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Nurse Practitioner vs Physician Assistant: Know the Difference

Amanda Guarniere

Nurse Practitioners (NPs) and Physician Assistants (PAs) are two healthcare professionals who work in primary care. They can diagnose and treat patients, administer medication, and collaborate in the same practice. However, the two have significant differences, including their education, scope of practice, and role in patient care.

In this article, we’ll discuss their differences in detail to help you decide which is ideal for you.


  • NPs and PAs are primary care providers in the healthcare system.
  • Both jobs demand a graduate degree, but the educational approaches differ.
  • Because of the shortage of primary care doctors, NPs and PAs are in high demand.

Table of Contents

Nurse Practitioner vs Physician Assistant 

Nurse practitioners are essential in healthcare, regardless of the setting or patient group they care for. NPs monitor patients’ health, provide direct medical care and serve as primary healthcare providers. Similarly, physician assistants play an essential role in the healthcare system since they diagnose medical disorders, create and monitor treatments, prescribe medications, and offer care.

This will serve as an overview for a better understanding of their differences:

Education and Certification

Nurse Practitioner:

Candidates must meet the following requirements to become a nurse practitioner:

  • Possess a nursing-related bachelor’s degree, preferably a Registered Nurse to Bachelor of Science in Nursing (RN-BSN). However, other related degrees may be allowed.
  • Pass an exam, such as the National Council License Examination for Registered Nurses, to get state RN licensure (NCLEX-RN).
  • Completing one to two years of hands-on nursing experience is required.
  • Earn your Master of Science in Nursing degree.
  • You must pass a background check.
  • After earning their master’s degree, they must pass a final certification exam.
  • Depending on their expertise, they may need anywhere from 750 to 2,500 clinical hours.

Physician Assistant:

Candidates must complete the following steps to become a physician assistant:

  • A bachelor’s degree in a scientific subject, such as physiology, chemistry, mathematics, or biology, is required.
  • Have some nursing job experience, while RN licensure is optional.
  • You must pass a background check.
  • Completing up to 2,000 clinical hours is required.
  • Completing 10 to 12 eight-week rotations in various medical specialities such as dermatology, emergency medicine, or surgery is required.
  • Take and pass the National Certifying Exam for Physician Assistants (PANCE).
  • To practice, you must first obtain a state license.

Role and Responsibilities

Nurse Practitioner:

Nurse practitioners typically specialize in servicing a particular patient “population” that concentrates on patients of a given age or with a specific ailment.

Physician Assistant:

Physician Assistants usually specialize in a specific area of medicine, such as emergency, internal, or surgical speciality. While both careers allow you to work independently, PAs must have an agreement to work with/under a physician.

Current Number of Practicing in the USA

Nurse Practitioner:

Employment: 234,690

Employment RSE: 1.3 %

Physician Assistant:

Employment: 132,940

Employment RSE: 1.6 %


Nurse Practitioner:

In May 2021, the median annual wage for nurse practitioners was $123,780. However, the lowest 10% earned less than $79,870, while the highest 10% earned more than $200,540.

Physician Assistant:

In May 2021, the median annual wage for physician assistants was $121,530. However, the lowest 10% made less than $77,940, while the highest 10% earned more than $164,620.


Nurse Practitioner:

Nurse practitioners’ employment has been predicted to grow by 40% between 2021 and 2031, much faster than the overall growth rate. An average of 30,200 job openings are predicted each year over the next decade, mainly to replace employees who transfer to other occupations or leave the workforce, such as those who retire.

Physician Assistant:

Physician assistant employment is expected to grow 28%between 2021 and 2031, substantially faster than the average for all occupations. Over the next decade, on average, 12,700 new opportunities for physician assistants are predicted. Many of those roles are most likely due to the need to replace individuals who change occupations or exit the labor force, such as retirees.

Career Advancement

Nurse Practitioner:

Nurse Practitioners can advance their careers through specialization, leadership and management, research and academia, entrepreneurship, and policy and advocacy. They can choose a path that corresponds to their interests and career goals.

Physician Assistant:

Physician Assistants can advance their careers through specialization, leadership, teaching and academics, entrepreneurship, and policy and advocacy. In addition, they can select a course based on their interests and goals.


Nurse Practitioner:

  • High-income potential: Nurse practitioners typically earn more than registered nurses.
  • Job security: Demand for NPs is predicted to rise, resulting in increased employment security.
  • Opportunities for advancement: NPs can specialize in a specific field of practice or advance to leadership positions.

Physician Assistant:

  • High job demand and promising future.
  • Salary and benefits are competitive.
  • Career opportunities in a variety of specialities and situations.
  • A team-based approach to patient care.
  • Prospects for progress in one’s career.


Nurse Practitioner:

  • Long education and training: Becoming an NP requires considerable time and financial investment in education and training.
  • Responsibility: NPs bear a great deal of responsibility in their employment and must make critical medical decisions for their patients.
  • Workload: Nurse practitioners frequently have a tremendous workload and may work long hours, which can lead to burnout.

Physician Assistant:

  • Long and difficult educational program.
  • Significant financial and time investment.
  • Medical supervision and collaboration are essential.
  • In comparison to independent medical practitioners, they have less autonomy.
  • High stress and long work hours are possible.

How To Choose Between Becoming an NP and a PA

There are several factors to consider when deciding whether to become a nurse practitioner (NP) or a physician assistant (PA). Both positions require a graduate degree and allow for specialization in a specific care area. However, being an NP requires first becoming a registered nurse (RN) and then finishing a graduate NP degree. In contrast, PA programs favor individuals with healthcare expertise in domains other than nursing. Furthermore, state scope of practice laws may influence your decision.

While NPs and PAs provide excellent patient care, NPs have advanced nursing education concentrating on a specific population or area of care. In contrast, PA programs stress a generalist approach to practice, diagnosis, procedures, and treatment. Consider the type of care you want to provide, your goals and interests, and your education and experience.

Available Online Resources To Know More About NPs And PAs 

Many online resources are available to learn more about nurse practitioners (NPs) and physician assistants (PAs) and the differences between the two professions. Here are a few:

  1. National Organization of Nurse Practitioner Faculties (NONPF) – Provides information about NP education, certification, practice and current research in the field.
  2. American Association of Physician Assistants (AAPA) – This offers information on PA education, certification, practice, advocacy, and career resources.
  3. The Journal of the American Association of Nurse Practitioners – This peer-reviewed journal provides up-to-date information on the NP profession, including research articles, clinical practices, and educational resources.
  4. Physician Assistant Education Association (PAEA) – A professional organization for PA educators and programs that provides information about PA education and the PA profession.

To gain more information and make an informed decision, it is also a good idea to talk with NPs and PAs, attend informational events and webinars, and contact professional organizations.

Why is There a Growing Demand For NPs And PAs in Healthcare?

The demand for NPs and PAs in healthcare is expanding as a result of reasons like an ageing and growing population, a physician shortage, and a shift toward a more patient-centred and cost-effective healthcare system.

Because of the shortage of primary care doctors, NPs and PAs are in great demand. According to a 2018 survey, 61% of PAs work in doctor’s offices, 26% in hospitals, 8% in outpatient care facilities, 3% in colleges, and 2% in employment services. In 2018, 54% of NPs worked in physician offices, 28% in hospitals, 11% in outpatient care facilities, 4% in other healthcare practitioner offices, and 3% in colleges, according to a survey of NPs.

Impact of NPs And PAs on The Overall Healthcare System  

A survey of 2,053 American adults found that, while most people prefer to visit a physician, a vast majority would rather see a PA or NP today than wait. However, some may be concerned that PAs and NPs are unprepared to tackle complex medical issues like diabetes, as physicians require at least seven years of post-B.S. education. PAs can become qualified in just two years, but NPs require 2-3 years of graduate study.

However, research comparing the competency of PAs and NPs to that of traditional physicians is generally positive, with studies demonstrating that PAs and NPs manage diabetes just as well as physicians. 


Due to the primary care shortage, there is an increasing demand for nurse practitioners (NPs) and physician assistants (PAs) in healthcare. Patients are also getting more comfortable with being treated by NPs and PAs rather than waiting longer to see a physician. While there is some concern regarding NPs’ and PAs’ ability, research has demonstrated that they can address complicated medical problems and may even give better care than traditional physicians. Factors such as educational requirements, salary, and scope of practice should be considered when picking between these two careers.

Searching for a nursing job that will make a difference? Our article on ER Nurse, Utilization Nurse, Travel Nurse, and Forensic Nurse can provide valuable insights.

FAQs on the Difference Between Nurse Practitioners and Physician Assistants

Can nurse practitioners, and physician assistants open their practice?

Yes! With the necessary licensure and certification, nurse practitioners and physician assistants can open their practices in some states. Physician supervision or collaboration agreements may be required in some states. It is critical to review your state’s unique rules and regulations.

How do the roles of nurse practitioners and physician assistants differ in primary care?

NPs are advanced practice registered nurses who are trained to diagnose and treat health problems as well as to prescribe medication. PAs are healthcare professionals who operate under the supervision of a physician to diagnose and treat health conditions but are not permitted to prescribe medication in all states. NPs and PAs work with physicians and other healthcare providers to offer patients comprehensive care.

Can nurse practitioners and physician assistants prescribe medication?

In the United States, nurse practitioners (NPs) and physician assistants (PAs) can prescribe medication. However, the regulations governing NP and PA prescribing authority differ from state to state. In some states, NPs and PAs have complete prescribing control, whereas, in others, they may be limited. For example, they may require the approval of a supervising physician for particular medications or doses. 

Can a nurse practitioner and a physician assistant work together in the same practice?

Yes! A nurse practitioner and a physician assistant can practice together. Nurse practitioners and physician assistants work together to deliver primary care services to patients in numerous healthcare settings. They have significant expertise in diagnosing and treating medical conditions and frequently collaborate with physicians to provide comprehensive care.


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