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| The NP and PA Urban Legend |
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by David Mittman, PA - January 24, 2011
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 Provided by Clinician 1
A few articles I have recently read about the PA and NP professions contained the insertion of what I feel is an urban legend. This legend has to do with some notion that PAs are going to be “better” at procedures and that NPs will be “more comfortable” managing patients with chronic diseases that require close management. Something like NPs are great with hypertension and diabetes, while PAs are great in surgery and emergency medicine. In fact, in the article that ran in AM News in their Jan. 10th issue “Bringing PAs and NPs on Board: What to do if you’re hiring”, this legend was again eluded to. I think the quote was something like “Physician assistants tend to carry out more procedures,” and there was an NP quoted said that NPs are better suited to “evaluation and management”.
While it is easy to compartmentalize things so we can explain them easily, to believe the above is to believe something that robs both professions and devalues what we both ultimately bring to the table. I know NPs who are great at procedures including biopsies and plastic surgery and PAs who are so adept at managing diabetic patients that they manage some patients most internists would not attempt to. So how did this urban legend come to be?
I think I know, and much of this is historical. PAs generally did get more training in procedures while in school. Over the years this “in house” training opened up areas like surgery, dermatology and emergency medicine as specialties that welcomed new PA grads. So, yes, PAs just out of school have found specialties that require procedures/acute care a bit less intimidating. But all PAs also learned family practice/primary care and that included the management of all the common illnesses our patients usually get. Also remember, PAs were trained as generalists while NPs traditionally were trained in specialties, (ANP, PNP, GNP, WHNP, etc). This generalist training exposed PAs to many different specialties. Over the last decade or so things have changed significantly. Family NPs became the predominant NP specialty and because of their more generalist training new NP graduates started to go into areas like emergency medicine, dermatology, surgery and master the same procedures PAs did. Those NPs were looked at in the same manner and expected to do the same things. This has now progressed to the point where one can not generalize about what a PA or NP will be better at-it really is up to the individual and their training, be it before PA or NP school, after in a residency or the type of program they went to.
I just wanted to set the record straight and remind people how fast both of our professions entered almost all specialties doing procedures and more unimagined only a few years before.To be sure this will continue well into the forseeable future. To limit either profession to a cliche sells us all short and makes assumptions that are just unfair.
Dave has been a PA, and later NP, leader for thirty years. He strongly believes that NPs and PAs must work together to insure a better future for both professions. Most recently Dave has been busy launching another dream; Clinician 1, the first internet community for PAs and NPs. In October 2008, Dave was honored by the New Jersey State society of PAs with its “Lifetime Achievement Award”.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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| Angel Ribo PA-C, MPAS (Longview, TX) |
on 09 Feb 2011 at 11:08 am |
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| Could not agree more! |
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