Nurse practitioners and physician assistants are advanced healthcare practitioners with similar responsibilities, such as diagnosing illnesses and prescribing medications. However, their training and paths toward certification differ in significant ways. This blog post unpacks the key differences between NPs and PAs to help you determine which career path best aligns with your goals. What Is a Nurse Practitioner? A nurse practitioner (NP) is a licensed clinician who provides comprehensive healthcare to patients of all ages. An NP can work in virtually any healthcare setting, diagnosing patient conditions and prescribing medications. As of October 2022, nurse practitioners have full practice authority in 27 states, meaning that they can practice Read more
Nurse practitioners (NPs) and medical doctors (MDs) spend their days making a difference in people’s lives. Providers in both professions are dedicated to treating patients’ illnesses and injuries with the best available science and acute care techniques. In the U.S. healthcare system (depending on the state), both can serve as primary care provider.
The main difference between a nurse practitioner and a doctor is that NPs undergo less training than MDs—so their responsibilities differ. This blog post outlines the main differences between the education and job description of a nurse practitioner vs. doctor to help you decide which career could be right for you.
What Do Nurse Practitioners Do?
What is a nurse practitioner? A nurse practitioner is a nurse who is focused on providing evidence-based, empathic care to patients. Not only does this type of advanced practice nurse treat acute and chronic conditions—they also focus on preventive and holistic care.
What do nurse practitioners do? The typical responsibilities of nurse practitioners may include: 1
- Recording patient medical histories and performing physical exams
- Administering primary and emergency care to patients
- Creating patient treatment plans, prescribing medications, and monitoring patient progress
- Ordering and administering diagnostic tests
- Educating patients about the benefits of healthy nutritional and exercise choices for disease prevention
- Providing mental health support
In states where nurse practitioners have full practice authority, they are able to act as primary care providers. In fact, according to the American Association of Nurse Practitioners, 89.7 percent of NPs are certified in an area of primary care, while 69 percent actually deliver primary care. The section “Why We Need Nurse Practitioners,” breaks down why this is important.
Key Differences: Nurse Practitioner vs. Doctor
Differences in Responsibilities
Nurse practitioners and medical doctors share many of the same responsibilities. In 22 states and Washington D.C., NPs have full practice authority, which means they can evaluate patients, order and interpret diagnostic tests, create and manage treatment plans, and prescribe medications—all without physician oversight. In the remaining states, nurse practitioners have reduced or restricted practice, which means they must have a medical doctor sign off on certain patient care decisions.2
To become a nurse practitioner and especially to become a primary care physician, you must undergo notoriously rigorous schooling. However, both career paths are also extremely rewarding, and whether you decide to pursue nursing school or medical school, you will be working to improve the lives of others.
One advantage of becoming a nurse practitioner is that students are more easily able to keep working while earning their nursing practitioner degree. Particularly with online graduate nursing programs, it’s very possible to hold down a job while getting your doctoral degree or master’s degree, as online learning programs offer greater flexibility.
In order to become a nurse practitioner, you need to complete the following requirements:
- Earn a Bachelor of Science in Nursing (BSN): Your path to a BSN may vary depending on your prior education, but typically, a full-time BSN program takes four years to complete.
- Pass the NCLEX-RN examination: You must pass this examination to earn your nursing license, which is required for practice as a registered nurse (RN). After licensure, it’s recommended that you gain two or more years of valuable work experience before applying to graduate school; however, program requirements vary.
- Earn a graduate degree: Earn a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) with a nurse practitioner role specialty, such as Family Nurse Practitioner (FNP), Adult Nurse Practitioner (ANP), or others. After your didactic coursework, you must complete a practicum, where you work directly with a preceptor in a clinical setting for several hundred clock hours. Depending on the program you choose, a graduate degree (including the practicum) typically takes two to three years to complete.
- Become a Certified Nurse Practitioner (CNP): You must take a national certification exam through one of the five national certification boards in order to become licensed as a nurse practitioner.
Doctors spend more time in school than nurse practitioners: They attend a four-year medical school, then complete an accredited residency training program. Depending on the area of specialty, the residency takes at least three years.3The steps to becoming a medical doctor include:4
- Earn a bachelor’s degree: Your bachelor’s degree can be in any subject—but medical schools do require a number of rigorous prerequisite courses.
- Take the Medical College Admission Test® (MCAT®): Before applying to medical school, you will need to complete this standardized test.
- Earn a Doctor of Medicine (MD) degree: In this typically four-year program, med students complete coursework and clinical experience that prepare them for the internship and residency.
- Pass the U.S. Medical Licensing Examination (USMLE): Before applying for a medical license, you must pass this three-step test. 5
- Complete residency training: Resident physicians typically spend three to seven years training alongside health practitioners and under the supervision of attending physicians. The first year of residency is called the “internship.”
- Obtain a state license: To practice, physicians must become licensed in their state. Regulations vary from state to-state.
- Earn a board certification (optional): Physicians can become board certified in their chosen specialty.
Both nurse practitioners and doctors can specialize or even sub-specialize in a particular area. Nursing specialties tend to be slightly different than those for MDs. For example, a nurse practitioner may specialize in women’s reproductive health and childbirth as a women’s health nurse practitioner (WHNP) or as a family nurse practitioner (FNP)6, whereas a physician would specialize in obstetrics and gynecology as an OB-GYN.
Common Nurse Practitioner Specialties
- Family nurse practitioner
- Pediatric nurse practitioner
- Orthopedic nurse practitioner
- Psychiatric nurse practitioner
- Clinical nurse specialist
- Nurse anesthetist
Common Physician Specialties
- Family medicine
- Physical medicine and rehab
- Internal medicine
Work Environment Differences
Physicians typically work in private offices, as well as group practices, clinics, and hospitals.7 Doctors also work in academia and for the government.
Nearly half of nurse practitioners work in the offices of physicians.8 About one-third work in state, local, and private hospitals. NPs also work in outpatient care centers, educational services, and the offices of other healthcare practitioners.
How Do Career Outlooks Differ?
U.S. News & World Report ranks the profession of nurse practitioner as #4 and physician as #5 in its 2020 Best Healthcare Jobs list.
The demand for nurse practitioners is growing rapidly. Employment growth is projected to grow 28.2 percent between 2018 and 2028, with an estimated 53,300 jobs being added during that period. sup9 In 2019, the median base salary for full-time NPs was $115,800. This is significantly higher than the median base salary for RNs, which was $73,300 in 2019.
The estimated growth rate of physician employment is much lower than that for nurse practitioners, but still above average at 7 percent, with an estimated 55,400 jobs being added between 2018 and 2028. (This reflects the fact that physicians greatly outnumber NPs, at 756,800 vs. 240,700 in 2018.) The BLS says that in 2019, the median annual wage for physicians and surgeons was equal to or greater than $208,000.
The Need for Nurse Practitioners
In 2019, the Association of American Medical Colleges projected that the United States will see a shortage of nearly 122,000 physicians by 2032. Since the U.S. population is growing and aging, and as population health issues like obesity and tobacco use are addressed so that people can live longer, the demand for physicians is growing faster than the supply. sup10
It’s possible that nurse practitioners, who can deliver primary care of equal quality at a lower cost than physicians, will help close this gap. Inflexible care models that rely on physicians to deliver primary care are contributing to the fact that a growing number of patients lack access to primary care. sup11
It has long been the vision of nurse practitioners to close this gap. In 1965, assistant professor of nursing Loretta Ford and pediatrician Henry Silver developed the pediatric nurse practitioner role (PNP) at the University of Colorado, suggesting that this role could “bridge the gap between health care needs of children and families’ ability to access and afford primary health care.” sup12
Choosing between a career as a nurse practitioner vs. doctor largely depends on your personal and professional goals, as both roles are highly rewarding positions in healthcare.
The University of St. Augustine for Health Sciences (USAHS) offers Master of Science in Nursing (MSN), Doctor of Nursing Practice (DNP), and Post-Graduate Nursing Certificates designed for working nurses. Our degrees are offered online, with optional on-campus immersions* and an annual interprofessional trip abroad. Role specialties include Family Nurse Practitioner (FNP), Nurse Educator,** and Nurse Executive. The MSN has several options to accelerate your time to degree completion. Complete coursework when and where you want—and earn your advanced nursing practice degree while keeping your work and life in balance.
*The FNP role specialty includes two required hands-on clinical intensives as part of the curriculum.
**The Nurse Educator role specialty is not available for the DNP program.
- Nurse Practitioner Schools, “Nurse Practitioner vs. Doctor (Physician)”: https://www.nursepractitionerschools.com/faq/np-vs.-doctor/
- American Association of Nurse Practitioners, “Issues at a Glance: Full Practice Authority,” Revised Dec. 2019: https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief
- American Medical Association, “Residency program requirements for international medical graduates”: https://www.ama-assn.org/education/international-medical-education/residency-program-requirements-international-medical#
- Association of American Medical Colleges, “The Road to Becoming a Doctor,” Dec. 2019: https://www.aamc.org/system/files/2019-12/Road_to_Becoming_a_Doctor_December%202019.pdf
- Princeton Review, “What Is the USMLE?”: https://www.princetonreview.com/med-school-advice/usmle
- Nursing License Map, “Nurse Practitioner”: https://nursinglicensemap.com/advanced-practice-nursing/nurse-practitioner/
- U.S. Bureau of Labor Statistics, “Physicians and Surgeons,” Occupational Outlook Handbook, last modified April 10, 2020: https://www.bls.gov/OOH/healthcare/physicians-and-surgeons.htm
- U.S. Bureau of Labor Statistics, “Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners,” Occupational Outlook Handbook, last modified April 10, 2020: https://www.bls.gov/OOH/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm#tab-3
- U.S. Bureau of Labor Statistics, “Employment Projections — 2018–2028,” Sept. 4, 2019: https://www.bls.gov/news.release/pdf/ecopro.pdf
- American Association of Medical Colleges, “New Findings Confirm Predictions on Physician Shortage,” April 23, 2019: https://www.aamc.org/news-insights/press-releases/new-findings-confirm-predictions-physician-shortage
- Christopher Kerns and Dave Willis, “The Problem with U.S. Health Care Isn’t a Shortage of Doctors,” Harvard Business Review, March 16, 2020: https://hbr.org/2020/03/the-problem-with-u-s-health-care-isnt-a-shortage-of-doctors
- Keeling, Arlene, “Historical Perspectives on an Expanded Role for Nursing,” OJIN: The Online Journal of Issues in Nursing, May 31, 2015: http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-20-2015/No2-May-2015/Historical-Perspectives-Expanded-Role-Nursing.html