Great video! I agree with so many of these points and the large majority of them are why I’m applying to PA school as an RN. (Oversaturation, scheduling clinicals, less lateral mobility) My local NP school is also a doctorate only, and I cant imagine paying another year of school for nursing theory classes that likely won’t change my practice.
I’m half way through np school and wish I would have done what your doing. Just spent way too much damn money and time on theory and writing courses that are for the most part irrelevant to what I want to do
Hey! Great presentation of the differences of the two mid-level Professions. One of the things I would like to add to the PA school would be this. PA school can be described as a shorter medical school. By that I mean PAs are trained the same way as Physicians are but they graduate with a Masters of Medical Science versus a Medical Doctorate degree. Of course some can choose to get their Doctor of Medical Science degree. The schooling for PAs is structured the same as medical schools, in fact most PAs do their clinical rotations with medical students during their rotations. PAs just do not be on rotations as long as medical students and get a more deeper knowledge.
“Nurse Practitioner”, “Physician Assistant”, “Physician Associate”….. I think these are often confusing titles for patients. I was talking with a PA in our ER and he suggested we all have the title MLP - Mid Level Provider, as a way to help patients better understand who was treating them. To me, it seems like it would be good to have a title that more conveys that scope and authority of the provider. Not sure what it would be. Thoughts?
@@Drewski720 Agree. His thought was that NPs and PAs would all have the collective title of “Mid Level Provider” or “MLP” in the clinical setting to explain to patients their role. Not saying this is the best or correct direction to take, just passing along a thought from a colleague.
Hey David. Can you talk about debt for NPs? Specifically your debt (if you’re comfortable). I’m about to start my NP journey and I’m concerned about the cost and how to pay it off. Thanks
I'm a paramedic with experience in ground and flight EMS & a bachelor's degree in health science. I considered going to nursing school with the goal of eventually doing an NP program. But, I felt like my past clinical experience would be more valued going into PA school. Transitioning to nursing and getting a BSN just seemed more like starting over instead of building on my current skills and education. So, I'm preparing to apply for PA school next year's application cycle. I love the insight in this video and I'd really be interested in hearing an opinion on AA vs CRNA also. Im curious if theres as much of a difference between those roles.
Hey David! From my understanding, PA’s have to do 2000 clinical hours and they sit for the AAPA board exam. However, when you mentioned the PANCE exam, I wonder if they have a choice to sit for one or the other or if they can do a duo certification like NP’s with the ANCC/AANP?
Hi- anyone feel free to correct me if I’m wrong, but PANCE is the only certification exam they have. So everyone sits for the same exam. For recertification, they take the PANRE I think which is for recertification specifically.
Yes that is correct. PAs only have the PANCE coming out of school. However, PAs can choose to get Board Certified in a specific area like Dermatology or Surgery just like Physicians and do a PA residency although it is not required and is up to them.@@DavidWarrenNP
@@DM-MDgreetings -- "However, PAs can choose to get Board Certified in a specific area like Dermatology or Surgery just like Physicians and do a PA residency"
This is an interesting video, for sure. I apologize in advance for the length of this response. It's interesting that you seem to feel entry into a PA program is significantly more difficult than entry into NP programs. For reference, I'm on the outside looking in as a respiratory therapist who's just now applying to nursing school and beginning my program this Fall. The barrier to entry into nursing school by itself, is significant, and after graduating as a nurse and having additional clinical experience under your belt afterward, it would make sense that one could progress onward into NP school as the initial barrier to entry into RN practice had been met. Am I completely wrong in thinking this way? I mean, I have definitely seen NP's who struggled and were lost after graduating from their programs, but I've seen the same thing in PA's, especially in emergency situations and/or critical care, and even MD's and DO's who don't really seem to know what's going on when they first graduate from school. A nurse who has been through school, passed their RN certification and gained additional experience at whatever level, seems to me to be better prepared to enter advanced practice school than someone who has no clinical experience whatsoever and applies directly into PA school. I would hope that they have more clinical hours as they haven't had the previous experience that all nurses have through clinical nursing school rotations plus real-world working experience as RN's. PA's definitely don't saturate the market like NP's do, however, so it will be interesting to see how it all plays out.
It's realistic to think it is a significant barrier to have to become an RN before being admitted to NP school. However, while nursing school can be challenging due to requirements of time and effort, it wasn't as difficult as you might think. Anyone who puts in the time and effort will most likely be successful. Also, as it was noted in the video, some NP schools are not hard to get into at all. The field is so saturated with schools, that it is almost as if you're just going back to college to get your master's in any generic degree. I know many PA's who have shared their journey/curriculum and I would say it is definitely more difficult than becoming an NP. Many PA schools require an undergraduate degree, usually in some sort of advanced level science such as Biochemistry. A degree in advanced level sciences is already up to par or harder than most nursing school programs. What makes a PA degree harder to obtain than an NP degree is the less saturation and availability of schools. Applying for and getting accepted into a PA school is a much harder feat than getting into an NP school. In the hospital, PA's and NP's are typically on an even playing field, in terms of "hierarchy". As expected, you will see way more NP's than PA's working in the field. Personally, I think it would be a great idea to require a DNP to practice as an NP, just as they have implemented for CRNA. It helps to weed out the individuals who just want their degree to make more money, and who don't see the true responsibility and importance of the occupation.
@@Drewski720 Becoming an RN requires a Bachelors of Science in Nursing ( If your applying to NP school) and passing state boards in order to practice nursing in the clinical setting in where your are managing and monitoring patient care. I would say that is much more of a barrier than academic work to be accepted into a PA program. The requirement for PA program is not a biochemistry degree, although some might have this, most PA students do not, the requirements to be accepted into PA is a bachelors ( In any discipline, math, English etc..) as long as general science courses have been completed. PA programs appear more rigorous because they have a generalist practice so 2000 hours divided between every speciality in medicine is comparable to NPs who specialize in an area like family med NP, psych NP etc. If we got certified in every specialty we could as an NP the clinical hours we would have would be 3,000 hours if were just calculating the minimum requirement which, most schools require more.
PA is on the medical model and NP is on the Nursing model but in practice most of the mid-levels are interchangeable Good move on CRNA, too many NP schools, which translates into too many NP’s and the pay is too low oftentimes I work for the government and I make about $1500 more per month than my RN outpatient, inpatient RN makes more than NP given shift differential etc But I like writing orders more than taking orders 😊 Good video
@@metorphoric like $45-$50 per hour6 figures is only $48 hr, lots of RN’s getting same and more plus bonus, w/o cost of masters degree, this of course will vary depending on location etc but generally true
@@tonyw.3210 according to the BLS, the median wage for an RN ( I believe with a Bachelors) is $39 per hour. The median hourly wage for an NP is $58. Would love to know where you’re getting your figures from. Of course this various from state which is why the median is significant but these median hours wages just family medicine. Certain specialties can pay significantly more. Plus, NP can bill for services which can increase earning as well as have their own practice (in a few states).
@@metorphoric for example, using your BLS website, the area I moved from, Johnson City, Tennessee, is number two in the country for highest percentage of the overall employment, at being a nurse practitioner, annual mean salary is less than $90,000 under $43 per hour, which is substantially higher than the local RNs salary, that’s still not worth going to school debt in my opinion. The original point that I was making was that the nurse practitioner industrial complex is out of hand, compared to PA, standards for entry into PA school is much higher. In general, the curriculum is tougher, in general, although from the salary scales that I have seen in the government, not much different than nurse practitioners.
@@tonyw.3210 The value of going to school for NP is based on the person's interest. The salary for Johnson City is lower than the national average and the median in TN is also lower than the national average. I would say that practicing as a NP in TN may be tough for recruiters. That being said, I think that both NP/PA are often times underpaid. Regarding the education, I look at it this way. Both NP/PA must earn a MS from an accredited school (some schools are requiring DNP) and pass highly regulated and regurious state boards to practice medicine.
David, as an NP student i would lile to know how did you address the "mid level provider" comments? Is it a derogatory manner in which to address NPs? Would appreciate your take on that. Regarding NP school, I purposely selected a school that places us in clinical, went through a challenging application process, interview and high threshold for passing a class.. I purposely selected the tough path to NP with so many options out there and glad I did.
AANP ( American Association of Nurse Practitioners) have commented on the mid-lvl title and physician extender as inappropriate. They should be addressed by their title NP or APRN
I'm a critical care flight paramedic with a decade of experience. When I'm working an ambulance shift, non-ER nurses routinely refer to me as "ambulance driver". It used to bother me a lot, but over time it mattered less to me. I recognize the importance of knowing interdisciplinary roles and titles in any setting. But I don't think "mid-level" provider is meant to be derogatory at all. Anytime I've heard that term, I immediately assume it's a PA or NP & both are, to me, highly respectable roles as clinicians. I think "mid-level" is regarded more highly by others than might be assumed. At least, much more so than "ambulance driver" is. To me, and many others, it's just a term that distinguishes NP/PAs from physicians.
Barrier to entry: to enter PA schools any degree will get u in plus you might have to work as an EMT etc .. to become an np you need to be a nurse it's a higher barrier to entry
Both are RN and requires a minimum of a Masters Degree but FNP has a broader scope to practice in any fields as a provider whereas a CNRA is trained to administer anesthesia. I believe all CRNA programs must doctorate level only by 2025 (current CRNA will be grandfathered). You can practice as a NP with a Masters although, some programs are no longer offering it and are going straight from Bachelor's to Doctorate (DNP or PhD). I think this is a good thing to be honestly.
How is it not a clear answer that PA's are better trained? The vast majority of not all of NP students have a BSN and my mom has one and says she knows nothing and can't do anything different than she could as a diploma RN. I would trust a biochem student with a crass course on disease process over an NP I don't understand how learning how great nursing is readies anybody to diagnose and treat a patient. I went over the NP syllabus on several schools and shit like cultural competency, diversity, bias in nursing and bullshit like that and one on pharmacology and pathophysiology. If I go see someone I want the shit fixed not a lecture on inclusion and maybe the nurses will fuckin strike if they don't get to write prescriptions. I'm gonna become an NP because it's easy and I get to write scripts that's it the reason
As you mentioned, your mother has a BSN, I assume you do not. My guess is that you are also not in the healthcare field as you would probably not say "If I go see someone I want the shit fixed not a lecture on inclusion and maybe the nurses will f***** strike if they don't get to write prescriptions". If you are in the healthcare field, you can tell you have a lack of education as your first concern is writing a script, or that master's is an easy degree. Good luck either way! I am currently pursuing a master's degree and doing my clinical rotations. I can tell when people are in the program for the potential monetary gain only, or if they have a lack of knowledge regarding nursing in general. I have worked in many areas of nursing, and they differ exponentially from what kind of care you provide and how much individuality and critical thinking you need to have, including assessing and treating. I also know many MD's that are not very good at their job and that are "in it for the money". Degrees and titles do not make you a good provider. Lastly, please do not enter this area of nursing or any areas of healthcare, if your outlook on people's care is as you portray with these comments.
![NP & PA vs MD & DO | The Scope Creep Controversy [Research Explained]](http://i.ytimg.com/vi/Ow5N9jXJ-_A/mqdefault.jpg)
Great video! I agree with so many of these points and the large majority of them are why I’m applying to PA school as an RN. (Oversaturation, scheduling clinicals, less lateral mobility)
My local NP school is also a doctorate only, and I cant imagine paying another year of school for nursing theory classes that likely won’t change my practice.
I’m half way through np school and wish I would have done what your doing. Just spent way too much damn money and time on theory and writing courses that are for the most part irrelevant to what I want to do
In PA school they work with cadavers and are more surgical, but I’ve heard of some NP programs adding some type of surgical rotation
The programs in Mississippi incorporated cadavers into their clinical labs. Really depends on the program.
Hey! Great presentation of the differences of the two mid-level Professions. One of the things I would like to add to the PA school would be this. PA school can be described as a shorter medical school. By that I mean PAs are trained the same way as Physicians are but they graduate with a Masters of Medical Science versus a Medical Doctorate degree. Of course some can choose to get their Doctor of Medical Science degree. The schooling for PAs is structured the same as medical schools, in fact most PAs do their clinical rotations with medical students during their rotations. PAs just do not be on rotations as long as medical students and get a more deeper knowledge.
“Nurse Practitioner”, “Physician Assistant”, “Physician Associate”….. I think these are often confusing titles for patients. I was talking with a PA in our ER and he suggested we all have the title MLP - Mid Level Provider, as a way to help patients better understand who was treating them. To me, it seems like it would be good to have a title that more conveys that scope and authority of the provider. Not sure what it would be. Thoughts?
I feel as though this would get them confused with physician "providers".
@@Drewski720 Agree. His thought was that NPs and PAs would all have the collective title of “Mid Level Provider” or “MLP” in the clinical setting to explain to patients their role. Not saying this is the best or correct direction to take, just passing along a thought from a colleague.
I'm currently an NP student, and it is expensive. The online cost right now (2023) average is 35-40k.
Hey David.
Can you talk about debt for NPs? Specifically your debt (if you’re comfortable). I’m about to start my NP journey and I’m concerned about the cost and how to pay it off.
Thanks
I'm a paramedic with experience in ground and flight EMS & a bachelor's degree in health science. I considered going to nursing school with the goal of eventually doing an NP program. But, I felt like my past clinical experience would be more valued going into PA school. Transitioning to nursing and getting a BSN just seemed more like starting over instead of building on my current skills and education. So, I'm preparing to apply for PA school next year's application cycle. I love the insight in this video and I'd really be interested in hearing an opinion on AA vs CRNA also. Im curious if theres as much of a difference between those roles.
@@kdscanlo Did you get in?
Hey David! From my understanding, PA’s have to do 2000 clinical hours and they sit for the AAPA board exam. However, when you mentioned the PANCE exam, I wonder if they have a choice to sit for one or the other or if they can do a duo certification like NP’s with the ANCC/AANP?
Hi- anyone feel free to correct me if I’m wrong, but PANCE is the only certification exam they have. So everyone sits for the same exam. For recertification, they take the PANRE I think which is for recertification specifically.
Yes that is correct. PAs only have the PANCE coming out of school. However, PAs can choose to get Board Certified in a specific area like Dermatology or Surgery just like Physicians and do a PA residency although it is not required and is up to them.@@DavidWarrenNP
@@DM-MD idk what country ur on about, however in america theres no official "board exams" or "residency" for physicians associates in the USA
@@dayyyzz2083 Hey! I appreciate your response although I didn’t say anything about board exam or residency.
@@DM-MDgreetings -- "However, PAs can choose to get Board Certified in a specific area like Dermatology or Surgery just like Physicians and do a PA residency"
This is an interesting video, for sure. I apologize in advance for the length of this response.
It's interesting that you seem to feel entry into a PA program is significantly more difficult than entry into NP programs. For reference, I'm on the outside looking in as a respiratory therapist who's just now applying to nursing school and beginning my program this Fall.
The barrier to entry into nursing school by itself, is significant, and after graduating as a nurse and having additional clinical experience under your belt afterward, it would make sense that one could progress onward into NP school as the initial barrier to entry into RN practice had been met.
Am I completely wrong in thinking this way? I mean, I have definitely seen NP's who struggled and were lost after graduating from their programs, but I've seen the same thing in PA's, especially in emergency situations and/or critical care, and even MD's and DO's who don't really seem to know what's going on when they first graduate from school.
A nurse who has been through school, passed their RN certification and gained additional experience at whatever level, seems to me to be better prepared to enter advanced practice school than someone who has no clinical experience whatsoever and applies directly into PA school. I would hope that they have more clinical hours as they haven't had the previous experience that all nurses have through clinical nursing school rotations plus real-world working experience as RN's.
PA's definitely don't saturate the market like NP's do, however, so it will be interesting to see how it all plays out.
It's realistic to think it is a significant barrier to have to become an RN before being admitted to NP school. However, while nursing school can be challenging due to requirements of time and effort, it wasn't as difficult as you might think. Anyone who puts in the time and effort will most likely be successful. Also, as it was noted in the video, some NP schools are not hard to get into at all. The field is so saturated with schools, that it is almost as if you're just going back to college to get your master's in any generic degree.
I know many PA's who have shared their journey/curriculum and I would say it is definitely more difficult than becoming an NP. Many PA schools require an undergraduate degree, usually in some sort of advanced level science such as Biochemistry. A degree in advanced level sciences is already up to par or harder than most nursing school programs. What makes a PA degree harder to obtain than an NP degree is the less saturation and availability of schools. Applying for and getting accepted into a PA school is a much harder feat than getting into an NP school.
In the hospital, PA's and NP's are typically on an even playing field, in terms of "hierarchy". As expected, you will see way more NP's than PA's working in the field. Personally, I think it would be a great idea to require a DNP to practice as an NP, just as they have implemented for CRNA. It helps to weed out the individuals who just want their degree to make more money, and who don't see the true responsibility and importance of the occupation.
@@Drewski720 Becoming an RN requires a Bachelors of Science in Nursing ( If your applying to NP school) and passing state boards in order to practice nursing in the clinical setting in where your are managing and monitoring patient care. I would say that is much more of a barrier than academic work to be accepted into a PA program. The requirement for PA program is not a biochemistry degree, although some might have this, most PA students do not, the requirements to be accepted into PA is a bachelors ( In any discipline, math, English etc..) as long as general science courses have been completed. PA programs appear more rigorous because they have a generalist practice so 2000 hours divided between every speciality in medicine is comparable to NPs who specialize in an area like family med NP, psych NP etc. If we got certified in every specialty we could as an NP the clinical hours we would have would be 3,000 hours if were just calculating the minimum requirement which, most schools require more.
What uni did you finish your NP school. I like they set up rotations
I went to UAB in Alabama!
PA is on the medical model and NP is on the Nursing model but in practice most of the mid-levels are interchangeable
Good move on CRNA, too many NP schools, which translates into too many NP’s and the pay is too low oftentimes
I work for the government and I make about $1500 more per month than my RN outpatient, inpatient RN makes more than NP given shift differential etc
But I like writing orders more than taking orders 😊
Good video
Define "low pay"? Most NP's are making 6 figures...
@@metorphoric like $45-$50 per hour6 figures is only $48 hr, lots of RN’s getting same and more plus bonus, w/o cost of masters degree, this of course will vary depending on location etc but generally true
@@tonyw.3210 according to the BLS, the median wage for an RN ( I believe with a Bachelors) is $39 per hour. The median hourly wage for an NP is $58.
Would love to know where you’re getting your figures from. Of course this various from state which is why the median is significant but these median hours wages just family medicine. Certain specialties can pay significantly more.
Plus, NP can bill for services which can increase earning as well as have their own practice (in a few states).
@@metorphoric for example, using your BLS website, the area I moved from, Johnson City, Tennessee, is number two in the country for highest percentage of the overall employment, at being a nurse practitioner, annual mean salary is less than $90,000 under $43 per hour, which is substantially higher than the local RNs salary, that’s still not worth going to school debt in my opinion.
The original point that I was making was that the nurse practitioner industrial complex is out of hand, compared to PA, standards for entry into PA school is much higher. In general, the curriculum is tougher, in general, although from the salary scales that I have seen in the government, not much different than nurse practitioners.
@@tonyw.3210 The value of going to school for NP is based on the person's interest. The salary for Johnson City is lower than the national average and the median in TN is also lower than the national average. I would say that practicing as a NP in TN may be tough for recruiters. That being said, I think that both NP/PA are often times underpaid.
Regarding the education, I look at it this way. Both NP/PA must earn a MS from an accredited school (some schools are requiring DNP) and pass highly regulated and regurious state boards to practice medicine.
David, as an NP student i would lile to know how did you address the "mid level provider" comments? Is it a derogatory manner in which to address NPs? Would appreciate your take on that.
Regarding NP school, I purposely selected a school that places us in clinical, went through a challenging application process, interview and high threshold for passing a class.. I purposely selected the tough path to NP with so many options out there and glad I did.
AANP ( American Association of Nurse Practitioners) have commented on the mid-lvl title and physician extender as inappropriate. They should be addressed by their title NP or APRN
I'm a critical care flight paramedic with a decade of experience. When I'm working an ambulance shift, non-ER nurses routinely refer to me as "ambulance driver". It used to bother me a lot, but over time it mattered less to me. I recognize the importance of knowing interdisciplinary roles and titles in any setting. But I don't think "mid-level" provider is meant to be derogatory at all. Anytime I've heard that term, I immediately assume it's a PA or NP & both are, to me, highly respectable roles as clinicians. I think "mid-level" is regarded more highly by others than might be assumed. At least, much more so than "ambulance driver" is. To me, and many others, it's just a term that distinguishes NP/PAs from physicians.
Thank you explain❤❤❤❤
The main difference is philosophy of care
Barrier to entry: to enter PA schools any degree will get u in plus you might have to work as an EMT etc .. to become an np you need to be a nurse it's a higher barrier to entry
Is crna the same as a np?
Both are RN and requires a minimum of a Masters Degree but FNP has a broader scope to practice in any fields as a provider whereas a CNRA is trained to administer anesthesia.
I believe all CRNA programs must doctorate level only by 2025 (current CRNA will be grandfathered). You can practice as a NP with a Masters although, some programs are no longer offering it and are going straight from Bachelor's to Doctorate (DNP or PhD). I think this is a good thing to be honestly.
How is it not a clear answer that PA's are better trained? The vast majority of not all of NP students have a BSN and my mom has one and says she knows nothing and can't do anything different than she could as a diploma RN. I would trust a biochem student with a crass course on disease process over an NP I don't understand how learning how great nursing is readies anybody to diagnose and treat a patient. I went over the NP syllabus on several schools and shit like cultural competency, diversity, bias in nursing and bullshit like that and one on pharmacology and pathophysiology.
If I go see someone I want the shit fixed not a lecture on inclusion and maybe the nurses will fuckin strike if they don't get to write prescriptions. I'm gonna become an NP because it's easy and I get to write scripts that's it the reason
While it is obvious that PAs are better trained across the board generally. You’ve also obviously never worked High acuity ICUs with Acute Care NPs.
As you mentioned, your mother has a BSN, I assume you do not. My guess is that you are also not in the healthcare field as you would probably not say "If I go see someone I want the shit fixed not a lecture on inclusion and maybe the nurses will f***** strike if they don't get to write prescriptions". If you are in the healthcare field, you can tell you have a lack of education as your first concern is writing a script, or that master's is an easy degree. Good luck either way!
I am currently pursuing a master's degree and doing my clinical rotations. I can tell when people are in the program for the potential monetary gain only, or if they have a lack of knowledge regarding nursing in general. I have worked in many areas of nursing, and they differ exponentially from what kind of care you provide and how much individuality and critical thinking you need to have, including assessing and treating. I also know many MD's that are not very good at their job and that are "in it for the money". Degrees and titles do not make you a good provider.
Lastly, please do not enter this area of nursing or any areas of healthcare, if your outlook on people's care is as you portray with these comments.