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PA vs NP for primary care?


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I'm in the Boston area, and will be applying to PA school this spring. I have a friend who is going to NP school, and when I mentioned that I was mainly interested in primary care, she said that I would be better off going NP for that in MA. A mentor of mine told me to search jobs that I would like in the area that I would like to live in in the future and see who they are looking for, PA or NP. I did a quick search for a few specialties I'm interested in (FM, Peds, Geri, Psych) and it was much more NP heavy than PA. I found a lot of PA jobs in surgical specialties, which I would not be against and I have enjoyed when I've shadowed but as of now I'm leaning towards primary care. A major reason I want to go to PA school over NP school is the curriculum and diversity of clinical rotations but I also don't want to have a difficult time finding a job in the specialities I'm interested in. What has your experience been in MA? I would eventually like to settle down in MA/RI area. 

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My experience going to PA school in MA was:

 

1. My thinking about what sort of work I wanted to do changed during PA school. This was also true for probably the majority of my classmates. Getting out on rotations and actually experiencing what it's like to work in that area, can really change your view.

 

2. Pretty much everyone was able to get a job in the specialty that they wanted. ED jobs are a little harder to come by without prior experience, as is critical care. Doing a residency helps for those. Or you can take a primary care, urgent care or hospitalist job just coming out of school to get some experience.

 

Good luck!

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NPs are slightly ahead in primary care

 

Both still need a SP if you write Scheduled meds (not independent there)

NP must have the name of their SP on their Scripts - PA's do not

Both must have quarterly supervision meetings with their SP

NP can sign Death Certs - PA can not

NP can sign all MASS HEALTH forms - PA can not

Neither NP or PA can sign for VNA or Hospice

Practice ownership - NP can direct bill - PA has to own a Corp (see my tag line below - it is totally doable)

 

Biggest issue for you - NP is limited to the field they are trained in.

 

If you want to try surgery, then ICU, then ER and then PCP - no go as an NP (with a few rare exceptions)

 

If you want to do Psych - go for it as a PA - but as NP you had better be a Psych Nurse....

Same with Geri - but they just eliminated Geri NP's so now FNP or Adult gets it.....

 

I believe PA education prepares you far better for practice.

 

NP's are much more politically active

 

 

 

Clear as mud.....

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So you are ready to apply to PA school now, so Im assuming you HCE, PA shadowing, all the classes, the grades, the LORs, etc. How much longer would it take for you to be able to apply for NP school? From the limited info, it seems like it would take you at least at extra year to be ready to apply to NP school (again, limited info), plus the loss of income associated. On the flip side, NP school is a lot cheaper than PA school, and it is geared towards working nursing with a good schedule whereas PA is the opposite (im sure you know this)

 

Also consider that PAs are trained to assist in surgery as well as perform some procedures that would require an extra course in NP school, but you wanting to go into PC would negative the need for that, unless you decided you hate PC and now wanted to return to EM (as happened to a NP I know)

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Actually NP's cannot sign death certificates in MA, same as PA's. NP's and PA's can pronounce death, however.

 

That's my understanding, at least.

 

 

not true

 

changed after the 2012 cost containment bill

 

Best piece of advocacy I have ever seen - this is the same bill that gave huge amounts to PA's with maybe 10 parapraghs in the bill

 

The NP's had a single line.....

 

 

NP's can sign anything a doc can.....

BOOM

 

They can sign all forms except federal

Last year the DOH actually changed all the form

 

 

Yes, NP can sign death cert.....

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Hmmm, very interesting. Thanks everyone. I think I will continue on my path to becoming a PA, just wanted to check with those who are practicing here to see what the job climate is like. Charlottew you are right, I really won't know what I like until I get into rotations, and the beauty of being a PA vs NP is that I don't have to choose upfront. I would like to do a residency after school anyway, so I wouldn't be looking for a job right away. 

 

Davidccs - I would apply to direct entry MS programs for NP school. However, I didn't like that I had to choose right away which track I would be on, and the curriculum and smaller amount of clinical hours did not appeal to me as much. I would only have to take nutrition I believe to be eligible for NP programs. 

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  • 3 months later...

not true

 

NP's can sign anything a doc can.....

BOOM

 

They can sign all forms except federal

Last year the DOH actually changed all the form

 

 

Yes, NP can sign death cert.....

 

Sorry for the late reply, but a little Googling confirms that indeed you are right, under MA state law NP's can sign death certificates. I guess this means they can be on-line certifiers, too?

 

At my institution at least, we do not allow NP's to sign death certs, they have to do pronouncements just like PA's. I guess we are still living in 2011. Hunh.

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  • 2 years later...
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On 6/10/2016 at 11:32 PM, charlottew said:

 

Sorry for the late reply, but a little Googling confirms that indeed you are right, under MA state law NP's can sign death certificates. I guess this means they can be on-line certifiers, too?

 

At my institution at least, we do not allow NP's to sign death certs, they have to do pronouncements just like PA's. I guess we are still living in 2011. Hunh.

NP and PA can sign.  Yes to online. 

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