Definition

Physician Assistant

  • Health care professionals licensed to practice medical care with physician supervision.

Nurse Practitioner

  • Registered nurses with advanced education and training in a clinical specialty who can perform delegated medical acts with physician supervision.

Philosophy/Model

Physician Assistant

  • Medical/physician model, disease centered, with emphasis on the biological/pathologic aspects of health, assessment, diagnosis, treatment.
  • Practice model is a team approach relationship with physicians.

Nurse Practitioner

  • Medical/Nursing model, biophysical centered, with emphasis on disease adaptation, health promotion, wellness, and prevention.
  • Practice model is a collaborative relationship with physician

 

Education

Physician Assistant

  • Affiliated with medical schools.
  • Previous health care experience required; most require entry-level bachelors degree.
  • The program curriculum is advanced science based.
  • Approximately 1000 didactic hours and over 2000 clinical hours.
  • All PAs are trained as generalists - a primary care model and some receive post-graduate specialty training.
  • Education is procedure and skill oriented with emphasis on diagnosis, treatment, surgical skills, and patient education.
  • Currently, more than 50%of programs award Masters degrees and all are currently transitioning to the Master's level

Nurse Practitioner

  • Affiliated with nursing schools.
  • BSN is prerequisite; curriculum is bio-psycho-social based, based upon behavioral, natural, and humanistic sciences.
  • Approximately 500 didactic hours and 500 - 700 clinical hours.
  • NPs choose a specialty training track in adult, acute care, pediatric, women's health or gerontology.
  • Emphasis on patient education, diagnosis, treatment and prevention.
  • Generally not trained for surgical settings and are not taught procedural skills.
  • NPs generally have Masters degrees

Certification/Licensure

Physician Assistant

  • Separate accreditation and certification bodies require successful completion of an accredited program and NCCPA national certification exam.

Nurse Practitioner

  • Nursing accreditation and multiple nursing certification agencies.
  • Master's degree required to sit for exam.
  • The national certification is voluntary and utilized for advanced nurse prescribers within their specialty training.

Recertification

Physician Assistant

  • Recertification requires 100 hours of CME every 2 years and exam every 10 years.
  • Recertification is comparable to the family  medicine physician's exam.
  • All PAs are licensed by their State Medical Board and the Medical Practice Act provisions.

Nurse Practitioner

  • Recertification requires 75 CEUs every 5-6 years.
  • No exam is required.
  • NPs practice under their basic RN license, under the Nurse Practice Act.

Scope of Practice

Physician Assistant

  • The supervising physician has relatively broad discretion in delegating medical tasks within his/her scope of practice to the PA in accordance with Maryland regulations.
  • PAs in Maryland may prescribe Schedule II-V controlled substances if the physician delegates this.
  • On-site supervision is not required.

Nurse Practitioner

  • Under recently passed legislation, NPs may be listed as providers at HMOs, providing the supervising physician is indicated to the patient.
  • The practice agreement with the physician must contain the protocols as well as the medical acts which will be delegated.
  • NPs may prescribe controlled substances.
  • On-site supervision is not required.

Third Party Coverage and Reimbursement

Physician Assistant

  • PAs are eligible for certification as Medicaid and Medicare providers, Commercial payer reimbursement is currently variable.

Nurse Practitioner

  • NP's are eligible for certification as Medicaid and Medicare providers, and generally receive favorable reimbursement fro commercial payers.

Further Information

Maryland Academy of Physician Assistants, Inc.                                                                                               Nurse Practitioner Association of Maryland

American Academy of Physician Assistants                                                                                            American College of Nurse Practitioners

Maryland Board of Physicians                                                                                                                                 Maryland Board of Nursing

National Commission of Certification of Physician Assistants