Nurse Practitioner vs Physician Assistant

In many respects, nurse practitioners and physician assistants share duties. Both of these professionals can treat patients and perform some of the functions of a doctor, such as prescribing medications, and often work for some of the same healthcare systems. There are, however, some significant differences to keep in mind.

Nurse practitioners and physician assistants saw an increase in their ability to provide care with the passage of the Affordable Care Act. With a growing senior population, NPs and PAs are playing more of a role in health practices than ever before. Graduates of these programs will have no shortage of career options, with the location being one of the significant factors.

Another effect of the Affordable Care Act has been additional people added to healthcare systems because they could afford insurance. Insured patients are more likely to seek regular medical care. Nurse practitioners and physician assistants can help meet the increased demand.

If you are thinking about pursuing either path, it is a good idea to know the differences. Understanding these differences will help you make the right decision. Let’s dig into what both professionals do a little more so you can make the right choice.

Nurse Practitioner vs Physician Assistant Educational Requirements

Nurse practitioner vs. physician assistant differences starts with students going into both professions following different academic paths. Because the duties of nurse practitioners and physician assistants can vary, there is no one-size solution for all applicants. Students taking either path who intend to specialize will also need to take courses relevant to their specialty.

Nurse practitioners will have, at a minimum, six years of education with a nursing focus. A current nursing license, CPR certification, and a 3.0 GPA on all coursework are usually the minimum requirements for admission to the Master of Science in Nursing programs. Much of the focus will be on working independently and cooperatively with a doctor. 

There will be both classroom instruction and clinical units that involve subjects such as pathophysiology, advanced health assessment, and pharmacology. A national certification in the specialty you choose is necessary, as well as licensing requirements for your state. Graduates of nurse practitioner programs will be ready to get into practice in even high-demand settings quickly.

Physician assistant candidates will spend about the same amount of time in school as nurse practitioners but will take more of a medical degree path. Also, as with nurse practitioner students, there will be different requirements based on the school where you apply and the state. Clinical coursework, usually taken during the final year, is also necessary, along with classroom and lab classes. 

Once they have completed the coursework and taken all necessary certification exams, physician’s assistants will be able to help fill a real need for medical professionals. Both professionals can fill needs in high-demand locations that have fewer physicians, easing the burden on the doctors. The situation is a winning one for the healthcare systems, the patients, and the professionals alike.

What About Accelerated Programs?

A common trend in recent years has been for some schools to allow nurse practitioners and physician assistant students to complete their degrees in less time. The schools that offer accelerated programs will provide most of the classroom courses online, at least for nurse practitioner students. Lab and clinical work will still be completed in-person as usual.

One of the things that people must think about for either program is the time commitment required. For example, nurse practitioner applicants need to still be able to meet the requirements to maintain their nursing license. Academic requirements will need to be carefully balanced out against work and personal responsibilities.

Applicants to physician assistant programs will also need to carefully consider the time commitment that must be made for an accelerated program. Because most applicants accepted to these programs usually have jobs with intensive time commitments, these must also be balanced out when taking an accelerated program.

Functions of Both Jobs

Nurse practitioners and physician assistants can perform many of the same tasks. With their experience, both professionals can diagnose and treat a variety of conditions. Some of their duties also include prescribing medications and reviewing their patients’ medical histories, possibly making referrals to a physician as necessary. 

Both types of professionals will usually work under a physician’s supervision, although the amount of supervision required may vary by state. The level of prescribing authority that each professional has may also vary depending on their state. Some patients may be able to use a physician assistant as a primary care provider.

Another advantage that both medical professionals have is that they have the option of doing either general practice or a specialty, spending on where the demand is. A medical professional who specializes in specific fields can play a key role in expanding healthcare to underserved populations. The different patient groups that people work with in these settings help provide continued experience.

Educational Cost

Although the costs for nurse practitioners and physician assistants may seem high, they are still lower than medical school costs. Nurse practitioner educational costs average between $22,500 and $31,500. This cost is a small fraction of the cost of medical school, yet it provides a lot of value for any graduate.

The education for a physician assistant program is higher than that of a nurse practitioner program. Most degree programs for this concentration average between $79,941 and $90,659. Although the cost is higher, many graduates consider their future earnings worth the price.

The cost of attending school is a legitimate concern for students to think about. One of the most refreshing things that most students can take comfort from is knowing that financial aid options are available to make pursuing one of these Master’s degree programs more affordable. 

Unsubsidized Direct Loans are available for those doing graduate-level academic work. Depending on the servicer for any existing student loans, students may have the option of deferring payment on their current loans. Taking advantage of a deferment option is one way to relieve the financial strain while pursuing your degree.

Scholarships, through either businesses or non-profits, can also be a good idea. An advantage that scholarships offer for students is that they never need to repay the funds. A scholarship can help relieve some of the financial burdens after graduation. 

Work-study programs are another option that many students decide to pursue. Such programs allow for the possibility of working in a similar setting to where students will be employed after graduation. Another advantage of work-study is gaining valuable experience that will be useful on the job. 


The salaries that NPs or PAs can earn make the time and money spent on further education worth the effort. The median salary for a nurse practitioner in 2018 was $113,930, which many would consider a good return on their investment. Hospitals provide some of the best pay rates for nurse practitioners. Having a particular area of specialty can also help to increase your pay rate.

In 2018, physician assistants enjoyed a median salary of $112,260, which is an amount that most find satisfactory. Many feel that salary rates like this make their educational investment worth the money. Employment in a more extensive healthcare system in the right area of the country can help assure decent salary rates. 

Outpatient care centers provide some of the best earnings potential for physician assistants, especially for PAs with a specialty. As more large hospital systems use outpatient facilities to provide care, the demand for physician assistants to work in them will grow. Hospital-affiliated healthcare systems are playing a leading role in providing care for people living with chronic conditions like diabetes.

The ten-year job outlook for both professions has a healthy projected growth rate, especially for physician assistants, who can look forward to a 37% job growth rate by 2026. The “Sun Belt” states that attract retirees will increase the need for health care professionals across the board. With metropolitan areas throughout the United States seeing continued growth, the demand for health services will also grow. 

Locations with the Greatest Demand and Highest Pay

Nurse practitioners will find a high demand in Alaska, California, Massachusetts, New Jersey, and New York. California has the highest average salary at $133,780. The next highest-paying sate for nurse practitioners is Alaska, with $122,880 as an average pay rate.

Massachusetts, New Jersey, and New York have the next-highest pay rates, at $122,740, $122,100, and $120,970, respectively. The states with the highest numbers of available jobs include Alabama, Maine, Mississippi, New Hampshire, and Tennessee.

Regions and cities that have a high demand for nurse practitioners include:

  • Big Thicket area of Texas
  • Central Louisiana
  • Coastal Bend area of Texas
  • Eastern Sierra area of California
  • New Bedford, Massachusetts
  • San Francisco, CA
  • Spokane, WA
  • Southwest New York
  • Sumter, SC
  • Vallejo, CA

The demand for physician assistants is highest include Alaska, Connecticut, Montana, New York, and South Dakota. Of these states, Connecticut has the highest-paying average salary of $125,610. Alaska also boasts a high average salary of $122,260.

The other high-paying states include:

  • Washington with a rate of $123,980
  • Hawaii, with an average of $121,120
  • California, with a $117,230 rate

Some of the cities and regions with a high demand include:

  • Big Thicket area in Texas
  • Central Louisiana
  • Danbury, CT
  • East central Illinois
  • Lower peninsula area of Michigan
  • Northwest Minnesota
  • Olympia, WA
  • Salinas, CA
  • Spokane, WA
  • Visalia, CA

Is Being a Nurse Practitioner or Physician Assistant the Best Path?

You will need to think about your career goals and the educational commitment required when you’re making your choice. What you expect your lifetime earnings to be, the costs of your degree, and how long the whole process will take are essential factors. Failing to take any of these factors into account will make things more difficult in the long run.

The decision is not easy, because there are so many personal dynamics to consider. Internship opportunities can help give you on-the-ground experience that will bring you closer to a choice. One of the things that is an advantage where it comes to internships is seeing what goes on in the daily life of one of these professionals while you are still in a position to decide which path to pursue.

Many of the internships are available through non-profits that allow you to work internationally or in relief settings. Working in a different culture can serve as excellent preparation for communities within the United States that have different needs. A relief setting helps provide a solid foundation for working in emergency settings. 

Working Independently or Not

One thing that many prospective students wonder about for either program is whether it is possible to establish a private practice. This question is reasonable and has an answer that might surprise some. Nurse practitioners can operate a private practice if permitted in their state, while physician assistants cannot.

A nurse practitioner, when permitted to operate a practice, will be able to perform a broad range of treatments. NPs will usually work with multiple age groups. Nurse practitioners may not only diagnose and treat conditions but may also perform regular wellness exams.

By definition, a physician assistant will work under a physician. Doctors of many specialties, as well as primary care doctors, make use of physician assistants. One area of practice where physician assistants are in high demand is surgical practices.

The Next Steps

The decision to become a nurse practitioner or physician assistant is not one to take lightly. Consider applying to a healthcare internship abroad with International Medical Aid to gain practical, real-world experience that can help you determine which career path is best for you!