from some clinicians who come in right out of school."

NPs must hold previous nursing degrees to qualify for the graduate programs as well as professional nursing experience prior to entering school. Students are taught by other NPs, according to the AANP. Like PAs, NPs can practice in a variety of specialty areas.

In the end, both NPs and PAs are licensed and accredited by exam.

NPs and PAs practice in all 50 states and Washington, D.C., though practice is regulated state-to-state. Both professions also have prescriptive rights in all 50 states, with some limitations varying from state to state.

"While some states have no requirements for an NP to have a collaborative relationship with a physician or other providers, so that they are more 'independent,' other states do have requirements for some level of collaborative agreement to be in place," Goolsby said.

For PAs, a physician is the head of the practice, Killeen said, but there is still a great deal of autonomy. He described a PA in rural Wyoming who practices under a physician available by phone and by Internet, but he is the primary care provider for his patients.

"And that's our goal, that within accordance with state laws, PAs are able to practice within the full extent of their license," he said.

Goolsby said there is one thing that remains constant between NPs and PAs: "At the end of the day, if a person is being treated for any condition, the standard of care should be the same."

This special advertising section was written by Stacy Kess, a freelance writer and editor, in conjunction with the advertising department of The Washington Post and did not involve the news or editorial departments of this newspaper.

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