NPs vs. PAs: What’s the difference?

Advanced practice providers, including nurse practitioners (NPs) and physician assistants (PAs), play key roles in healthcare. Both NPs and PAs have a high level of patient interaction and often share similar duties on the floor. To a patient or family member of a patient, it may be hard to differentiate who does what on their care team.

So what is the difference?

The main difference between an NP and a PA is education. NPs attend nursing school, while PAs attend a medical school or medical center. PA school focuses more on the pathology and biology of disease, while nursing school emphasizes the patient, including their mental and emotional needs.

Post-graduation, NPs and PAs have excellent job prospects. According to the Bureau of Labor Statistics, both professions are in high demand and are projected to become even more so in the next decade.

NPs practice in a wide variety of settings, including hospitals, doctors’ offices, and clinics, as well as camps, schools, and companies. NPs also have the ability to practice independently, diagnose and treat illnesses, as well as prescribe medication (without physician oversight), in most states.

PAs, on the other hand, usually work in doctors’ offices and hospitals. Although they do have a lot of autonomy in their role, PAs cannot practice independently. They can diagnose illnesses and injuries, prescribe medication, perform procedures, and design treatment plans under doctor supervision.

The Michael E. DeBakey Department of Surgery at Baylor College of Medicine has a number of advanced practice providers. Our lead providers share their experiences in the Q&A below.

Philip Bowden, NP, is a lead advanced practice provider and instructor in the Michael E. DeBakey Department of Surgery.

Q: When did you know you wanted to pursue a career in healthcare?
A: I was eight years old. My mother was a receptionist in a busy ER in Birmingham, Ala., and after school, I would go to her workplace. I remember following the nurses around and thinking, “That’s what I want to do.”

Q: What made you decide to work in surgery?
A: I have always related well with surgeons, both in the way they think and their approach to patient care.

Q: When did you join Baylor and what is it like working in the Department of Surgery?
A: I joined Baylor in 2014. Being a part of the Department of Surgery has been exciting and rewarding. I have enjoyed watching the department grow and flourish as we make new treatments available to patients. I have always enjoyed being a part of academic medicine. Working at one of the top institutions in the country makes me believe we make an impact in patient’s lives.

Q: What is your favorite part of the job?
A: The best part of my job is meeting people who come from all over the world for care at our facility. I enjoy getting to know them, hearing their stories, and caring for them.

Q: What would you tell someone who is just getting into your field?
A: There are so many directions you can go. Our field is wide open, and there are options. Find something that you love to do and pursue it!

Holly Clayton, PA-C, is a lead advanced practice provider and instructor in the Division of General Surgery at Baylor.

Q: Where are you from, and where did you go to PA school?
A: I grew up in Clear Lake, Texas, and I went to the University of Texas Medical Branch in Galveston.

Q: What made you decide you wanted to become a PA?
A: I always enjoyed biology in school, so I did some research on different avenues for a career. When I figured out that I wanted to go into medicine, I ended up liking the PA profession the most.

Q: In what area of medicine do you practice?
A: I work mostly in acute care surgery. I enjoy it because I like being busy with my hands as well as doing and assisting in procedures.

Q: When did you join Baylor and what is it like working in the Department of Surgery?
A: I joined Baylor straight out of PA school in 2015 and just celebrated four years here. I love working in the Department of Surgery because everyone enjoys the fast pace of surgery life. Each division is innately different but it is exciting to watch them collaborate so well together to work towards quality care and better patient outcomes.

Q: What is your favorite part of the job?
A: The best part of my job is that it is so multifaceted. Over the course of a day, I may first-assist in the operating room, round on patients in the hospital with the team, and then manage postoperative patients on my own in clinic.

Q: What would you say to someone who is thinking about becoming a PA?
A: I would 100% encourage them to do it. I would do it all over again in a heartbeat.

Additional Resources

Learn more about the School of Health Professions and the Physician Assistant Program at Baylor.

Read more information from the American Association of Nurse Practitioners.

-By Debbie Sugarbaker, editor in the Michael E. DeBakey Department of Surgery at Baylor