PA vs. NP...in the future

[EMEDPA]

Thanks for the insight. Does that mean graduates of the program need to apply to the state nursing board for an NP license and to the medical board for a PA license in order to represent themselves as either or both?

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YUP. they apply to both.

[Nonlegit]

Might come down to all money for me...the difference could be around 50 grand in education costs when its all said and done according to my most recent calculations.

 

Just so its very clear in my head, there is no income disparity between the two professions, correct? Specifically, EM in the northeast.

[ssmith]

Is there a topic discussing why the PA lobby is so slow (compared to NP)? I'd like to understand this better.

[EMEDPA]

Is there a topic discussing why the PA lobby is so slow (compared to NP)? I'd like to understand this better.

numbers. NPs are supported by all NPs(200k or so) AND all nurses ( 1 million or so). by comparison there are maybe 80k PAs in clinical practice of 100k ever trained and only 30% are involved in their professional organizations.

#s=$=influence.

[db_pavnp]

"There were an estimated 2,824,641 RNs and 690,038 LPNs within the nursing workforce during the 2008 to 2010 time period."

 

http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/nursingworkforcefullreport.pdf

[EMEDPA]

"There were an estimated 2,824,641 RNs and 690,038 LPNs within the nursing workforce during the 2008 to 2010 time period."

 

http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/nursingworkforcefullreport.pdf

thanks for getting the #s. I wasn't even thinking about LPNs as the RNs tend to treat them poorly and many are not involved in nursing unions but align with other techs.

[Marinejiujitsu]

Working in Emergency medicine I have discovered PAs are more desirable in emergency medicine in California but it seems like NPs are more desirable I'm primary care. I recently talked to an EM medical director who said they used to have a bunch of NPs but have now moved more towards PAs because overall performance . The general consensus among nurses I work with at another ER, they prefer working with PAs over NPs because we perform better but I feel it maybe just because they feel like it's more the boss is in town. I do feel NP so have brighter futures due to their union.

[Marinejiujitsu]

There's probably a little bias in there too. Lol

[LT_Oneal_PAC]

Just as an FYI, general nursing does not contribute to the NP PAC. Numbers aren't all that matters either because CRNAs are entirely their own organization ( long story pissing match from nearly 50 years ago) thus receive no money from any other nursing group. They are easily the most politically "advanced" , with independent practice in more than half the country (not to mention 100% billing everywhere) and they only have 60,000 at my last count. Granted they give more money and have near 100% participation in their advocacy organization.

[EMEDPA]

Just as an FYI, general nursing does not contribute to the NP PAC. Numbers aren't all that matters either because CRNAs are entirely their own organization ( long story pissing match from nearly 50 years ago) thus receive no money from any other nursing group. They are easily the most politically "advanced" , with independent practice in more than half the country (not to mention 100% billing everywhere) and they only have 60,000 at my last count. Granted they give more money and have near 100% participation in their advocacy organization.

nursing unions subsidize malpractice for NPs. an NP policy is about 1/2 that of a pa in any specialty.

[LT_Oneal_PAC]

nursing unions subsidize malpractice for NPs. an NP policy is about 1/2 that of a pa in any specialty.

which I can understand since they are all nurses which belong to that union. But they aren't the PAC that funds political agendas.

[Nonlegit]

I sat down with a nursing school advisor today and thought I would share some updates about the situation I originally posted as well as some stuff the advisor said.

 

First, the grad entry program cancelled some options, notably the ACNP track. This was apparently because new grads couldn't get (keep?) a job out of school, ostensibly because of lack of "nursing" experience. This was too bad because it likely would have been the option I would be interested in should I have chosen that route.

 

Also, the FNP route was now set up so that working full time was not an option at all through the program. One could work half-time, about half of the time during the program. This was a big downer for me, as the no-school-loans thing was my biggest draw the whole time. In addition, when asking about precepting sites (and mentioning EM), the advisor sort of recoiled and said "our department heads think that an FNP in an ED is practicing outside of their scope. We don't precept there." I kind of laughed since clearly FNPs work in EDs (including my own, the university's hospital), but the advisor stuck to this, and basically gave me the impression that I would be spinning my wheels persuing that.

 

I also learned that admissions apparently would not take my experience into account. It was mostly the standard stuff; GPA, GRE, LORs, PS, yadda yadda. Bummer. I could probably get in on my own account but I find it weird that they wouldn't have a system to acknowledge my, and others, experience. I would however get underrepresented status if applying, as I am male. Cool, I would have taken it, haha.

 

So, essentially case closed for me at this point in the meeting. No free school and crappy clinical tracks. One more thing of note, I was in a small office setting with other advisors around sort of chiming in here and there. I kind of dissapointedly mentioned that it was too bad there was no good options for me at the university, since the PA program that was supposed to be started here was cancelled. They all perked up and one said "I know, we were really glad!" I asked why and the only answer I heard was "it would have detracted from everything here." I assume that to mean the nursing school since I never mentioned med school at all. I didn't really press it so I don't exactly know what anyone meant, but many of the advisors were current graduate nursing students, so I wasn't thrilled to hear the attitude, especially since I don't dish it back.

 

The flip side? I pretty much know for sure now that its PA or die for me! What I always wanted, but the decision was made for me, it appears. Onwards.

[MICURN]

I'm choosing NP for multiple reasons including the lobby and advancement of the profession politically, etc. I like the pa education model more, however, I feel they're falling farther and farther behind NPs. Especially in my area and the fields I'm interested in - CCM/pulm/trauma service. The major hospital systems in my area use NPs almost exclusively to staff their ICUs (mostly trauma, surg and CTICU) at the level of about a 3rd year resident. I'm looking at the multiple combined ACNP/FNP programs. I think it compliments my critical care RN and hemodialysis RN experience. Plus it opens any door in medicine.

 

I also want to get the post-masters DNP at some point solely so I can teach and acquire research grant monies. Not because I think it adds anything clinically - because it's not meant to... The DNP is not a clinical doctorate. It is not touted as one. You can get a DNP and not be a NP. Generally, however, NP programs that offer a DNP do have more clinical hours - although they still tend to count RN work as time counted. Which even I don't necessarily agree with, and I must admit I have learned a lot in my years as an RN. But I still have never diagnosed or prescribed meds.

[db_pavnp]

I am in much the same boat.  I think the PA model is a sexier, stronger program, but the license is weaker.  I already have a weak healthcare certification and have taken my share of hard knocks because of it.  I want the back pocket RN both as a security blanket and as leverage into any organization if I need it.

[WorkHardPlayHard]

PA all the way.

 

1.) Numbers:

The number of PAs being churned out continues to go up, with 180 programs open now and 60+ coming down the pipe through 2018 we'll quickly reach a much higher volume of practicing PAs in the future, eventually I think we'll come close to or reach parity with practicing NPs.

 

2.) Rotations:

PA students don't have to mess with cold calling for preceptors and hoping for the best. A minimum of 2,000 hours of hands-on medical education and it's built into the program. I have a coworker going through NP rotations right and now and he's dealing with cancellations from preceptors and is jumping through hoops just to get his rotations in; no thanks.

 

3.) Residency Options

The number and type of different residencies opening for PAs is excellent. I imagine that the differentiation into every specialty will become available and this is something that PAs can capitalize on to further win patient trust and PR concerns over competency to practice medicine.

 

4.) The Name change/Semantics

The name change is a battle that will eventually be won with time and persistence. With PAFT pushing positive change and AAPA slowly coming around, all it will take is a name change in 1 state to start the dominos falling. Regarding "supervision", it will eventually be moved to collaboration which destroys the perception of us being glorified medical assistants.

 

5.) Masters vs. Doctorate

The upcoming option for DPAM (I prefer Doctorate of Medical Science or DMS, but it's a start) will be a new beginning for PAs wishing to compete directly with NPs over educational requirements. If we can produce more doctoral level programs a la Baylor's DHSc tied into specialties, we'll be up to speed with every other non physician provider who's done the same thing (PTs, OTs, NPs, etc).

 

 

This is still a young profession, with plenty of room for growth. It needs leadership and students/PAs who will not simply settle for a 9-5 with +/- $100k a year. Honestly, $ + #'s is what will turn this ship around and I refuse to accept that these goals are unobtainable. It's worth remembering too that this forum represents a microcosm of the total number of PAs out there; take the sunshine/rainbows AND doom/gloom with a grain of salt. For me, I can't wait to start, August can't come soon enough!

[zbritt]

PA all the way.

 

1.) Numbers:

The number of PAs being churned out continues to go up, with 180 programs open now and 60+ coming down the pipe through 2018 we'll quickly reach a much higher volume of practicing PAs in the future, eventually I think we'll come close to or reach parity with practicing NPs.

 

2.) Rotations:

PA students don't have to mess with cold calling for preceptors and hoping for the best. A minimum of 2,000 hours of hands-on medical education and it's built into the program. I have a coworker going through NP rotations right and now and he's dealing with cancellations from preceptors and is jumping through hoops just to get his rotations in; no thanks.

 

3.) Residency Options

The number and type of different residencies opening for PAs is excellent. I imagine that the differentiation into every specialty will become available and this is something that PAs can capitalize on to further win patient trust and PR concerns over competency to practice medicine.

 

4.) The Name change/Semantics

The name change is a battle that will eventually be won with time and persistence. With PAFT pushing positive change and AAPA slowly coming around, all it will take is a name change in 1 state to start the dominos falling. Regarding "supervision", it will eventually be moved to collaboration which destroys the perception of us being glorified medical assistants.

 

5.) Masters vs. Doctorate

The upcoming option for DPAM (I prefer Doctorate of Medical Science or DMS, but it's a start) will be a new beginning for PAs wishing to compete directly with NPs over educational requirements. If we can produce more doctoral level programs a la Baylor's DHSc tied into specialties, we'll be up to speed with every other non physician provider who's done the same thing (PTs, OTs, NPs, etc).

 

 

This is still a young profession, with plenty of room for growth. It needs leadership and students/PAs who will not simply settle for a 9-5 with +/- $100k a year. Honestly, $ + #'s is what will turn this ship around and I refuse to accept that these goals are unobtainable. It's worth remembering too that this forum represents a microcosm of the total number of PAs out there; take the sunshine/rainbows AND doom/gloom with a grain of salt. For me, I can't wait to start, August can't come soon enough!

 

K you just sold me.

[whoRyou]

^^^^