Friday, January 22, 2021

Medical profession: Here's who does what

| January 5, 2021 1:00 AM

A report from the Association of American Medical Colleges projects the nation’s growing shortage of doctors could widen to 139,000 physicians after 2030.

That, an aging Boomer population and growing pressure on health care providers due to COVID-19 this year drive increasing reliance on nurse practitioners.

The U.S. has about 300,000 nurse practitioners, or NPs, according to the American Association of Nurse Practitioners. According to their 2015-2016 Bureau of Labor Statistics occupational handbook, employment of NPs is expected to grow as much as 31 percent.

All states license them, but governing rules vary. As reported in The Press on Jan. 2, these “midlevel” health care providers have full practice authority in Idaho and 24 other states, allowing NPs to evaluate, diagnose, order and interpret tests, and prescribe treatments and medications — much like doctors.

How do they compare to doctors, nurses, and physician assistants (PAs)?

Qualifications: NPs typically earn a bachelor’s degree in nursing (BSN) plus a master’s in nursing (MSN) or doctorate in nursing practice (DNP) degrees. In total, that’s six to eight years after high school.

Doctors go to medical school after getting a bachelor’s degree, then a residency, for an average total of 11 years post-secondary. Registered nurses (RNs) complete either a two-year associate’s or four-year bachelor’s degree (BSN) in nursing.

Physician assistants have master’s degrees, with roughly the same amount of schooling as NPs. They can diagnose and treat, but only under doctor supervision. Unlike PAs, in many states NPs can operate their own practices.

Like other practitioners, NPs undergo rigorous national certification, periodic peer review, clinical outcome evaluations and adhere to a code of ethics.

Services: Sometimes autonomously but often in collaboration with doctors and other providers, NPs provide a broad range of primary and specialty healthcare services. NPs may specialize in acute care, family practice, neonatal, women’s health, oncology, pediatrics, psychiatry, cardiac, allergy, dermatology, neurology and other areas. Physician assistants tend to be more generalized, or have a surgical specialty.

While many RNs are excellent front-line health care providers and nursing and licensure standards ensure certain medical knowledge, they are legally forbidden to diagnose or prescribe. Of course, more serious conditions and health care challenges are best handled by fully qualified physicians.

Perhaps what sets NPs apart is an emphasis on the health and well-being of the whole person, compared to the more classic medical model followed by physicians and PAs. NPs are often as focused on health promotion and disease prevention as diagnosis and treatment, apt to guide an overall approach to health.

For more side-by-side comparisons, see and


Sholeh Patrick is a columnist for the Hagadone News Network. Contact her at