This paper presents an analysis of the similarities and differences between nurse practitioners and physician assistants with respect to their functions, responsibilities, and legal obligations. The starting point for the paper is a review of the history of both professions and their evolution to their current status. Next is a discussion of the similarities and differences between the positions of a nurse practitioner and a physician assistant, as well as their entailing responsibilities, both from a patient and a legal perspective. In most respects, nurse practitioners and physician assistants, especially in urban areas, carry the same duties and responsibilities. However, in rural areas, differences between nurse practitioners and physician assistants are more prominent. This paper highlights both the similarities and differences between the two professions within a historical perspective and includes observations relating to the future of these professions.
The first nurse practitioner demonstration project, in 1965, was used to "determine the safety, efficacy, and quality of a new mode of nursing practice designed to improve health care to children ... and to develop a new nursing role--that of the pediatric nurse practitioner" (Ford & Silver, 1967, p. 43). Nurse practitioner programs were given a boost by the Nursing Act of 1964 (PL 92-158), Title II of the 1968 Health Manager Act (PL 92-158), and the Nurse Training Act of 1975 (PL 94-63). These acts provided monies for advanced nurse training and the establishment of practitioner programs (Levine, 1977, p. 1799).
In the 1970s, as the nurse practitioner movement gained momentum and programs proliferated, a number of the professional organizations, both nursing and medical, set about the task of developing scope-of-practice statements and guidelines for educational preparation. The American Nurses' Association took the lead in developing program guidelines and sco...