Physician vs. Physician Assistant vs. Nurse Practitioner

Hayley Arceneaux in 2013 as an intern in St. Jude‘s Pediatric Oncology Education program.

By Tab O.

In September, Hayley Arceneaux simultaneously accomplished a number of “firsts” as one of the crew members on the SpaceX Inspiration4 mission which orbited the Earth for three days: she became the first physician assistant to visit space, the first pediatric cancer survivor to visit space, the first person with a prosthetic body part to visit space, and the youngest American to visit space.

Hayley, 29, graduated in 2016 from LSU Health in Shreveport, Louisiana. As a former St. Jude cancer patient now working as a physician assistant at St. Jude Children’s Research Hospital, Arceneaux brings hope to other children battling pediatric cancers and inspires them to reach for the stars.

At the time of the space flight, at least one reporter said that Hayley was a physician at St. Jude, while others called her a physician assistant. My friend was impressed to think that she was a physician, saying, “Wow, I thought she was just an orderly or something.” But then when he heard that she was actually a physician assistant, he remarked, “Oh so she’s not a doctor then.”

I was kind of taken aback, because I always thought physician assistants were just as good as doctors. After all, I’d had a physician assistant as my primary care provider. So what’s the big difference between a physician or medical doctor (MD) and a physician assistant (PA), anyway?

Not much, really, as I found out when I went and looked it up. The two are very similar careers. They’re both part of the same team, working collaboratively. There’s also considerable overlap for some of their duties, particularly in primary care settings.

“Where I work in family medicine, PAs and MDs see similar patients and do many of the same things, including conducting sick visits, physicals, and procedures,” said Ann Marie Strong, Family Medicine Physician Assistant in Minneapolis, Minnesota.

When it comes to patient care, physician assistants are able to assess the patient, diagnose the issue, and formulate a course of treatment. However, PAs are not permitted to write any prescriptions. The PA will brief the supervising medical doctor and make recommendations for treatment including medications.

Medical doctors have more expertise treating less common issues, due to the fact that they experienced a longer hospital training period. A licensed physician (MD) is able to start his or her own practice, while a physician assistant must always work under the supervision of a physician. On the other hand, that means a physician also has administrative and managerial duties, whereas a physician assistant does not.

A physician assistant will go to college for about 6 or 7 years, which includes getting a 4-year undergraduate degree and then spending 2-3 years in a PA program (most are master’s degree). Physicians need to complete 4 years of undergraduate education plus 4 years of medical school, and then they must complete an internship or residency which lasts another 3-4 years.

According to DocWireNews, “The cost of a physician’s education will, on average, be $207,866, whereas a PA will spend around $71,369 on education.” Looking ahead, physicians have a projected growth of only 7%. Physician assistants, on the other hand, are projected to grow at a rate of 31%, leading to more job openings for PAs. Their salary isn’t bad, either, at an average of $100,000 vs. $200,000 for an MD.

There is also some confusion between a Nurse Practitioner (NP) versus a Physician Assistant (PA). Nurse Practitioners are key players in clinical settings, and in some places they serve as primary care providers just like PAs. The main difference is that NPs can write prescriptions whereas PAs cannot.

Nurse Practitioners have a wider scope of practice than Physician Assistants, since NPs are allowed to execute the entire treatment workflow including prescriptions. Some state boards of nursing even permit NPs to work independently without the direct oversight of a medical doctor. In those states, a Nurse Practitioner has the ability to open a private practice without the need for having an MD on staff.

A Nurse Practitioner must obtain a Master’s Degree or Doctor of Nursing Practice (DNP) degree. The Nurse Practitioner’s salary is similar to a Physician Assistant’s at around $100,000 or $50/hour. The job growth rate for Nurse Practitioners is expected to be 36% from now until 2026.

For more information, see:

Physician Assistants vs. Medical Doctors

Nurse Practitioner vs. Physician Assistant

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