Nurse Practitioner vs Physician Assistant: Salary, Scope of Practice & More

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Differences between FNPs and PAs fall into three primary areas: work focus, education, and degree of autonomy.

For healthcare workers who want to go beyond nursing, but who do not wish to become doctors, the jobs of nurse practitioner and physician assistant can be excellent options. Both of these positions allow greater responsibility and autonomy than nursing does, while avoiding some of the stressful pressures faced by physicians.

From a patient’s perspective, there may be little apparent difference between a nurse practitioner and a physician assistant. Practitioners, however, know the marked differences that fall into three primary areas: education, degree of autonomy and scope of practice. Understanding these differences can help candidates choose the career that best suits their personality and inclinations.

After choosing a career as a nurse practitioner versus a physician assistant, a candidate must seek the necessary education. After navigating how to compare nursing programs, candidates will find many fine choices, such as an online Master of Science in Nursing program. Also offering post-master’s certificate programs to meet the needs of all healthcare providers, Duquesne University’s online Master of Science in Nursing can provide a springboard to a satisfying healthcare career.

Differences Between Nurse Practitioners and Physician Assistants

A nurse or healthcare professional choosing to further a career as a nurse practitioner versus a physician assistant should understand the differences between the jobs. Each career path has different educational and certification requirements, as well as varying levels of autonomy.

Education and Certification

To obtain the skills they need for their careers, prospective nurse practitioners and physician assistants will follow slightly different paths. To become a nurse practitioner, candidates must:

  • First possess a nursing-related bachelor’s degree, typically a Registered Nurse to Bachelor of Science in Nursing (RN-BSN), but related degrees are sometimes acceptable
  • Obtain state RN licensure by taking an exam, such as the National Council Licensure Examination for Registered Nurses (NCLEX-RN)
  • Complete one to two years of hands-on nursing experience
  • Earn a Master of Science in Nursing
  • Pass a background check
  • Pass a final certification exam upon completion of a master’s degree
  • Complete anywhere from 750 to 2,500 clinical hours, depending on the specialty

To become a physician assistant, a candidate must:

  • First possess a bachelor’s degree in a scientific field, such as physiology, chemistry, mathematics or biology
  • Have some work experience in the nursing field, but RN licensure is not necessary
  • Pass a background check
  • Complete up to 2,000 clinical hours
  • Complete 10 to 12 eight-week rotations in varied medical fields, such as dermatology, emergency medicine or surgery
  • Take and pass the Physician Assistant National Certifying Exam (PANCE)
  • Obtain state licensure to practice

There are differences when comparing the requirements of becoming a nurse practitioner versus a physician assistant. However, beyond these basic requirements, nurse practitioners and physician  assistants will both be expected to pursue continuing education and certification courses as they move through their careers. Like all healthcare professionals, they must keep up with the changing state of scientific and medical knowledge to be effective in their work.


After the education and certification processes are completed, nurse practitioners and physician assistants can launch into their careers. Both types of medical professionals can expect to operate with a high degree of autonomy, but Ryanne Coulson, a certified physician assistant, explains the legal distinctions and regulatory differences between the two roles.

“State medical boards are responsible for licensing PAs within their state. Licensure is built upon the concept of a physician-PA team, with each state outlining the requirements of ‘collaborative’ or ‘supervisory’ relationship,” she says. “Conversely, NPs are considered independent practitioners. The NP scope of practice varies widely based on each state’s regulations, but some states allow for independent practice with full practice authority under the state board of nursing. PAs have no such autonomous state PA boards in any state.”

In plain language, what she’s saying is that physician assistants must team up with a physician who oversees their work. Nurse practitioners, on the other hand, do not have this requirement in most states, so they can operate completely independently in all respects.

In practice, however, the requirement for physician oversight is often less enforced than it may seem. Physician assistants may, for instance, run clinics where no doctors work. A supervising physician may show up once or twice a month to ask questions and make sure all is well — but the rest of the time physician assistants are on their own, just as nurse practitioners would be.

Nurse Practitioner vs Physician Assistant Scope of Practice

The scope of practice for nurse practitioners versus physician assistants differs in work focus. Nurse practitioners are primarily involved with working with patients and placing them at the center of their attention. On the other hand, physician assistants work according to a disease-centered model.

In its simplest terms, this difference can be explained this way:

  • The nursing model looks holistically at patients and their outcomes, giving attention to patients’ mental and emotional needs as much as their physical problems.
  • The medical model places a greater emphasis on disease pathology, approaching patient care by looking primarily at the anatomical and physiological systems that make up the human body.

This difference in focus affects the training and education necessary for nurse practitioners and physician assistants. Nurse practitioners are expected to choose a specific patient population as their primary specialty. Examples include family, pediatrics, geriatrics and women’s health.

Physician assistants, on the other hand, are more likely to specialize in a particular area of medicine, such as emergency or internal medicine. In their work, they will apply this knowledge equally to patients in any population.

Despite these differences, there are also many similarities between nurse practitioners and physician assistants. Both nurse practitioners and physician assistants will complete patient assessments, prescribe treatment and medications, and perform diagnostic tests to determine the health of their patients. Although the essential focus may be different, the ultimate goal of both professionals is to address the patients’ medical needs.

Nurse Practitioner vs Physician Assistant Salary

The annual median salaries for nurse practitioners and physician assistants are not too different from each other. According to the U.S. Bureau of Labor Statistics (BLS), in May 2019:

  • Nurse practitioners earned $115,800
  • Physician assistants earned $112,260

Even though salaries can vary based on medical facilities and years of experience, these figures suggest that there is little material benefit to choosing to be a nurse practitioner versus a physician assistant. Candidates should consider the basic work focus and pick the path best suited to their interests and temperament.

Nurse Practitioner vs Physician Assistant Job Outlook

According to the BLS, nurse practitioner and physician assistant professions are projected to increase about five times the national average for all occupations. The expected job outlook demonstrates a bright future for both careers.

  • Nurse practitioner employment is projected to grow 28% between 2018 and 2028.
  • Physician assistant employment is projected to grow 31% between 2018 and 2028.

Pursue an Online Master of Science in Nursing Degree

As a leader in online nursing education, Duquesne University has helped RNs and advanced practice registered nurses learn skills, strategies and evidence-based practices to become nurse practitioners. The coursework is presented entirely online, so students can maintain their careers and personal lives while pursuing their education goals. Graduates are prepared to successfully complete the American Academy of Nurse Practitioners Certification Board (AANPCB) and the American Nurses Credentialing Center (ANCC) Family Nurse Practitioner–Board Certified (FNP-BC) examinations.

Within the Master of Science in Nursing program, students can choose from six concentrations: Adult-Gerontology Acute Care Nurse Practitioner, Family (Individual Across the Lifespan) Nurse Practitioner, Psychiatric-Mental Health Nurse Practitioner, Executive Nurse Leadership and Health Care Management, Nurse Education and Faculty Role, and Forensic Nursing.

If you are interested in pursuing a career as a nurse practitioner versus a physician assistant, explore how Duquesne University’s online Master of Science in Nursing program can prepare you for a rewarding nursing career.

Recommended Readings

Caring for Patients with Mental Health Disorders

Family Nurse Practitioners Using Differential Diagnoses to Identify and Treat Medical Conditions

FNPs Treating Infectious Diseases



Be a Physician Assistant, “PA vs. NP: A Simple Explanation of the Fundamental Differences” 

CareerBuilder, 3 Differences Between a Nurse Practitioner and a Physician Assistant

The Balance Careers, “What Is a Physician Assistant?”

U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners 

U.S. Bureau of Labor Statistics, Physician Assistants