Nurse Practitioners and Physical Assistants

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

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implicit loss of services. Educational programs for physician assistants, many of which are based within university medical centers, will be asked to respond to new service needs. Nurse practitioners are less likely to experience such transitions, since advanced practice nursing already includes clinical specialists who function within subspecialty areas, such as coronary care, and are most often hospital-based. Both the nurse practitioner and physician assistant professions are relatively young. They are allied with the older professions of medicine and nursing. Both professions were developed for similar purposes. Many studies have documented their impact, the quality of care they provide, the cost effectiveness of this care, and patient satisfaction with services from each group. Evaluation of care provided by nurse practitioners and physician assistants suggests that, within their areas of competence, they provide care that is equivalent in quality to that of physicians, with patient support and communication functions perhaps superior to those of many physicians (U.S. Congress, Office of Technology Assessment, 1986). Many settings employ both nurse practitioners and physician assistants, with similar job descripti

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