NPs and PAs: Working With You

Introduction

Ever wonder who those "mysterious" physician assistants (PAs) and nurse practitioners (NPs) are? Or, perhaps, you say you've never heard of them. That's not surprising, given that there are roughly 42,000 PAs^[1] and 71,000^[2] NPs in the United States -- which isn't much compared with 700,000^[3] physicians. Additionally, much of the growth in these professions has occurred in the last several years.^[4]

Generically, PAs and NPs are known as "mid-level providers." They are also sometimes lumped in with other professions such as physical therapists, occupational therapists, and the like, under the title "allied health professionals." PAs are licensed to practice medicine with physician supervision. NPs provide much the same type of service, but they are registered nurses (RNs) who have advanced training within a specific area of medicine.

Moreover, as a medical student you need to know:

1. PAs and NPs will be your fellow healthcare providers when you graduate. You may end up working next to them, and it behooves you to know a little about what they can and can't do.

2. Limitations in powers and duties can vary widely. For example, in Ohio, PAs have legal restrictions on seeing patients who are new to a practice, while in Wyoming, PAs can prescribe category II-V controlled substances. So what a PA or NP can or can't do may be up to state law, hospital rules, or restrictions placed by the supervising or collaborating physician.

3. Your classmates may be PA and NP students. Some educational institutions have PA or NP programs. Often, medical schools and PA/NP programs share courses. A PA or an NP may even serve as one of your instructors or clinical preceptors.

4. The nature of clinical education (and the legalities of what one can do prior to being licensed) being what it is, there is actually not a great deal of difference between freshly minted graduates from PA, NP, and medical schools. Residency is what really makes the physician. Experience, of course, never hurts, irrespective of your field. So take advantage of other providers around you -- you may learn a lot.

Medscape Med Students. 2002;4(1) © 2002 Medscape

Cite this: NPs and PAs: Working With You - Medscape - Mar 13, 2002.