Training
Nurse practitioners are first registered nurses (RNs). This involves three to four years of college level training at a certified school. Gaining level of Nurse Practitioner requires further training at the master’s and possibly even the doctorate levels. NPs choose a specialty during training such as pediatrics, occupational health or oncology. The Nurses model of practice focuses on maintaining health, the preventions of illness and patient education.

Physician’s Assistants also have training beyond the four years of college. The additional education is largely clinical in nature relating to diagnosing and treating disease, which is the physician’s model of practice. PAs don’t specialize at this level. Instead they pass through a rotation of specialties much like that of a physician and a master’s degree is earned.

Licensing
NPs and PAs are licensed through different organizations which set the standards for competency in their fields and administer tests and certifications. NPs must first become certified on the national level as RNs, then take additional tests for licensing as a NP on the national and state level. PAs, when finished with their program of study, must take a national exam and become licensed in their state to practice. Both must meet required continuing education standards and become recertified at regular intervals.

Practice
NPs can do everything a nurse can as well as some things a doctor can. They can diagnose and treat common illnesses, order diagnostics tests and write prescriptions for many drugs. They coordinate referrals to specialists and can perform certain procedures and minor surgeries. In some states nurse practitioners can open their own offices and work for themselves without supervision but in cooperation with doctors and other health care providers. Many doctors’ offices employ NPs to carry out routine office visits with patients. Other NPs work in hospitals and clinics focusing on the specialty they chose during training.

Physician Assistants always have to work under the supervision of a physician, although they can do many of the same things. This might be the biggest difference between NPs and PAs. However, they can assist during major surgeries. The physician they work under may give them some in-office supervisory responsibility over medical assistants and technicians and other autonomy based on the competency of the PA. Most work in the office of the supervising doctor although some may work in clinics, nursing homes, hospitals, etc., but still accountable to the doctor he or she works for.

Medicare and Medicaid recognize both as providers and most insurance reimburse for services at favorable rates.
The differences between Nurse Practitioners and Physician Assistants (video link) aren’t very noticeable to patients. Both work closely with other members of the medical community to provide the best possible patient care. But you might notice a difference on your bill if you see an NP or PA instead of a doctor. And that’s not a bad thing.