OT vs NP vs PA

[spartanguy625]

I'm having trouble figuring out which career I should go into. In less than a year I graduate with my bachelor's and I've took/taking the pre-reqs for:
- Occupational therapy
- Nursing (Accelerated 2nd bachelor's degree) then later NP
- And most of Physician Assistant

Recently I've been looking into Occupational therapy but with experience at an Alzheimer's and dementia unit along with assisted living I'd more like to do Occupational therapy at a hospital. I want to work in a hospital no matter which path I take.

Just curious if anyone has been in the same issue or what are some Pros/Cons for each career in your opinion.

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[Jlady]

y

 

[Makati2008]

I considered doing an NP immersion program. I decided against it primarily because I did not care so much for the medication side of things. I could have done it, but meds are not all that interesting to me. My mom and sis work as NP's. They love their jobs for the most part, but deal with things like Docs not respecting them necessarily or people in general being confused as to what their role is (ie: "what? you are not a doctor? I thought i was seeing a doctor!"). They are paid well, and can have a good work life balance but hospitals generally do not provide that-so I assume its not an issue for you.

PA is in my opinion worse then an NP. PA's are not as regulated, and they must have a doc supervise their work (sign of on their notes, review rx). They have a smaller scope of practice for this reason. An NP can do different things depending on the state, but in my state they could have their own practice if they want. If you move around states, an NP is nicer because it transfers best.NP training is different, encompassing holistic healthcare. Pay rate may be around the same, although NP's can get slightly more because of the independence factor (especially in a hospital setting).

I wanted a career with patients that would allow me enough time with patients and also be independent. I wanted an option to work with both adults and peds. I did not want the hastle or liability of Rx's. I loved that OT's can work in a large varUiety of settings, and that most of their appointments are between 30-60 minutes long. I looked into it a lot, and the other options (NP and PA) will surely involve more daily stress.

In the end, you need to do what you can see yourself doing and desire to do. If you want to be in a more black and white treatment position, go with NP. If you want to be more therapeutic and independent go with OT. Do a job shadow in each for a day, and see what you like. That has been helpful for me.

Worth noting is that OT's i have seen in the hospital never work nights..only days. Also, they seem to have more opportunities (job listings) then NP's do in hospitals.

Absolutely wrong about PAs lol. The scales are equal in pay also going to different states is quite easy I cut a check for that states license and I am done.

Also Nps are not well regulated due to so many direct entry programs springing up.
Also the NPs have less scope than PAs(some Nps cannot even see peds(acnp)) due to them not receiving the generalist training a PA has

 

[ellwoodis]

PA is certainly the best track for the prescriber only track. There's no need to specialize in grad school. Their degree is twice as hard as an NP degree however. They are better respected by the MD's on this site.

NP's however have access to a whole range of administrative and medical review jobs that PA's don't. Nurses have organized into unions in many states and many health care organizations have specific hiring laws that state the NP's must be hired over a PA, all other matters being equal. See Kaiser Permanente CA's jobs postings. Plus, NP's do have that option of prescribing without oversight, which some practices in rural areas prefer.

I will be posting another thread on the OT job market. Please join me there. I can answer questions about the NP profession by messenger too.

 

[Jlady]

Absolutely wrong about PAs lol. The scales are equal in pay also going to different states is quite easy I cut a check for that states license and I am done.

Also Nps are not well regulated due to so many direct entry programs springing up.
Also the NPs have less scope than PAs(some Nps cannot even see peds(acnp)) due to them not receiving the generalist training a PA has

Regardless of direct entry, NP's all have to take the same certification exam. They also have to go through a masters program, which means they need a bachelors degree. Thus, they generally are more educated then a PA but not necessarily. Here is a online excerpt:

"A physician assistant (PA) provides medical care under the supervision of a physician. If you are a PA, you will be able to do most of the duties of a physician, such as diagnosing and treating patients, ordering tests and reading x-rays. You may also be able to prescribe some medications. PAs must usually consult with physicians due to state legal regulations.

Nurse practitioners, on the other hand, usually work independently of a physician and offer a combination of nursing and health care services. Nurse practitioners may have similar duties as a PA, but in all states, nurse practitioners can prescribe medication. It is typical for a nurse practitioner to specialize in one area of medicine."

While I PA can of course make roughly the same it depends. My sis/mom are FNP (so see adult and peds) and they make well over 6 figures each- oh, and that is part time work (2 days per week, the other is 3). One works with a derm MD who prefers NP's over PA's. I work with 5 neurologists who agree. You will also note that a PA cannot write Rx's in all states. I do not believe they can write Rx's for controlled substances such as adderall, which is pretty difficult if working in peds.

Overall they are pretty similar, but to me the most disturbing thing is that a PA does not need a bachelors degree...scary. This is at least why the MD's I work with are not as trusting of them. If they are better trained then an NP, why can't they work independently of a Doctor?

 

[primadonna22274]

Wrong again. PAs have prescriptive privileges in all states and DEA controlled substance authority in most. Many states do still restrict the DEA schedule above II though which is a problem (Adderall and Ritalin are sch II).
Check your facts on aapa.org

Regardless of direct entry, NP's all have to take the same certification exam. They also have to go through a masters program, which means they need a bachelors degree. Thus, they generally are more educated then a PA but not necessarily. Here is a online excerpt:

"A physician assistant (PA) provides medical care under the supervision of a physician. If you are a PA, you will be able to do most of the duties of a physician, such as diagnosing and treating patients, ordering tests and reading x-rays. You may also be able to prescribe some medications. PAs must usually consult with physicians due to state legal regulations.

Nurse practitioners, on the other hand, usually work independently of a physician and offer a combination of nursing and health care services. Nurse practitioners may have similar duties as a PA, but in all states, nurse practitioners can prescribe medication. It is typical for a nurse practitioner to specialize in one area of medicine."

While I PA can of course make roughly the same it depends. My sis/mom are FNP (so see adult and peds) and they make well over 6 figures each- oh, and that is part time work (2 days per week, the other is 3). One works with a derm MD who prefers NP's over PA's. I work with 5 neurologists who agree. You will also note that a PA cannot write Rx's in all states. I do not believe they can write Rx's for controlled substances such as adderall, which is pretty difficult if working in peds.

Overall they are pretty similar, but to me the most disturbing thing is that a PA does not need a bachelors degree...scary. This is at least why the MD's I work with are not as trusting of them. If they are better trained then an NP, why can't they work independently of a Doctor?

 

[theWhat]

Regardless of direct entry, NP's all have to take the same certification exam. They also have to go through a masters program, which means they need a bachelors degree. Thus, they generally are more educated then a PA but not necessarily. Here is a online excerpt:

"A physician assistant (PA) provides medical care under the supervision of a physician. If you are a PA, you will be able to do most of the duties of a physician, such as diagnosing and treating patients, ordering tests and reading x-rays. You may also be able to prescribe some medications. PAs must usually consult with physicians due to state legal regulations.

Nurse practitioners, on the other hand, usually work independently of a physician and offer a combination of nursing and health care services. Nurse practitioners may have similar duties as a PA, but in all states, nurse practitioners can prescribe medication. It is typical for a nurse practitioner to specialize in one area of medicine."

While I PA can of course make roughly the same it depends. My sis/mom are FNP (so see adult and peds) and they make well over 6 figures each- oh, and that is part time work (2 days per week, the other is 3). One works with a derm MD who prefers NP's over PA's. I work with 5 neurologists who agree. You will also note that a PA cannot write Rx's in all states. I do not believe they can write Rx's for controlled substances such as adderall, which is pretty difficult if working in peds.

Overall they are pretty similar, but to me the most disturbing thing is that a PA does not need a bachelors degree...scary. This is at least why the MD's I work with are not as trusting of them. If they are better trained then an NP, why can't they work independently of a Doctor?

Most PAs have a bachelors degree prior and receive quite substantially more clinical hours than an NP. PAs are trained in the medical model, while NPs are not. There is certainly crossover but PAs spend more time focusing in hard sciences. Furthermore, many have worked in a clinical capacity prior to school, not all, but most have.

 

[Jlady]

Guess I am wrong

But still, can anybody tell me why a PA cannot work independently where as an NP can own their own business? Why would this be a federal regulation? A NP does not need the MD checking their work-why would this be?

Since a PA does not need a bachelors, that is less regulated. Many may have one, but you could easily be leaving your healthcare in the hands of someone that does not.

Regardless, I am thrilled to be pursuing something totally different. Good luck with your choice. The best way thing to do is to do your own research, talk to people in your area, do some job shadows with all three, and ask important questions. Find out what is important to you long term.

 

[Makati2008]

Regardless of direct entry, NP's all have to take the same certification exam. They also have to go through a masters program, which means they need a bachelors degree. Thus, they generally are more educated then a PA but not necessarily. Here is a online excerpt:

"A physician assistant (PA) provides medical care under the supervision of a physician. If you are a PA, you will be able to do most of the duties of a physician, such as diagnosing and treating patients, ordering tests and reading x-rays. You may also be able to prescribe some medications. PAs must usually consult with physicians due to state legal regulations.

Nurse practitioners, on the other hand, usually work independently of a physician and offer a combination of nursing and health care services. Nurse practitioners may have similar duties as a PA, but in all states, nurse practitioners can prescribe medication. It is typical for a nurse practitioner to specialize in one area of medicine."

While I PA can of course make roughly the same it depends. My sis/mom are FNP (so see adult and peds) and they make well over 6 figures each- oh, and that is part time work (2 days per week, the other is 3). One works with a derm MD who prefers NP's over PA's. I work with 5 neurologists who agree. You will also note that a PA cannot write Rx's in all states. I do not believe they can write Rx's for controlled substances such as adderall, which is pretty difficult if working in peds.

Overall they are pretty similar, but to me the most disturbing thing is that a PA does not need a bachelors degree...scary. This is at least why the MD's I work with are not as trusting of them. If they are better trained then an NP, why can't they work independently of a Doctor?

Majority of PAs have bachelors and another chunk have Masters and doctorate level degrees so I don't know who is filling your head with lies??? There are old associate level PAs but they are a dying breed.

 

[theWhat]

Guess I am wrong

But still, can anybody tell me why a PA cannot work independently where as an NP can own their own business? Why would this be a federal regulation? A NP does not need the MD checking their work-why would this be?

Since a PA does not need a bachelors, that is less regulated. Many may have one, but you could easily be leaving your healthcare in the hands of someone that does not.

Regardless, I am thrilled to be pursuing something totally different. Good luck with your choice. The best way thing to do is to do your own research, talk to people in your area, do some job shadows with all three, and ask important questions. Find out what is important to you long term.

PA programs are either masters or bachelors programs, whether or not you have a bachelors prior to PA is largely irrelevant as they all take the same board exams and undergo the same clinical training, Why do NPs practice independently? It's largely lobbying, has little to do with qualification IMO. That said, there is a huge need for primary care providers thus independence is a way of helping meet this need. Also the supervision of PAs varies greatly by practice and state, some are verging on independence themselves.

 

[Makati2008]

Regardless of direct entry, NP's all have to take the same certification exam. They also have to go through a masters program, which means they need a bachelors degree. Thus, they generally are more educated then a PA but not necessarily. Here is a online excerpt:

"A physician assistant (PA) provides medical care under the supervision of a physician. If you are a PA, you will be able to do most of the duties of a physician, such as diagnosing and treating patients, ordering tests and reading x-rays. You may also be able to prescribe some medications. PAs must usually consult with physicians due to state legal regulations.

Nurse practitioners, on the other hand, usually work independently of a physician and offer a combination of nursing and health care services. Nurse practitioners may have similar duties as a PA, but in all states, nurse practitioners can prescribe medication. It is typical for a nurse practitioner to specialize in one area of medicine."

While I PA can of course make roughly the same it depends. My sis/mom are FNP (so see adult and peds) and they make well over 6 figures each- oh, and that is part time work (2 days per week, the other is 3). One works with a derm MD who prefers NP's over PA's. I work with 5 neurologists who agree. You will also note that a PA cannot write Rx's in all states. I do not believe they can write Rx's for controlled substances such as adderall, which is pretty difficult if working in peds.

Overall they are pretty similar, but to me the most disturbing thing is that a PA does not need a bachelors degree...scary. This is at least why the MD's I work with are not as trusting of them. If they are better trained then an NP, why can't they work independently of a Doctor?

Guess I am wrong

But still, can anybody tell me why a PA cannot work independently where as an NP can own their own business? Why would this be a federal regulation? A NP does not need the MD checking their work-why would this be?

Since a PA does not need a bachelors, that is less regulated. Many may have one, but you could easily be leaving your healthcare in the hands of someone that does not.

Regardless, I am thrilled to be pursuing something totally different. Good luck with your choice. The best way thing to do is to do your own research, talk to people in your area, do some job shadows with all three, and ask important questions. Find out what is important to you long term.

Well NPs are not independent providers in all states at this time....also to be blunt nursing unions are very very very influential to further their agendas. It's nothing to do with competency because if that were the case 50% of NPs that took a watered down version of step three would NOT have failed.

 

[ellwoodis]

Show me a PA school now that does not require a BA. They require all the premed curricula and often it takes biochem and a 3.5 to get in. Some accept the MCAT. They go for 3 years and have at least 12 clinical rotations. My father used to accredit PA schools. The better PA schools also have MD's running their curricula and their rotations.

NP's,= on the other hand can enter the program with only a BSN and 2 years exp in any nursing setting. Call one of their online programs. They can complete their coursework online with non-proctored exams. They must spend a little over a year with a preceptor who is an RN-NP. There are rarely traveling rotations that makes medical and PA school so hard. With traveling sites, it is inevitable that 1-2 professors will fail you and you'll have to repeat it again. The professors for their curricula are only NP's.

PA's can prescribe C2's in very few states. They can write them and get the supervising MD or NP to sign them. NP's can prescribe for C2's in many states if it's in their scope of practice..

PA's have no union and a very poor national lobby. Nurses are very powerful in all states and HCO's. About 40% of nurses work in administrative areas doing adjudication of claims or quality assurance review. These are cushy well-paid jobs that PA's have little access to.

Guess who does the initial claims review of occupation therapy and has the power to reject the therapy for the insurance co? RN's. State Medicaid boards are also staffed with RN's who audit for waste and fraud by MD's and allied health practitioners.

 

[theWhat]

Show me a PA school now that does not require a BA. They require all the premed curricula and often it takes biochem and a 3.5 to get in. Some accept the MCAT. They go for 3 years and have at least 12 clinical rotations. My father used to accredit PA schools. The better PA schools also have MD's running their curricula and their rotations.

NP's,= on the other hand can enter the program with only a BSN and 2 years exp in any nursing setting. Call one of their online programs. They can complete their coursework online with non-proctored exams. They must spend a little over a year with a preceptor who is an RN-NP. There are rarely traveling rotations that makes medical and PA school so hard. With traveling sites, it is inevitable that 1-2 professors will fail you and you'll have to repeat it again. The professors for their curricula are only NP's.

PA's can prescribe C2's in very few states. They can write them and get the supervising MD or NP to sign them. NP's can prescribe for C2's in many states if it's in their scope of practice..

PA's have no union and a very poor national lobby. Nurses are very powerful in all states and HCO's. About 40% of nurses work in administrative areas doing adjudication of claims or quality assurance review. These are cushy well-paid jobs that PA's have little access to.

Guess who does the initial claims review of occupation therapy and has the power to reject the therapy for the insurance co? RN's. State Medicaid boards are also staffed with RN's who audit for waste and fraud by MD's and allied health practitioners.

It's rare, but University of Washington Medex still does a bachelors option, from what I understand this is getting phased out?

 

[keyboardmouse]

bump

 

[ExceptionalSea]

i realize this is an old discussion that has been revived but...i was under the impression that entry-level PA was graduate level these days, as is OT, and as you need graduate level work to become an NP. so i'll skip that part of the discussion.

anyways, i doubt the OP is still around but these are all very different professions. it all boils down to: do you want to practice medicine or do you want to practice therapy? i agree with another poster that if someone is deciding between these professions they really need to spend time shadowing each of these to figure out for themselves what they like. although these jobs are all in the health care field they're really very different. if someone is unsure between all of these they may not have done their homework enough. for someone who is very sure about themselves and well aware of their strengths and what they would be happy doing, i would think they would easily be able to choose between these options here. i know for me, personally, OT is hands down the winner (which is why i'm on this forum!) my advice for anyone contemplating these different paths is that they really need to take the time to reflect on themselves and learn more about themselves. doing extensive research about the daily activities of each profession will help. living in the real world for a year or two while you strenghthen your grad school applications really doesn't hurt either. it gives you perspective and helps you to realize a job is something you'll be spending a lot of your time at - so will you be happy doing it? at 26 i'm very different from when i was 22.

and for that matter, they say the human brain - prefrontal cortex, specifically - doesn't fully mature until you're about 25! (fact taken straight from my anatomy class and national geographic...not made up) not that you should wait that long to decide, but that you may have a very different understanding of the world and how you fit in it after a couple years.

some people know what they want when they're still in undergrad, or right after, which is totally awesome! sometimes i wish i could have been like that! but if you can't decide, take the time to really think about it. it won't kill you, i promise!

ok, so to end a long-winded post, in the end any job or career will have its pros and cons. there will be fabulous parts and really stupid parts. on an OT forum we will obviously try to convince you to go the OT route...on the PA forum they will try to convince you to go PA route...etc. etc. figure out what you want.

 

[msot4me]

As everyone pretty much said, as an NP you need to first get your BSN. You need to ask yourself, do you maintain a calm attitude in emergency situations? Are you okay with the ideas of working nights and juggling multiple high acuity patients at a time? If you anwsered yes to these then nursing may be the way to go. While OTs deal with sick people, it isn't life or death situations. If you would rather help someone regain/maintain functionality for ADLs then OT fits that. If you would rather take care of/advise someone with medical issues then nursing fits that. The best way to decide is to shadow both if you can. Unfortunately I don't know much about PAs.