Not sure which flair to use but I was wondering what the difference between the two is. I understand the academic background is different but if both can diagnose, prescribe, and treat patients, what’s the difference in terms of scope of practice?
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Exactly what they can and cannot do, from a legal standpoint, does vary from place to place so that’s important. They are not always “interchangeable” in the services they can provide.
That being said, you can imagine the Venn Diagram of a medical doctor and a nurse practitioner as being two overlapping circles, but the medical doctor is simply a bigger circle. Doctors undergo more detailed and lengthy training and have a broader area of experience which they can bring to their patients.
The basic difference would be than an RN is perfectly comfortable in the support role, doing administration tasks, things like blood drawing or basic treatment, all the way up to prescribing medication and providing moderate levels of medical diagnoses. A medical doctor probably won’t get involved in administrative or support tasks but can provide advanced diagnoses or complicated long-term treatment plans for rarer, more complicated illnesses.
In short, if your illness is one of those common 80% of people will experience type illnesses, or your getting routine medical care, than an RN is perfectly capable of providing that care probably cheaper and more quickly than a medical doctor. If you’re suffering from a 20% illness that even medical professionals don’t see very often or requires rapid, intense care to address, that’s when a medical doctor would be the better option.
A doctor goes to Medical school, does an internship, does a residency, and then is full-fledged in their specialty. Their scope of practice is wide and far. A nurse practitioner is a nurse that has gone on to specialized schooling and her scope of practice is honestly based on the state she’s in and who she works for. Or him. Yes, both can prescribe and treat patients. However, a doctor’s schooling is much more broad and intensive than a nurse practitioner’s schooling and thus his/her scope of practice is much more broad and intensive.
That being said we’re going to see a lot more nurse practitioners and physician’s assistants in the future. The healthcare crisis is critical right now and the only way to fill in the need for Physicians is to have more nurse practitioners and physician’s assistants. I honestly expect to see in the future schooling paid for some of these specialties because that’s how dire things are going to get.
This is for what I know about how it works in the US; Idk how it works in other countries. And as a disclaimer, I go to med school and never really considered NP or PA school so what I know is from what I hear from people that did those things/what I’ve read when I looked it up (out of curiosity).
A Nurse Practitioner (NP) is an advanced certification beyond nursing that trains them on some basics of the doctoring side of medicine. I believe they typically have their nursing degree (which is a bachelor’s), and then go to NP school which is a 2 year, masters level degree. I believe some NP schools require the GRE, but there are no entrance exams beyond that. They have to maintain their certification via either continuing to practice or retaking the certification exam if enough time has passed since they last practiced.
Physician Assistants (PA) is another kind of mid-level Healthcare worker. They typically need to have a bachelor’s as a prerequisite before applying to PA school, which is also a 2 year masters level course. I believe that PA school typically goes a bit more in depth in how they teach, but I could be wrong Idk I’ve never been to either of these. They have their own entrance exam called the PA-CAT. PA recertification works similarly to NPs iirc. Idk if they need extra training for certain specialities because I’ve read different things. Hopefully someone else in the comments can fill in some details.
Physicians also need a bachelor’s as a prerequisite. MD and DO schools are typically 4 year, doctorate level course. The first two years are largely in a classroom where you learn the basic science behind medicine in addition to how to treat some conditions, and you take the USMLE Step 1 afterwards. The second two years are clinical where you’re learning more about how to actually apply the stuff you learned to patients that they see in the hospital. They rotate through different specialties to gain a more broad medical education. At the beginning of the 4th year, you take USMLE Step 2. After that, you go to residency, which is basically an “on the job” training program. Residents are full physicians but are new to the field so they practice under the guidance and supervision of more experienced physicians (these take anywhere between 3 and 7 years depending on the field). At some point during this, you take USMLE Step 3. Afterwards if you wish to specialize further, you can do a fellowship (~1-2 years). Only then will you look for jobs. On top of all of that, physicians have to take certification exams every 10 years whether they practice or not to prove that they have up to date knowledge. Essentially, doctors have the most schooling and should be the most knowledgeable.
However for many, typical cases, an NP or PA should be enough. I still think it’s important to have an MD/DO sign off on their work, though, just in case. They’d likely be able to pick up on atypical cases that a mid-level may not have ever learned about in addition to understanding more of the nuances in medicine.
Working at a community clinic I can tell you that you will rarely see a MD working in any setting other than seeing primary patients on a scheduled basis. Even then it’s months out before you can see your Dr.
Clinics are always busy and are just behind ER’s as far as wait times. You won’t see a doctor here. Only Nurse practitiners or Physician Assistants.
It’s just the way the world is now.
For GP work, there is very little difference between a MD/DO and an NP. PA (Physician Assistant) can also be very effective as a PCP.
The gap between NP/MD in practice is not that wide until you start looking at specialties. That said, there is value in the 4+4 of a MD degree and I would be more comfortable with an MD if I had any kinds of specialized medical needs or a unique PMH
MD here and I will try to be as unbiased as possible:
NP/PAs were created and envisioned as extensions of a doctor to allow more patients to access care. As more people age, there will be a greater demand for medical care that the pipeline for creating new MDs simply could keep up. In especially rural areas, there might not be an MD available. In those cases, a PA/NP could help to provide care with guidance from a doctor, to catch the one sick patient that needs attention while taking care of the day to day upkeeping.
To specifically answer your question will require a bit of bias: the difference is the level, type, and quantity of education and learning to practice at the highest level of my credential. I am a trauma/critical care surgeon, and to get to this point requires 4 years of school, 5 years of residency, 1 year of fellowship, and sitting through and passing my board exams. I am expected to know and handle whatever comes my way and know my limitation. If I choose to switch career, I have to start all over from residency, if I can even find a place that will let me.
NP/PAs have their schools, and as far as I know, that is it. There are specialized PA/NP “residencies” but they are not accredited as far as I know and have no common core curriculum and requirements that are mandated. You may choose to specialize if you so choose. A family medicine NP can choose to specialize as a surgical NP then transition to a cardiology NP, with nothing more than a regular training period, without any oversight or general curriculum to ensure they have been exposed to the enough of the specialty. They can be good with enough time, and a cardiology NP with 10 years of experience certainly can be knowledgeable, but the key is there is no mandate that they get that amount of experience of way to certify that they have that knowledge.
My personal TL:DR summary/opinion: your day-to-day physical, boo-boos, prescription renewals, go ahead and see an NP or PA.
If you are actually worried about a problem that has been bothering you, try to find a doctor that may know the proper pathway to work you up.
From a labor perspective, there’s not enough doctors to meet the needs of our growing population; therefore you’re seeing a provider that’s been put in place to maintain the continuity of care in your community.
Doctor : Nurse Practitioner :: university professor : kindergarten teacher
Can a university professor teach kindergartners? Probably, but they’d quickly get overwhelmed with all the hassle of managing kids, and can’t put their specialist knowledge to use.
Can a kindergarten teacher teach a college level course? Probably, but that depends on how good they are as an individual, their professional training hasn’t prepared them to teach college courses, and so they will be out of their depth very soon.
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