In a recent episode of Crikey’s Diary of a Surgeon, Professor Guy Maddern wrote about the potential of physician assistants to help relieve pressures on our health care system. Physician assistants have been an integral part of the US health system for many decades.
His piece prompted some queries along the lines, what is the difference between a physician assistant (PA) and nurse practitioner (NP)?
As this question is often raised when the subject of PAs arises, I’ve asked Dr Rod Hooker, a PA for 30 years in the US and also a health economist, to explain how he sees the differences. Hooker is Director of Rheumatology Research, Medical Services, Department of Veterans Affairs, Dallas, Texas.
“Important issues arise when discussing similarities and differences between PAs and NPs. Viewing this from the prism of a health economist at first glance they look alike.
However, in the aggregate there are some differences that are notable. The generalist training of PAs permits role flexibility and mobility that neither NPs (nor doctors) have.
A urologist may employ a PA to do office based procedures, and undertake pre-surgical admission examinations – not to assist in theatre.
An emergency medicine PA may experience role fatigue after a few years and take up primary care or work in cardiology as an alternative.
The other differences may lie in the aggregate. NPs are highly skilled in the cognitive disciplines and tend to be providers of health promotion and disease prevention than doctors or PAs.
PAs in turn tend to be more technical oriented in nature. PAs in uniform are trained for combat roles as well as occupational health, battlefield medicine, family medicine, and refugee management. NPs are not deployable for combat roles and are not trained for those roles.
Finally, what Americans have found in PA/NP development is that diverse populations seem to like the idea of choice in providers; the younger generations have never known what it was like to not have a doctor, PA, midwife or NP in their midst.”