Amidst the physician shortage across the nation, two types of providers have been considered as the ‘key’ to addressing the said issue: FNPs and PA-Cs. Let’s go through the differences (and some overlapping features) of these healthcare professions.
Table of Contents
FNP
A family nurse practitioner is an advanced practice registered nurse who provides primary and preventative care. They cater to patients of all ages, from infants and children to adults and seniors.
Duties & Responsibilities
An FNP can:
- Perform physical exams
- Diagnose conditions
- Order and interpret tests
- Create a treatment plan
- Manage illnesses
- Educate patients
- Provide counseling
FNPs can also prescribe medications, but this can vary across states. For example, an FNP in any of the 28 states where there is full practice authority can work independently and prescribe medication with a doctor’s oversight.
FNPs in 13 reduced practice states may also prescribe medications, but they must have a collaborative agreement with the physician.
While FNPs in 11 restricted practice states may also prescribe medications, they can only do so with physician delegation or supervision.
Practice Settings
FNPs are often employed in:
- Primary care clinics
- Family medicine clinics
- Specialty clinics
- Urgent care centers
- Hospitals
- Public health agencies
- Long-term care facilities
- Home health agencies
- Educational institutions
Specializations
While FNPs are qualified to care for patients of all ages and conditions, they may opt to specialize in:
- Diabetes care
- Occupational health
- Men’s Health
- Integrative Health
- Telehealth
Pathway
Here’s how to become an FNP:
- Get a Nursing degree
A Bachelor of Science degree in Nursing (BSN) is most favorable, though aspiring FNPs may start with an associate degree in Nursing and complete their BSN, MSN, or DNP afterward. Similarly, those who have completed non-nursing degrees may apply for a direct-entry MSN program.
- Pass the NCLEX-RN exam
The NCLEX-RN exam is a requirement to work as a nurse in all states.
- Work as an RN
Nursing work experience can provide you with the knowledge and skills you need to become a competent FNP. While schools only require 1-2 years of experience, it goes without saying that ‘the more, the merrier’.
- Complete an MSN or DNP program
If you like to become an FNP in as quick as two years, your best option is an MSN-FNP degree. Depending on the school, the curriculum requires about 48-49 units and a minimum of 500 clinical hours. Do note that the MSN degree will be replaced by the DNP option by 2025.
A DNP is a terminal degree that takes about 3–4 years to complete. It requires a total of 70-80 credit units and a minimum of 1,000 clinical hours.
While the common entry options include BSN-DNP and MSN-DNP, some DNP programs offer direct admission to ADN-educated RNs. Likewise, they have the option to complete their BSN in order to enter a BSN-DNP program.
- Get Certified
Eligible graduates can sit in for the certification exam offered by the American Association of Nurse Practitioners or the American Nurses Credentialing Center. Once you pass the exam, you can begin working as an FNP in your setting of choice.
Salary
According to ZipRecruiter, the average salary of FNPs in the US is $127,976 a year or $62 an hour. However, some FNPs have been known to make as much as $191,000 a year.
Job Growth
Employment of nurse practitioners in general is expected to skyrocket to 45% this 2022-2032, according to the Bureau of Labor Statistics (BLS).
PA-C
A certified physician assistant is a healthcare professional with an advanced degree. Qualified to provide direct patient care, they work in collaboration with a physician.
The PA-C profession was first established in 1967. Currently, there are more than 178,000 PAs responsible for more than 500 million patient interactions per year.
Duties & Responsibilities
With their generalist medical training, PA-Cs are qualified to:
- Obtain patient histories
- Make patient rounds
- Perform physical examinations
- Diagnose illnesses
- Order and interpret tests
- Develop treatment plans
- Assist in surgery
- Counsel patients
PA-Cs can independently prescribe non-controlled medications. However, schedule II-V controlled medications must be prescribed per their practice agreement with a physician.
Practice Settings
PA-Cs often work in:
- Hospitals
- Doctor’s offices
- Retail clinics
- Community health centers
- Outpatient centers
- Nursing homes
- Correctional institutions
Specializations
PA-Cs can specialize in any (or several) of these fields:
- Anesthesia
- Cardiology
- Dermatology
- Emergency Medicine
- Internal Medicine
- Neurology
- Obstetrics & Gynecology
- Pediatrics
- Surgery
Pathway
Here are the steps to becoming a PA-C:
- Complete a bachelor’s degree program
Applicants must go for a science-leaning program, or a specialized pre-PA program if their university offers it.
- Complete a physician assistant program
A Master’s degree in Physician Assistant Studies has a curriculum that is modeled on medical education. It covers 80-100 credit units, including 2,000 hours of clinical rotation in various disciplines, such as family medicine, internal medicine, pediatrics, and surgery.
There are about 308 PA-C programs in the US, each running for about 27 months or 3 academic years.
- Get licensed
After completing the MA program, the graduate can go ahead and take the Physician Assistant National Certifying Examination offered by the National Commission on Certification of Physician Assistants.
To maintain their license, PA-Cs must undertake continuing education every two years and pass a recertification test every ten years.
Salary
According to ZipRecruiter, the average salary of PA-Cs in the US is $120,212 a year or $58/hour. However, some PA-Cs can earn as much as $177,500 a year.
Job Growth
According to the BLS, the job outlook for PA-Cs from 2023-2033 is 28% or much faster than average. This means that 43,700 jobs are expected to open within the decade to come.
Summary
Generally, FNPs and PA-Cs share many similarities. They are qualified to perform the same duties and responsibilities; they may even work in similar settings. Both have good employment opportunities in the years to come. While FNPs earn more, the salary difference is not that wide.
The difference, however, lies in each profession’s focus. FNPs work with a certain population (infants to adults, in this case), while PA-Cs focus on a specific medical field, such as pediatrics or dermatology.
Another difference lies in the educational pathway. FNPs must go to nursing school and take an MSN/DNP, where they are trained in advanced practice nursing. PA-Cs must complete a Bachelor’s degree and a Master’s in Physician Assistant studies, where they are trained on a curriculum based on medical education.
Practice limitations and restrictions also differ, but these usually are based on state law.