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PA salary vs NP
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amother




Mauve


Post  Tue, Jan 08 2019, 2:43 pm
Quote:

In a regular office, there is a more in depth and comprehensive evaluation and treatment. For example, tracking of strep throat and dealing with the long term picture. For high blood pressure, an internist will work on the cause and monitor the other effects on the body. This is where an NP is more appropriate and knowledgeable due to the in depth training she/he has received.


This is actually almost the exact opposite of the truth. An NP is trained first as a nurse in taking care of the patients needs, their schooling to become a nurse practitioner involves a lot of research on social issues and actually a very small amount of medicine based learning. As opposed to a PA who is basically going through a shortened version of medical school. An NP may know more on the surface because of their past experience but a PA will look into the physiological changes going on in a patient's body to get to the core of an issue.
I do think NPs are wonderful in certain specialities especially if they've worked in that speciality for a number of years. But if you're comparing schooling and medical knowledge I don't think there's a comparison (my very close relative is an NP so I'm very familiar with both types of schooling)
That being said I wouldn't tell anyone straight out that one job is better to go for than the other. I think a lot of it has to do with personality type, learning styles and personal finances.
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amother




Aquamarine


Post  Tue, Jan 08 2019, 2:57 pm
amother wrote:
Oh gosh didn't mean to get anyone up in arms . My husb is a doctor and a close friend of his opened up 2 urgent care branches and told my husb he much prefers PAs. Sorry that it offended u. Feel free to ignore ...


I’m a NP. Why wouldn’t I be offended? People like your husband make it harder for me to find parnasa.
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amother




Orchid


Post  Tue, Jan 08 2019, 3:06 pm
OP here
Wow didn't mean to open a can of worms and offend anyone! I'm sure preference of either will really depend on the area of practice, but method of training does seem very different regardless. Thank you very much to those who took the time to respond, I'm sure seeing both sides of the coin will be very helpful.
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amother




Mistyrose


Post  Tue, Jan 08 2019, 3:28 pm
amother wrote:
I’m a NP. Why wouldn’t I be offended? People like your husband make it harder for me to find parnasa.


I wrote that that it offended you. I didn't write sorry IF I offended u . I figured u were an NP based on your response. And I'm very sorry if your having trouble with your parnassa Sad
U seem to think I'm wrong in which case ur parnassa shouldn't be affected at all ...
Much luck to you 😍
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rydys




 
 
 


Post  Tue, Jan 08 2019, 3:40 pm
amother wrote:
Quote:

In a regular office, there is a more in depth and comprehensive evaluation and treatment. For example, tracking of strep throat and dealing with the long term picture. For high blood pressure, an internist will work on the cause and monitor the other effects on the body. This is where an NP is more appropriate and knowledgeable due to the in depth training she/he has received.


This is actually almost the exact opposite of the truth. An NP is trained first as a nurse in taking care of the patients needs, their schooling to become a nurse practitioner involves a lot of research on social issues and actually a very small amount of medicine based learning. As opposed to a PA who is basically going through a shortened version of medical school. An NP may know more on the surface because of their past experience but a PA will look into the physiological changes going on in a patient's body to get to the core of an issue.
I do think NPs are wonderful in certain specialities especially if they've worked in that speciality for a number of years. But if you're comparing schooling and medical knowledge I don't think there's a comparison (my very close relative is an NP so I'm very familiar with both types of schooling)
That being said I wouldn't tell anyone straight out that one job is better to go for than the other. I think a lot of it has to do with personality type, learning styles and personal finances.


Actually, the background and in depth schooling the NP goes through gives her a much more in depth understanding of the body and how it works than the courses a PA takes.

I have worked extensively with both NPs and PAs both in practice and in their training and there is no comparison. They each have their place in the medical field.

The depth of training that an NP receives is the reason that they can practice on their own with a collaboration agreement with a physician, while a PA has to be directly supervised by a physician.
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amother




Burlywood


Post  Tue, Jan 08 2019, 3:46 pm
rydys wrote:
Actually, the background and in depth schooling the NP goes through gives her a much more in depth understanding of the body and how it works than the courses a PA takes.

I have worked extensively with both NPs and PAs both in practice and in their training and there is no comparison. They each have their place in the medical field.

The depth of training that an NP receives is the reason that they can practice on their own with a collaboration agreement with a physician, while a PA has to be directly supervised by a physician.

In what capacity are you working with NPs and PAs?
The reason NPs can practice on their own is because there is far more of them and they have a much stronger lobby. PA has the word assistant in the name which is misleading to many and somewhat stunts the growth of the field. In reality, a collaboration agreement and direct supervision tend to mean exactly the same thing. Im in the NY/NJ area. I do know an NP who owns their own practice but has physicians on staff, similar to if I owned my own practice. In all the jobs I've had NPs were supervised the same way. Yes, there are currently technicalities that make it easier for them to practice independently in some states, but it's not because of their education it is because of their voice.
In terms of my "direct supervision" my charts are cosigned when I work in NJ. The doctor doesn't see 99% of my patients, or even hear about them, untill signing the chart. When in NY there is a percentage of charts the doctor has to review monthly. I've never worked with my supervising physician in the office so he never saw or heard about my patients in real time. He was reachable if I had questions but I never bothered him. I did have other providers to turn to for input (PA, MD, DO or more recently NP) if I had any questions.
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rydys




 
 
 


Post  Tue, Jan 08 2019, 3:49 pm
amother wrote:
I in no way intend to belittle NPs, but while they are fully trained nurses and have great clinical experience AS NURSES, many complete online degrees which you simply can't compare to a real live program and many more than you'd like to believe go straight to NP school without any nursing experience. Nursing experience is great but it is NOT NP experience which requires very different skills and knowledge.
PA school requires hundreds to thousands of hours of patient care experience (depending on the school) which can range from volunteering in an ER to being a medical scribe, EMT, nursing aid or even a nurse. So while it's not necessarily paid clinical work it is some experience. PAs also get 2000 hours of clinical experience in school which NPs don't (I could be wrong but I believe they require 500 hours).
In terms of starting salary--in NY/NJ area I started out between 110-120k (12-14 shifts a month) as an idependent contractor close to 10 years ago. Starting salary significantly went up. All the places I worked at preferred PAs but that doesn't say much--that was clearly the case because they hired me as a PA. My current company only recently started hiring NPs.


It is true that PAs need clinical experience, but that is where they get most of their training. I have volunteered in an ER and spent many hours shadowing doctors, that does not mean I learned the background of what was going on.

NPs also have clinical requirements and I have hosted them in my office many times. I have one starting next month. When they come to me they have a specific curriculum and requirements to see patients on their own with my precepting them.
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amother




Mauve


Post  Tue, Jan 08 2019, 3:50 pm
Quote:
The depth of training that an NP receives is the reason that they can practice on their own with a collaboration agreement with a physician, while a PA has to be directly supervised by a physician.

This is an utter lie. The ONLY reason NPs are allowed to practice on their own is because of politics and nothing else. Anyone who understand the workings of the nursing board and the American medical association will admit this. 0% has to do with the difference in what they know or how they're trained.
(I personally think neither should be allowed to work on their own, that's what medical school is for, I'm just clarifying your point)
And this whole argument is an age old disagreement between NPs and PAs that I really shouldn't have gotten myself involved in. So I'll bow out now
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amother




Burlywood


Post  Tue, Jan 08 2019, 3:55 pm
rydys wrote:
It is true that PAs need clinical experience, but that is where they get most of their training. I have volunteered in an ER and spent many hours shadowing doctors, that does not mean I learned the background of what was going on.

NPs also have clinical requirements and I have hosted them in my office many times. I have one starting next month. When they come to me they have a specific curriculum and requirements to see patients on their own with my precepting them.

Are you an NP? How many hours of clinical rotations did you have as a student? From what I understand it's in the vicinity of 500. PAs have 2000. Spent with a preceptor. Seeing patients and coming up with treatment plans. Similar to what NP students do while being precepted but for many more hours.
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amother




Pearl


Post  Tue, Jan 08 2019, 3:56 pm
I have precepted both PA and NP students and not even a question that PA's are better trained/more knowledgeable.
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rydys




 
 
 


Post  Tue, Jan 08 2019, 3:59 pm
amother wrote:
In what capacity are you working with NPs and PAs?
The reason NPs can practice on their own is because there is far more of them and they have a much stronger lobby. PA has the word assistant in the name which is misleading to many and somewhat stunts the growth of the field. In reality, a collaboration agreement and direct supervision tend to mean exactly the same thing. Im in the NY/NJ area. I do know an NP who owns their own practice but has physicians on staff, similar to if I owned my own practice. In all the jobs I've had NPs were supervised the same way. Yes, there are currently technicalities that make it easier for them to practice independently in some states, but it's not because of their education it is because of their voice.
In terms of my "direct supervision" my charts are cosigned when I work in NJ. The doctor doesn't see 99% of my patients, or even hear about them, untill signing the chart. When in NY there is a percentage of charts the doctor has to review monthly. I've never worked with my supervising physician in the office so he never saw or heard about my patients in real time. He was reachable if I had questions but I never bothered him. I did have other providers to turn to for input (PA, MD, DO or more recently NP) if I had any questions.


I have worked alongside them in my own training (they were given the same responsibilities as the medical students who worked with us, not on the level of residents). I have not supervised them specifically since I started practicing. However, I do interact with both NPs and PAs on a regular basis while in practice for the last 15 years. The discussions I have with both about patients that they have seen have a distinct difference.

Yes, a PA with experience will know what to do in general situations, more so with those that they have been exposed to and they do have an understanding of medicine. However, the depth and bredth of understanding is not the same as NPs.

To answer the person who wrote that critical cases do come in to urgent care centers, that is not the majority of cases. I do not believe that a PA could TREAT a heart attack, but I do believe they can provide initial care while waiting for EMS. In addition, urgent care centers are not designed for chronic care situations like treating hypertention nor for well visit monitoring. These are things that need to be taken care of by a primary care provider.
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amother




Burlywood


Post  Tue, Jan 08 2019, 4:07 pm
rydys wrote:
I have worked alongside them in my own training (they were given the same responsibilities as the medical students who worked with us, not on the level of residents). I have not supervised them specifically since I started practicing. However, I do interact with both NPs and PAs on a regular basis while in practice for the last 15 years. The discussions I have with both about patients that they have seen have a distinct difference.

Yes, a PA with experience will know what to do in general situations, more so with those that they have been exposed to and they do have an understanding of medicine. However, the depth and bredth of understanding is not the same as NPs.

To answer the person who wrote that critical cases do come in to urgent care centers, that is not the majority of cases. I do not believe that a PA could TREAT a heart attack, but I do believe they can provide initial care while waiting for EMS. In addition, urgent care centers are not designed for chronic care situations like treating hypertention nor for well visit monitoring. These are things that need to be taken care of by a primary care provider.

Are you a physician?
As a PA I've treated many patients with heart attacks in the ER. In urgent care we don't have a choice but to call EMS because a heart attack is not treated outpatient. If you mean we can't fix them in the cath lab, well, wrong again! Some PAs work in cath labs (yes, there will probably be a physician there too doing the bulk of that part of the work). And yes, we agree as to the limitations of an urgent care. However, PAs are perfectly capable of being primary care providers (as are NPs).
In case it's not clear I not saying one is better than the other. I fully believe it is provider specific and I've definitely met both PAs and NPs who were better providers than I am. However, I do believe that generally speaking the educational course for PAs is far better than NPs (considering the many that go straight from nursing school with no experience and do online programs).
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amother




Silver


Post  Tue, Jan 08 2019, 6:46 pm
amother wrote:
Oh gosh didn't mean to get anyone up in arms . My husb is a doctor and a close friend of his opened up 2 urgent care branches and told my husb he much prefers PAs. Sorry that it offended u. Feel free to ignore ...


I recently went to an urgent care and saw a pa. I felt more knowledgeable. What a was of $35.
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amother




Ivory


Post  Tue, Jan 08 2019, 6:51 pm
This whole discussion is kind of silly. There are jobs for PA's, jobs for NP's and jobs for MDs. Salaries for NPs and PAs are generally similar but of course that depends on many factors.

I won't even get into a discussion on who has better training or is more qualified. There are so many different areas of healthcare and what's a good fit for one person wont be great for someone else. And one patient might love you and the next patient hates you. We're all there to serve our patients and improve their lives to the best of our ability. And when we don't know something our job is to refer them to someone who does. Internecine battles over who is smarter or more knowledgeable or more qualified have no place in medicine. If you can't treat your colleagues with respect, find another profession.
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amother




Blonde


Post  Tue, Jan 08 2019, 8:01 pm
Main difference I’ve noticed working as a PA and interacting with both PAs and NPs...
is that NPs are always trying to prove they are superior to PAs! Most jobs are the same and with a few years experience it doesn’t matter where you trained! It’s probably because as a group they are involved in lobbying for changes regarding supervision etc...but as an experienced PA or NP it doesn’t make a difference! As a PA I’m just thankful for a job I enjoy that has zero pressure and a salary close to 150,000 (surgery)..
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amother




Burlywood


Post  Tue, Jan 08 2019, 10:33 pm
amother wrote:
Main difference I’ve noticed working as a PA and interacting with both PAs and NPs...
is that NPs are always trying to prove they are superior to PAs! Most jobs are the same and with a few years experience it doesn’t matter where you trained! It’s probably because as a group they are involved in lobbying for changes regarding supervision etc...but as an experienced PA or NP it doesn’t make a difference! As a PA I’m just thankful for a job I enjoy that has zero pressure and a salary close to 150,000 (surgery)..

How many hours do you work for that salary?
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eschaya




 
 
 


Post  Wed, Jan 09 2019, 12:54 am
Sounds like we have some PAs here with chips on their shoulders...

I'm an NP (full disclosure). I was an ICU nurse for a few years before going back to NP school for acute care NP. I continued to work in an ICU (prn) while in NP school. We had WELL over 500 clinical hours (as claimed by a PA above) during our training (around 1,000). Furthermore, our training is specialty specific, so even if we do have somewhat fewer clinical hour of training, they are all focused on the area in which we will be practicing. I did not need to get hundreds of hours in pediatric orthopedics... because I will never work with a pediatric ortho patient. But I do have many many hundreds of hours in an ICU. Also, keep in mind that many NPs in my program had been critical care nurses for >10 years prior to going back to school. So when a student PA sets hands on a patient for the first time in PA school, she is touching (assessing) a patient for the first time. When an NP student touches a patient for the first time in NP school, she has years (only a few if she's straight out of nursing school, or decades if she's been a nurse for a while) of experience and clinical judgement behind her.

That being said, I've worked with great NPs and terrible NPs. I've worked with great PAs and terrible PAs. I work closely with both (as well as physicians) and can definitively state that clinical judgement is not something that is particular to an educational model. In our hospital setting, we often overlap and I have great respect for individual practitioners of all educational backgrounds.

I wonder why some of the PAs here feel such animosity towards NPs, because most of the time in practice I don't see this. In fact, I just was involved in running a conference for Advanced Practice Nurses through the Orthodox Jewish Nurses Association... which we opened to PAs (and offered CMEs for them) because we are happy to share opportunities with our colleagues. Similarly, JAPA (the Jewish PA organization) recently had a conference which they opened and advertised to NPs. There is so much overlap between our professions, and so much we have to offer to one another. It's disturbing to see quick-trigger animosity and jealously reflected here. There are jobs enough for everyone...

Another thing to keep in mind is the tendencies of each group as a whole can lead to stereotyping that's not accurate in individual cases. On the whole, there is a much larger proportion of NPs who work in primary care or outpatient facilities. NPs often have a focus on preventative medicine and holistic care. PAs are more often found inpatient, and specifically in surgical specialties. More NPs are female as compared to PAs. Some of these characteristics may lead to assumptions about all the individuals in the group, which is obviously oversimplified. So a female NP working in an outpatient geriatric practice might not have the "sharpness" or glamour of a male PA working orthopedic trauma. I despise stereotypes, but I think this may be what makes some PAs "look down" on the more slow-paced, chronic/maintenance medicine that many NPs practice. But research has actually shown that patients who have NPs as their primary care providers have the same outcomes as patients who utilize MDs. Which speaks to pretty good training and skills on the part of NPs.
[And as a critical care NP - who manages an ICU on nights independently, without any intensivist inhouse - I must also say that the stereotypes are nothing more than that. Stereotypes.]

To answer the original question, our salaries are essentially the same, but in the cases of both NPs and PAs, will be dependent on geographical location and area of practice. An APP (advanced practice provider, the term we use in my hospital to denote both NPs and PAs) who works inpatient critical care in NYC will be making a whole lot more than an APP working home health in rural Kansas.
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amother




Cerulean


Post  Wed, Jan 09 2019, 1:08 am
eschaya wrote:
Sounds like we have some PAs here with chips on their shoulders...

I'm an NP (full disclosure). I was an ICU nurse for a few years before going back to NP school for acute care NP. I continued to work in an ICU (prn) while in NP school. We had WELL over 500 clinical hours (as claimed by a PA above) during our training (around 1,000). Furthermore, our training is specialty specific, so even if we do have somewhat fewer clinical hour of training, they are all focused on the area in which we will be practicing. I did not need to get hundreds of hours in pediatric orthopedics... because I will never work with a pediatric ortho patient. But I do have many many hundreds of hours in an ICU. Also, keep in mind that many NPs in my program had been critical care nurses for >10 years prior to going back to school. So when a student PA sets hands on a patient for the first time in PA school, she is touching (assessing) a patient for the first time. When an NP student touches a patient for the first time in NP school, she has years (only a few if she's straight out of nursing school, or decades if she's been a nurse for a while) of experience and clinical judgement behind her.

That being said, I've worked with great NPs and terrible NPs. I've worked with great PAs and terrible PAs. I work closely with both (as well as physicians) and can definitively state that clinical judgement is not something that is particular to an educational model. In our hospital setting, we often overlap and I have great respect for individual practitioners of all educational backgrounds.

I wonder why some of the PAs here feel such animosity towards NPs, because most of the time in practice I don't see this. In fact, I just was involved in running a conference for Advanced Practice Nurses through the Orthodox Jewish Nurses Association... which we opened to PAs (and offered CMEs for them) because we are happy to share opportunities with our colleagues. Similarly, JAPA (the Jewish PA organization) recently had a conference which they opened and advertised to NPs. There is so much overlap between our professions, and so much we have to offer to one another. It's disturbing to see quick-trigger animosity and jealously reflected here. There are jobs enough for everyone...

Another thing to keep in mind is the tendencies of each group as a whole can lead to stereotyping that's not accurate in individual cases. On the whole, there is a much larger proportion of NPs who work in primary care or outpatient facilities. NPs often have a focus on preventative medicine and holistic care. PAs are more often found inpatient, and specifically in surgical specialties. More NPs are female as compared to PAs. Some of these characteristics may lead to assumptions about all the individuals in the group, which is obviously oversimplified. So a female NP working in an outpatient geriatric practice might not have the "sharpness" or glamour of a male PA working orthopedic trauma. I despise stereotypes, but I think this may be what makes some PAs "look down" on the more slow-paced, chronic/maintenance medicine that many NPs practice. But research has actually shown that patients who have NPs as their primary care providers have the same outcomes as patients who utilize MDs. Which speaks to pretty good training and skills on the part of NPs.
[And as a critical care NP - who manages an ICU on nights independently, without any intensivist inhouse - I must also say that the stereotypes are nothing more than that. Stereotypes.]

To answer the original question, our salaries are essentially the same, but in the cases of both NPs and PAs, will be dependent on geographical location and area of practice. An APP (advanced practice provider, the term we use in my hospital to denote both NPs and PAs) who works inpatient critical care in NYC will be making a whole lot more than an APP working home health in rural Kansas.

As a patient and current college student whose deciding what major to take, I found many PA’s to be aggressive and undereducated. I’ve seen many who are amazing. I’ve had a PA yell at me for making up stories that I’m sick when I’m not. Well, turns out I had walking pneumonia! He should be disciplined for failing to see that AND for the way he spoke to me. that’s for sure. And I’ve had wonderful PA’s who simply r so kind.
Now I gotta choose my major. Gulp
Just my 2 cents.
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amother




Blush


Post  Wed, Jan 09 2019, 2:16 pm
I honestly think NP is the easier and cheaper route. You can go to a community college and get your RN and then work while you get your BSN and MSN and possibly have it paid for by your employer.

If you go the PA route you will need many hours volunteering\shadowing and a good GPA and do well on difficult courses such as organic chemistry to be considered a competitive applicant. Some say PA school is harder than Med school because it is condensed.

NP - longer, slower, cheaper, easier
PA - quicker, harder, more expensive
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