andersenpa Posted May 10, 2014 Share Posted May 10, 2014 Topic of discussion at my institution. For a department looking to hire a non-physician provider, should they recruit for "PA or NP", or would one be preferable over the other based only on the credentials they carry? Assume equal clnical experience, but not necessarily degree (eg DNP vs MPAS). Thanks! Link to comment Share on other sites More sharing options...
Guest Paula Posted May 10, 2014 Share Posted May 10, 2014 I voted yes. If same clinical experience (and they are competent) then I say are interchangeable. But then...... I would love to hear the discussion at your institution. Are you involved in it? As a PA I would support hiring a PA. HAHA love your avatar! Link to comment Share on other sites More sharing options...
KMD16 Posted May 10, 2014 Share Posted May 10, 2014 Joining in to vote yes. A potential for publication? Link to comment Share on other sites More sharing options...
andersenpa Posted May 10, 2014 Author Share Posted May 10, 2014 3 "No" votes but no explanation- c'mon guys..... This question is to ask if you would recruit for a position to either, and THEN look at the candidates, not dismiss out of hand b/c the candidate is a certain credential. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 10, 2014 Moderator Share Posted May 10, 2014 I might consider a very experiened emergency NP or acute care NP for an er job, but not an fnp, peds np, or adult np. I Have hired nps in the past and most of the time have been disappointed. Link to comment Share on other sites More sharing options...
Dunedain Posted May 10, 2014 Share Posted May 10, 2014 I have seen some LEGIT (Like >MD legit) ACNPs as hospitalists and been around some FNPs who shouldn't even be floor nurses. Quality varies pretty wildly depending on experience and program. Link to comment Share on other sites More sharing options...
Guest Paula Posted May 10, 2014 Share Posted May 10, 2014 Here's another thought I cogitated on overnight: If the position included any type of management responsibilities along with clinical the DHSc/DNP would probably get preference over one without. Not all PAs/NPs are good at or want administrative duties. Some might rise to the challenge without the D behind their name and do a stellar job. But is perception reality in the world of human resource departments? Link to comment Share on other sites More sharing options...
Mainer Posted May 10, 2014 Share Posted May 10, 2014 You're always hiring an individual regardless of degree. Although often used interchangeably, I would argue are very different products. They obviously undergo very different educational models. As EMEDPA eluded, an NP has a limited scope of practice and you may have to recruit a very specific NP for the job with very little latitude professionally. I personally believe that a broad education matters as well as experience. There are numerous objective measures that favor the PA. Link to comment Share on other sites More sharing options...
KMD16 Posted May 10, 2014 Share Posted May 10, 2014 Interchangeable? Not really. Depends on who you ask. It's easier to mold a new grad PA due to the generalist nature of our training than a new grad NP. It's also depend on specific needs of the practice or groups. Very specialty dependent. A very good MD friend owns a FM clinic who lost his PA of ten + years ended up hiring an NP. He said to me, the difference between a PA and an NP is NPs thinks like a nurse. His words not mine. Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 10, 2014 Moderator Share Posted May 10, 2014 if we are going to boil down to general ideas if < 3 years out of school the PA > NP - our education is just so much better! if in the hospital environment - PA > NP - most NP programs have such small clinical hour requirements and it is possible to never step foot in a hospital and become an NP If a small practice NP>PA - the $44k for Hitech is a huge deciding factor and in the PCP world an NP is okay (I still think PAs are better prepared having worked with both PA and NP) In hospital - commonly PA gets the specialty jobs - as we are actually trained to do them, but if the nursing union is strong or their is a nursing influence in the admin - ie senior management came from the nursing fields - then they are likely to hire NP Overall the PA education is just so much better I have a tough time siding with NP early on.... BUT as a small business owner, in the process of hiring - for a Geri House Call clinician, I would take either - and in fact in MASS an NP can sign a Death Cert and a PA can not - it would be nice to have someone else besides my SP to sign a death Cert. tough question...... Link to comment Share on other sites More sharing options...
andersenpa Posted May 10, 2014 Author Share Posted May 10, 2014 Remember we are assuming equal clinical experience and qualifications eg for an ED job an EM PA vs Acute Care ARNP Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted May 10, 2014 Moderator Share Posted May 10, 2014 This question is to ask if you would recruit for a position to either, and THEN look at the candidates, not dismiss out of hand b/c the candidate is a certain credential. I voted yes for this reason Link to comment Share on other sites More sharing options...
UGoLong Posted May 10, 2014 Share Posted May 10, 2014 I guess it depends. I've worked with 4 different NPs (all FNPs) in our practice (a mixed inpatient and outpatient practice) over the past few years and have found the following: 1. They're good people who care about our patients 2. Their experience varies wildly, generally depending more on what they did as nurses than what they learned in their relatively-limited NP clinicals. The NPs who have come to our place did 400 hours in their primary area and another 200 in optional rotations. 3. Patients accept them (they know what an NP is, as opposed to what a PA is, in general) 4. They seem to have a bit more of an issue adjusting to things outside of their prior clinical experience than the PAs I have known. 5. If you want a good NP, find one who either trained in your specialty or worked in it extensively as a nurse. 6. If you want a good PA, find one with a good work ethic. The generalist training seems to be a big advantage. That said, I like NPs and have enjoyed training and working with them. They do good work. Link to comment Share on other sites More sharing options...
coloradopa Posted May 11, 2014 Share Posted May 11, 2014 Topic of discussion at my institution. For a department looking to hire a non-physician provider, should they recruit for "PA or NP", or would one be preferable over the other based only on the credentials they carry? Assume equal clnical experience, but not necessarily degree (eg DNP vs MPAS). Thanks! They are relatively interchangeable as long as the NP is within their scope of practice. NP by their specialty. ACNP for inpatient and critical care. FNP or ANP for primary care. PACNP and ACNP for full practice EM (not urgent care). RNFA for OR. Or you can hire someone that can work anywhere that their SP can (PA). Link to comment Share on other sites More sharing options...
Acebecker Posted May 12, 2014 Share Posted May 12, 2014 I initially voted "no," but re-read the qualifications. NPs and PAs are interchangeable, certainly on the internal medicine/family practice side of the house. ER as well. Surgery is where it gets a little more tricky. A 2 year seasoned PA will be better, likely, than a 2 year seasoned NP in surgical assisting, procedures, and post-op care - they may still be interchangeable, but the PA will perform better. The difference is because the training of each is different. PAs get exposure to surgery, and a lot of it. NPs get little or none as their core requirements are different. So it's a guarded "yes." Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 12, 2014 Moderator Share Posted May 12, 2014 I initially voted "no," but re-read the qualifications. NPs and PAs are interchangeable, certainly on the internal medicine/family practice side of the house. ER as well. there are far more em pas than em nps and pas are the "midlevel provider of choice" according to acep. I'm sure there are jobs out there for nps working solo in rural facilities seeing all pts of all acuities and doing all procedures. I have just never seen one. the vast majority of these jobs are offered to pas, most who were former medics. Link to comment Share on other sites More sharing options...
andersenpa Posted May 12, 2014 Author Share Posted May 12, 2014 I initially voted "no," but re-read the qualifications. NPs and PAs are interchangeable, certainly on the internal medicine/family practice side of the house. ER as well. Surgery is where it gets a little more tricky. A 2 year seasoned PA will be better, likely, than a 2 year seasoned NP in surgical assisting, procedures, and post-op care - they may still be interchangeable, but the PA will perform better. The difference is because the training of each is different. PAs get exposure to surgery, and a lot of it. NPs get little or none as their core requirements are different. So it's a guarded "yes." Why would a PA and NP, each with 2 yrs surgical experience, be unequal in performance/competency? Link to comment Share on other sites More sharing options...
andersenpa Posted May 12, 2014 Author Share Posted May 12, 2014 there are far more em pas than em nps and pas are the "midlevel provider of choice" according to acep. I'm sure there are jobs out there for nps working solo in rural facilities seeing all pts of all acuities and doing all procedures. I have just never seen one. the vast majority of these jobs are offered to pas, most who were former medics. ACEP actually took a position on it? Link to comment Share on other sites More sharing options...
andersenpa Posted May 12, 2014 Author Share Posted May 12, 2014 They are relatively interchangeable as long as the NP is within their scope of practice. NP by their specialty. ACNP for inpatient and critical care. FNP or ANP for primary care. PACNP and ACNP for full practice EM (not urgent care). RNFA for OR. Or you can hire someone that can work anywhere that their SP can (PA). Any literature on this? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 12, 2014 Moderator Share Posted May 12, 2014 Why would a PA and NP, each with 2 yrs surgical experience, be unequal in performance/competency? the pa likely did inpt and surgical rotations and the np did not. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 12, 2014 Moderator Share Posted May 12, 2014 ACEP actually took a position on it? the president of acep made this statement at a sempa conference a few years ago. sempa also is allowed to send reps to several acep committees. acep also helped write the caq in em. they are firmly in the pas corner. acep also helps manage sempa administratively with support from their organization. Link to comment Share on other sites More sharing options...
andersenpa Posted May 12, 2014 Author Share Posted May 12, 2014 the pa likely did inpt and surgical rotations and the np did not. After 2 yrs working experience, any edge the PA had from student rotations should be negated Link to comment Share on other sites More sharing options...
andersenpa Posted May 12, 2014 Author Share Posted May 12, 2014 the president of acep made this statement at a sempa conference a few years ago. sempa also is allowed to send reps to several acep committees. acep also helped write the caq in em. they are firmly in the pas corner. acep also helps manage sempa administratively with support from their organization. We have a similar relationship between STS and APACVS Link to comment Share on other sites More sharing options...
UGoLong Posted May 12, 2014 Share Posted May 12, 2014 I'm not so sure that the initial edge is lost, except for the actual field of practice. After 2 years (or whatever), one would expect an NP and a PA who have been practicing in the same area to be pretty much equivalent. The PA who has to keep taking the PANRE has to keep up some of his or her generalist skills and that might translate into being more readily able to transition to a new area. Just a thought. Link to comment Share on other sites More sharing options...
andersenpa Posted May 12, 2014 Author Share Posted May 12, 2014 I'm not so sure that the initial edge is lost, except for the actual field of practice. After 2 years (or whatever), one would expect an NP and a PA who have been practicing in the same area to be pretty much equivalent. The PA who has to keep taking the PANRE has to keep up some of his or her generalist skills and that might translate into being more readily able to transition to a new area. Just a thought. My question is specifically related to the field of practice; although it is further upstream. As a recruiter, if you need to fill a surgical or EM position, would you recruit ONLY to PAs? Would you post a job listing as "PA or NP"? Are there practices where a PA or NP should not even be considered based on credential alone? Comes down to prejudice and bias. Link to comment Share on other sites More sharing options...
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