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Dr, NP, PA



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amother
OP


 

Post Tue, Jan 11 2022, 11:25 pm
Dont really know where to ask this, but am trying to figure out what's the difference and their roles.
Thank you
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amother
Lightcyan


 

Post Wed, Jan 12 2022, 12:09 am
They all provide medical care and realistically, may provide the same role for you as a patient. The difference is in their schooling. Schooling itself does not dictate how good a provider one is.
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bruriyah




 
 
    
 

Post Wed, Jan 12 2022, 12:14 am
Doctors/physicians are either "MD" (medical doctor) or "DO" (doctor of osteopathy). PAs and NPs are colloquially known as "midlevels" meaning, they are medical practitioners but have less formal training than physicians.

Doctors (MD or DO) have a minimum of 7 years of education/training *after* college, but can range anywhere from 7-12. For example:
- Cardiologist: 4 years of medical school, 3 years internal medicine residency, 3 years cardiology fellowship (10 yrs post college).
-Infertility specialist: 4 years of medical school, 4 years obgyn residency, 3 years infertility fellowship. (11 years)
-Dermatologist: 4 years of medical school, 4 years dermatology residency. (8 years)
-Trauma Surgeon: 4 years of medical school, 5 years of general surgery residency, 1 year trauma surgery fellowship. (10 years)
-Generalist: 4 years of medical school, 3 years internal medicine residency (7 years)

In addition MDs/DOs take lots of very rigorous exams throughout all their training and being accepted to medical school (and residency) is a highly competitive process. Roughly 50% of medical school applicants each year are not accepted and half of those accepted obtain acceptance to only one medical school. Getting accepted to PA/NP school is competitive, but not in the same league as medical school.

A PA has a minimum of 1.5-2 years training post-college. They have a masters in physician's assistant studies. Some PAs prefer the name physician associate.

A nurse practitioner is a registered nurse who then goes on to get a masters in nursing, so also minimum if 1.5-2 years of post-college training.

PAs and NPs can get a lot of experience on the job and become really good at what they do. Is some states they are allowed to practice independently and in some states they must practice under the supervision of a physician.

One unique thing that physicians do that midlevels usually do not do is lead a medical team. One upside of being a PA/NP is that it is easy to switch between fields. Doctors cannot usually do that because of the depth and breadth of knowledge you must acquire to qualify as a physician in any given field. This is why doctors often suffer from burnout.

Hope that helps, happy to answer any other questions!

-local MD
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bruriyah




 
 
    
 

Post Wed, Jan 12 2022, 12:18 am
amother [ Lightcyan ] wrote:
They all provide medical care and realistically, may provide the same role for you as a patient. The difference is in their schooling. Schooling itself does not dictate how good a provider one is.


In addition to a difference in the schooling, there is a difference in on-the-job training. Doctors must complete a residency before practicing independently. PAs and NPs do not need to; they can start working soon after they graduate. PAs and NPs will often do voluntary training but it is not as rigorous or formally structured like a medical residency.

It is incorrect to say that schooling does not dictate how good a provider is. In medicine, schooling is not just about reading books and taking tests. There’s a hands-on component to the “schooling”, so yes, more schooling usually means a provider who is more competent.


Last edited by bruriyah on Wed, Jan 12 2022, 11:55 pm; edited 1 time in total
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amother
OP


 

Post Wed, Jan 12 2022, 9:26 pm
Thank you! Appreciate the explanation!
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thanks




 
 
    
 

Post Wed, Jan 12 2022, 9:44 pm
NPs can write prescriptions, PAs cannot.
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amother
cornflower


 

Post Wed, Jan 12 2022, 9:47 pm
thanks wrote:
NPs can write prescriptions, PAs cannot.


PAs can prescribe in NY. Not sure if it differs by state.
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amother
Gardenia


 

Post Wed, Jan 12 2022, 9:52 pm
thanks wrote:
NPs can write prescriptions, PAs cannot.


You don’t know what you are talking about. PAs can prescribe medications including controlled substances. In all 50 states. Can’t prescribe in Puerto Rico however.
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greenteaorange




 
 
    
 

Post Wed, Jan 12 2022, 9:57 pm
NPs can open their own practice and work without an MD
PAs cannot
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amother
Beige


 

Post Wed, Jan 12 2022, 10:17 pm
greenteaorange wrote:
NPs can open their own practice and work without an MD
PAs cannot


Wrong. This depends on the state you live in. In general the more rural states give more autonomy to np and pa. Both nps and pas can prescribe under a physician. In some states they are limited in what they can prescribe.

Something that was not mentioned here is that NPs often have more of holistic humanistic approach to treatment due to the nature of their education and their experience as nurses.
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bruriyah




 
 
    
 

Post Wed, Jan 12 2022, 11:31 pm
thanks wrote:
NPs can write prescriptions, PAs cannot.


This is incorrect. Both can prescribe. But depending on the state and setting, it may need to be done under the supervision of an MD/DO.
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bruriyah




 
 
    
 

Post Wed, Jan 12 2022, 11:33 pm
amother [ Beige ] wrote:
Wrong. This depends on the state you live in. In general the more rural states give more autonomy to np and pa. Both nps and pas can prescribe under a physician. In some states they are limited in what they can prescribe.

Something that was not mentioned here is that NPs often have more of holistic humanistic approach to treatment due to the nature of their education and their experience as nurses.


Can you explain what you mean by “holistic”?
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amother
Peru


 

Post Wed, Jan 12 2022, 11:34 pm
thanks wrote:
NPs can write prescriptions, PAs cannot.

PAs can prescribe..
My husband is a PA and says nurses are trained to follow specific rules and regimens. PAs are trained to think more outside the box. Obviously he is biased, just putting it out there
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amother
Lightpink


 

Post Thu, Jan 13 2022, 12:15 am
As an NP, I disagree with your husband Wink

Like another poster said, nurse practitioners were nurses first. It’s like getting to know a person from the ground up- basic body functions, how their emotional/ social health impact their physical and mental well-being.. which is what is meant by “holistic”. I see time and time again- patients with supportive family and the will to get better will be healthier and live longer than patients with better “diagnoses” but don’t have family/ friends or have untreated depression.

I think we have a better understanding of how to communicate with a patient. Nurse practitioners are good at speaking everyday language and explaining to the patient what to expect, what side effects from meds, what to look out for. Sometimes patients won’t take their meds unless you talk to them about the barriers- which can be that they’re too expensive, or they’re ashamed of them, or they don’t think they’ll help, or side effects are difficult to tolerate.

Obviously that’s my own biased opinion
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