Is a nurse practitioner a doctor’s assistant?

No. The NP role, which originated in Colorado in the early 1960s, trained experienced registered nurses to replace doctors in areas where there were no doctors. This “experiment” proved to be so successful and the care the NPs provided proved to be so safe, effective and well-liked by patients that the role of the NP has continued to grow ever since. While NPs still face practice restrictions in some states many states are granting NPs full practice and prescriptive authority so they can provide primary care in the face of looming provider shortages. This is happening in spite of continued resistance by physician organizations who want to keep control over the health care system strictly to themselves. (See my post on this topic: Why NPs Need Full Practice and Prescriptive Authority.)

NPs practice under their own license. They are nurse experts who also practice medicine. NPs practice either independently or in collaboration with a physician, depending on the laws of the state in which they work and the experience of the individual NP. In 23 states, NPs may practice independently without physician involvement. In 28 states, NPs practice under a collaborative agreement with a physician who is available to take referrals or offer consultations at the NP’s request (See the Glossary in my book for more on NP, PA, and MD/DOs scopes of practice and training).

NPs are often confused with PAs (physician assistants). While the two professional groups have similar scopes of practice they are not the same. Historically, in the 60s and 70s the “assistant” role was the model for the evolution of the PA profession. But since that time the PA role - like the NP role - has evolved away from that of strictly an assistant to an independent role - at least in primary care. PAs who work with physicians in specialty practices, like surgery for example, still function in more of an assistant role. PAs, like NPs, are medical professionals whose roles continue to evolve. PAs are formally trained to provide diagnostic, therapeutic, and preventive health care services - sometimes delegated by a physician, sometimes not. They take medical histories, examine and treat patients, order and interpret laboratory tests and x-rays, and make diagnoses. PAs have their own licenses and their own board certification process just like NPs.

The main difference between PAs and NPs is in the philosophy and approach to care. PAs are educated, as physicians are, in the “medical model” of care. NPs, by contrast, are educated in the “nursing model” and trained in both medical and nursing disciplines. While the tasks and functions each performs are often the same their guiding philosophies are somewhat different. One is neither better or worse than the other. In fact, they are complementary but they are not the same. All three professional providers - physicians, NPs and PAs - perform primary medical care and specialty care according to their individual experience, training and expertise. All three groups have a lot to offer patients.

Please see my post It is a Mistake to Call a Nurse Practitioner a Nurse to learn about the various titles and roles of nursing professionals.

<< back to FAQ