From the Guidelines
Both Physician Assistants (PAs) and Nurse Practitioners (NPs) provide safe and high-quality care, with no significant differences in safety outcomes between the two professions, as evidenced by the 2020 report from the American College of Cardiology 1. When evaluating the safety of care from PAs versus NPs, it's essential to consider the individual provider's experience, communication style, and specialty training.
- PAs typically train in a medical model with generalist education before specializing,
- while NPs train in a nursing model and often specialize during their education in areas like family practice, pediatrics, or women's health. Both professionals can diagnose conditions, prescribe medications, order tests, and provide treatment plans, though their scope of practice varies by state. The safety of care depends more on the provider's individual competence, the complexity of the patient's medical needs, and how well the healthcare team collaborates, as highlighted in the 2020 ACC clinical competencies report 1. For routine primary care, preventive services, and management of common conditions, both PAs and NPs demonstrate excellent safety profiles, improving access to care and providing comprehensive clinical care, including diagnosis, management, test ordering and interpretation, procedure participation, patient education, and care coordination 1. In complex medical issues, either provider should appropriately collaborate with or refer to physicians when necessary, which is a key component of safe practice for both professions. Ultimately, the choice between a PA and an NP should be based on the individual provider's qualifications and the patient's specific needs, rather than the provider's title, as both professions play integral roles in the healthcare team, enhancing practice performance, physician efficiency, revenue generation, improved clinical outcomes, and enhanced patient satisfaction 1.
From the Research
Safety of Care from PA vs NP
- The safety of care provided by Physician Assistants (PAs) and Nurse Practitioners (NPs) has been compared in several studies, with results indicating that both provide high-quality care 2, 3.
- A systematic review of 11 studies found that NPs in specialty settings performed as well as physicians in terms of clinical safety and positive patient outcomes 2.
- A comparison of NPs, PAs, and primary care physicians in health centers found no statistically significant differences in quality of care and practice patterns on 7 out of 9 outcomes studied 3.
- Another study found that visits to NPs and PAs in emergency departments shared many similar characteristics, with an increase in NP visits between 2014-2016 4.
- Patient preferences for primary care provider type were also examined, with results indicating that patients preferring physicians cited qualifications and trust, while those preferring NPs/PAs cited bedside manner and convenience 5.
Comparison of PA and NP Care
- Studies have shown that NPs and PAs provide comparable care to primary care physicians in terms of quality and safety 2, 3.
- NPs have been found to match or exceed their physician counterparts in patient education and satisfaction 2.
- PAs and NPs have been shown to have similar practice characteristics in emergency departments 4.
Patient Outcomes and Satisfaction
- Patient outcomes and satisfaction have been found to be similar for NPs, PAs, and primary care physicians 2, 3.
- NPs have been found to provide more health education and counseling services than primary care physicians 3.
- Patients preferring NPs/PAs cited bedside manner and convenience as reasons for their preference, while those preferring physicians cited qualifications and trust 5.