COMPARISON OF
PHYSICIAN ASSISTANTS AND NURSE PRACTITIONERS
Updated
CATEGORY
|
PHYSICIAN
ASSISTANT
|
NURSE
PRACTITIONER
|
|
Definition |
Health care professionals
licensed to practice medical care with physician supervision. |
Registered nurses with advanced
education and training in a clinical specialty who can perform delegated
medical acts with physician supervision. |
Philosophy/Model
|
Medical/physician model, disease centered, with emphasis on the
biological/pathologic aspects of health, assessment, diagnosis,
treatment. Practice model is a team approach relationship with physicians. |
Medical/Nursing model, Biopsychosocial
centered, with emphasis on disease adaptation, health promotion, wellness,
and prevention. Practice model is a
collaborative relationship with physicians. |
|
Education |
Affiliated with Medical schools Previous health care
experience required; most programs require B.S. and confer Masters
degree. Program curriculum is advanced
science based. Approx. 1000 didactic
and over 2000 clinical hours. All PAs are trained as generalists in the
primary care model and some receive post-graduate specialty training. Procedure and skill oriented with emphasis
on diagnosis, treatment, surgical skills, and patient education. |
Affiliated with Nursing schools BSN is prerequisite;
curriculum is bio-psychosocial based, based upon behavioral, natural, and
humanistic sciences. NPs choose a
specialty-training track in adult, acute care, pediatric, women’s health or
gerontology. Approx. 500 didactic hours
and 500-700 clinical hours. Emphasis on patient education,
diagnosis, treatment and prevention.
Generally not trained for surgical settings. Master’s conferred. |
|
Certification/Licensure Recertification
|
Separate but single
accreditation and certification bodies require
successful completion of an accredited program and NCCPA national
certification exam. NCCPA
certification is the gold standard and is required to obtain a PA license in |
Nursing accreditation and
multiple nursing certification agencies. Master’s Degree required to sit for exam; national certification is voluntary. An optional certificate (APNP) and a
written collaborative agreement with a physician are required for
prescribing. (Chapter N 8) Recertification
requires 1500 direct patient contact hours and 75 CEUs
every 5-6 years. No exam is required. NP’s practice
under their basic RN license under the Nurse Practice Act |
|
Scope of Practice |
The supervising physician
has relatively broad discretion in delegating medical tasks within his/her
scope of practice to the PA in accordance with state regulations. Written
guidelines are required for prescriptions.
Does not require on-site supervision Chapter Med 8 in WI
Administrative Code |
Nursing care is provided as
an independent function. However, protocols or
written or verbal orders are required for delegated medical acts -
such acts require general MD supervision.
Sec. N6.03(2), WI
Administrative Code |
|
Third Party Coverage
and Reimbursement |
PAs are eligible for
certification as Medicaid and Medicare providers, and generally receive
favorable reimbursement from commercial payers. |
NP’s are eligible for certification as Medicaid and
Medicare providers, and generally receive favorable reimbursement from
commercial payers. |
References
|
http://academic.son.wisc.edu/wistrec |
WI Regulatory Digest |