When choosing a healthcare career that involves direct patient care, two common paths often come up: nurse practitioner (NP) and physician assistant/associate (PA). These roles share many responsibilities, including diagnosing patients, prescribing medication and providing treatment. However, there are several differences between nurse practitioners and physician assistants that make each career path unique in terms of training, scope of practice, work environment and autonomy.
Understanding the differences is important for making an informed decision. Develop this understanding with Radford University’s online Registered Nurse (RN) to Bachelor of Science in Nursing (BSN) program. Read on to discover which path might be the right fit for your goals and interests in healthcare.
Education and Training
One main difference between a nurse practitioner and a physician assistant is in the training they receive. The Muse states nurse practitioners typically begin their careers as registered nurses and build on that foundation with advanced clinical training. Nurse practitioners complete a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP). Their education focuses on patient-centered care and often includes specialization in areas like pediatrics, geriatrics or family health.
In contrast, physician assistants must hold a bachelor’s degree and satisfy all PA program pre-requisites, including a minimum number of hands-on patient care hours prior to enrollment (these vary per program). They are educated using a medical model like that used in medical schools. PAs earn a master’s degree from an accredited PA program, where the training emphasizes disease pathology, diagnosis and treatment from a pathophysiologic approach that mirrors the approach of physician training. The PA curriculum does not include specialization but teaches students to work in all fields, which allows for their ability to work in any area of healthcare and change specialties throughout their career. While both programs require approximately two to three years of training after a bachelor’s degree, the approach and philosophy behind their training differ.
Scope of Practice and Independence in Patient Care
One difference between NPs and PAs is the current degree of independence with which they can practice. Nurse practitioners may have more autonomy, especially in states that grant full-practice authority. In these states, NPs can diagnose illnesses, treat patients and prescribe medications without needing a physician supervision. Currently, 27 states allow NPs to practice fully on their own, providing them with greater flexibility in delivering care.
Physician assistants typically work in collaboration with patient-care team physicians, although it is important to recognize that there are approximately 10 states that have removed the need for physician supervision or collaboration, allowing independent practice for PAs as well. There are a number of states that are in the process of removing regulatory requirements for PA collaboration, equating the practice of Pas with NPs. The requirement of a collaborating physician to be in remaining states is largely administrative. PAs diagnose, treat and prescribe with increasing levels of autonomy depending on the experience level of the PA and regulatory requirements.
In practice, PAs and NPs function very similarly, if not equally. While state regulations may differ somewhat, most practices and hospital systems have PAs and NPs practicing in the same roles with the same expectations and requirements for practice.
Career Paths and Specializations
Both NPs and PAs have multiple specialization options, but their paths differ. According to Verywell Health, NPs typically select a specialty, such as women’s health, mental health or acute care, at the start of their advanced training and usually remain in that area throughout their career.
In contrast, PAs are trained as generalists, which allows them to move between specialties without additional formal education. This flexibility can be appealing to those who prefer variety or want to explore different fields over time.
Work Settings, Job Outlook and Earning Potential
Nurse practitioners and physician assistants/associates often work in different healthcare settings. According to the U.S. Bureau of Labor Statistics, nurse practitioners are more likely to be found in outpatient care centers, private practices or community clinics, where the hours tend to be more predictable and workloads are generally less intense. This makes the NP role appealing to those looking for a better work-life balance. In contrast, PAs commonly work in hospitals, surgical units and emergency departments, settings that often involve shift work and fast-paced environments. While more demanding, these roles can offer a wide variety of clinical experiences.
Both NPs and PAs have strong job outlooks, with NPs expected to see a 40% growth in employment from 2023 to 2033, and PAs a 28% growth during the same period. In 2024, NPs earned an average salary of $132,050, while PAs earned around $133,260.
Choosing the Right Path
Deciding between a nurse practitioner and a physician assistant depends on your career aspirations, lifestyle choices and preferred work setting. NPs typically have more autonomy and often work in consistent environments like outpatient clinics or private practices, which can appeal to those seeking stability and independence. PAs, on the other hand, may enjoy the flexibility to switch specialties and work in dynamic hospital or surgical settings alongside physicians.
Both careers offer strong job growth, competitive salaries and the opportunity to make a meaningful impact on patient care. Regardless of which career path you choose to follow, an online RN to BSN program can be an important step to future success. Ultimately, the best choice is the one that aligns with your long-term goals in the healthcare field.
Learn more about Radford‘s online RN to BSN program.
