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Difference Between Advanced-Practice Providers and Physicians

Different paths in medicine

What are advanced-practice providers (APPs)? What is the difference between advanced-practice providers and physicians? To be honest, many physicians don’t even know the difference. If you’re considering a career in medicine, it would be negligent of you to fail to research and understand the role of APPs.

Physician assistants, nurse practitioners, nurse anesthetists, nurse midwives and clinical nurse specialists all fall under the category of APPs. APPs have historically gone by other names such as non-physician providers, mid-level providers, physician extenders, associate providers, allied-health providers. These other titles, however, are not accepted by the APP community and often times do not accurately reflect the role that APPs play in the healthcare system. So if you interact with any of these types of providers, call them APPs or by their actual title (physician assistant, nurse practitioner, etc).

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How do their roles different from physicians? This is a tricky question because it can often differ by state. Nevertheless, here are some ways to keep it simple.

  1. They have prescribing privileges, included controlled substances, in all 50 states
  2. They have responsibilities that often overlap or are similar to resident physicians
  3. Many states allow APPs to practice independently without a collaborative physician

Similar to resident physicians, they can see patients independently under the oversight of a supervising physician. They diagnose and evaluate patients, order tests, interpret data, and treat patients. They can perform in-office procedures and assist in surgery. They commonly work hours that are similar to registered nurses such as 3-4 12-hour shifts per week as an inpatient provider or 5 8-hour shifts per week as an outpatient provider.

The way to become an APP is difference based on the type of degree that you are pursuing. To become a physician assistant, you need to go to physician assistant school after getting an undergraduate degree which is usually 3 years long. To become a nurse practitioner, you need at least a master’s degree in nursing along with an undergraduate degree with clinical nursing experience. After you finish your schooling as an APP, you can jump start into clinical practice without doing residency or fellowship while still making a very competitive salary. Nevertheless, one-year fellowships are becoming more common especially for APPs that want to provide more subspecialized care.

Therefore, the length of training for APPs can be as short as 6 years (a bachelor’s degree and a master’s degree). This is very different from physicians who all have to get an undergraduate degree, go to medical school and finish residency to practice medicine (usually a minimum of 11 years). Based on the length of training alone, it’s no secret why many people who want to become healthcare providers are choosing the APP route.

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Since I never went to PA or NP school, I cannot make direct comparisons about the type of training that we receive. However, based on working with APPs so far, I would say the biggest difference between an APP and a full-fledged attending physician is still scope of practice. Most APPs still need a collaborating physician as part of their practice. If you are absolutely set on practicing completely independently, the APP route is likely not for you. Otherwise, if you are interested in becoming a healthcare provider, becoming an APP might be the route for you. You will need to carefully consider the risks and benefits of both including length of training, scope of practice, lifestyle, and compensation prior to deciding which path you want to take.

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Edward Chang

Edward Chang is the Co-founder and Director of Operations of ProspectiveDoctor.com. He graduated from the David Geffen School of Medicine at UCLA and is currently a urology resident at the University of Washington. He also attended UCLA as an undergraduate, graduating with a major in Molecular, Cell, and Developmental Biology. If you are interested in contributing to ProspectiveDoctor.com, please contact him at edwardchang@prospectivedoctor.com. Follow him on Twitter @EdwardChangMD and Prospective Doctor @ProspectiveDr.

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