What is an APP? APP stands for Advanced Practice Providers. They comprise of Nurse Practitioners (NPs) or Advanced Practice Registered Nurses (APRNs), Certified Nurse Midwives (CNM), Registered Nurse Anesthetists (CRNAs), or Physician Assistants (Physician Assistants). These providers are all independently licensed, they are not physicians, but they take on some roles historically performed by physicians such as diagnosing patients and prescribing medications. Both careers are challenging and well-paying. Both NPs and PAs are integral members of a collaborative healthcare group that work intently with physicians. However, the differences between NPs and PAs are further described in this article.
 
NPs study advanced nursing techniques that focus mostly on patient-centered care, therefore, enabling them to pick a patient population to specialize in. This could be pediatrics, geriatrics, acute care, psychiatry, women’s health, or family practice. PAs receive education that tail a medical model; thus, they are considered more disease centered. They too, tend to choose a medical specialty such as emergency medicine, internal medicine, or surgery, to name some. Both require a master’s degree, but NPs are mostly also licensed as RNs beforehand and continuing to become a Doctor of Nursing Practice (DNP) is also an option. NPs practice with physician oversight in 22 states but are allowed Full Practice Authority (FPA) in the other regions, some are even permitted to open their own healthcare business themselves. Likewise, PAs work under the delegation of physicians, but their specific supervision or agreement is mandated differently depending on the state. According to the American Medical Association in 2018, PAs were supervised in 47 states. However, there are also PAs who own their healthcare businesses. Both are currently working towards more FPA.
 
As stated, NPs choose a specialty and usually need to finish 500 of didactic hours and are also required between 500 to 700 clinical hours, or 1,000 clinical hours for DNPs. On the other hand, PAs undergo a generalist training that require 1,000 didactic hours and 2,000 clinical hours. National certification for NPs in their specialty area is done through the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners (AANP) while PAs receive theirs from the National Commission on Certification of Physician Assistants (NCCPA). Recertification is also necessary for both. 
 
No matter what variances there are for both professions, they are both highly qualified. The salaries are also similar and the demands for both are continuously on the rise. APPs are appreciated to bridge the gap that has been caused by the physician shortage. They are also known to be an integral part of healthcare, delivering the care needed to all populations. Moreover, health facilities or institutions favor APPs since they are also cost-effective being that they are paid much lesser than physicians. If you are someone who is contemplating on becoming an APP, I suggest becoming an NP if you are already in the route of the nursing model, or if you already are an RN. Nevertheless, it is also a good option to become a PA and follow the medical model. Whichever choice would be a great accomplishment, just follow what works for your life and what your heart yearns to become. The path to becoming an APP may seem like a lot of effort, and it is indeed. Nonetheless, I am here to tell you that it is worth it.
 
 
About the Author
Tricia Alegado, FNP-C, CNOR


Tricia has been an APPAA contributor since 2020. She has over 15 years of experience as a registered nurse and 2 years of experience as a nurse practitioner.