Nurse practitioners and physician assistants often practice medicine just like MDs. Here’s what sets them apart.
If you’ve ever checked out the initials listed after various providers’ names at any medical office, you might have noticed a couple of letters beside the typical MD, also known as a doctor of medicine. Often, nurse practitioners (or NPs) and physician assistants (PAs) also work in settings like family medicine offices or holistic medicine practices, like Parsley Health. While every type of practitioner goes through extensive training to earn their letters, we’re here to clear up any confusion on NPs and PAs.
What is an NP?
A Nurse Practitioner (NP) is a registered nurse who through advanced formal graduate-level education is able to provide a wide range of health care services to patients. NP’s are skilled in the treatment of many common health problems, both chronic and acute. Most graduate NP programs require 1-2 years of experience as an RN, explains Annie Shaltz, NP, a practitioner at Parsley Health. Many NPs advance to doctoral-level education with a PhD or a Doctor of Nursing Practice (DNP).
Shaltz explains that graduate education is 2-4 years depending on the program and focuses on advancing knowledge in topics like research and statistics, evidence-based practice, advanced pathophysiology or disease process, advanced pharmacology, community health, disease prevention, diagnostic reasoning, and healthcare policy. Just like physicians, NPs can assess, diagnose, perform a physical exam, create a treatment plan including diagnostic imaging or prescription medication, and then evaluate the outcomes, Shaltz says. NPs are known for their excellence in patient education and believe in involving patients in their own health care plan. In addition to the didactic work in the classroom and lab, NP education requires between 500 – 800 hours of experience rotating through a variety of clinical settings.
Once graduate education is completed NPs obtain licensure through their state and board certification in their specialty (primary care, family medicine, acute care, psych-mental health, or pediatrics) from one of several national certifying organizations. NPs can be found providing care in a variety of clinical settings.
The Position Statement on Quality of Care of NPs by the American Association of Nurse Practitioners details the abundant literature that supports that NP quality of care is equal to the quality of physician care.
One thing that often makes NPs stand out, Shaltz says, is that nursing is intrinsically holistic—from day one of training, they’re taught to think of the whole person, taking into account a patient’s diet, lifestyle, exercise, culture, work, and how all of those areas may impact health. At Parsley, the emphasis on holistic care goes even further.
What is a PA?
Physician assistants, or PAs, like all medical professionals, also go through years of schooling post-undergrad. Following comprehensive prerequisite courses in biology, science, nutrition, and mathematics as well as over 2,000 hands-on patient care hours, PAs complete an additional 3 years of in-class and clinical training. After the classroom-focused education, the additional training throughout clinical rotations gives them time to train in areas like family medicine, pediatrics, psychiatry, obstetric and gynecology, hospital medicine, and more. Mary Stratos, PA-C, a physician assistant at Parsley Health explains that PA programs tend to get quite competitive, as there are limited programs across the country. The PA curriculum is consistent with a medical school model of education, with a focus on pathophysiology, diagnostic evaluation, and creating an ongoing and appropriate treatment plan.
Just like MDs and NPs, PAs also pursue a specialty and receive additional training on the job or through another program. Stratos, for example, went through additional functional medicine training programs, earning her certification as a Functional Medicine Practitioner through the Cleveland Clinic’s Institute for Functional Medicine, as well as completing coursework with The Kalish Institute for Functional Medicine and The School of Applied Functional Medicine.
Similar to other medical pros, PAs are trained and licensed to do everything from diagnosing a patient, creating and assessing a treatment plan, writing prescriptions, ordering labs for evaluative work-up, and then interpreting those labs to help complete the clinical picture, Stratos says. PAs have a supervising physician, though they still have autonomy over their patients’ care.
NPs and PAs at Parsley Health: Skilled holistic medicine practitioners
Whether your practitioner is an MD, DO (doctor of osteopathic medicine), NP, or PA, every healthcare provider at Parsley Health goes through extensive training in functional medicine before becoming an official part of the team—regardless of their previous training. This additional training involves a 12-week clinical fellowship that includes deep education around topics like the gastrointestinal system, endocrine system, autoimmunity, female hormone health and fertility, cardiometabolic health, and mental health, says Elisa Haggarty, manager of clinical learning and development for Parsley Health.
In addition, practitioners go through learning modules to understand the flow of patient visits, observe in-person case studies done by other providers, and conduct mock case studies themselves, shadowed by a mentoring practitioner, Haggarty explains. They’ll also get scored on these mock cases and will have discussions with their mentor about their performance. Practitioners new to Parsley Health have their mentoring practitioner shadow their patient visits for the first few weeks to ensure care is up to Parsley’s standards.
Potential Parsley providers take a quiz at the start of the fellowship to assess their base knowledge, which they retake at the end of the 12-week program. Throughout the 12 weeks, they also take a weekly quiz on the subject matter, which requires an 80 percent grade or higher.
Throughout the program, each provider will also learn about different labs Parsley conducts, plus when they’re appropriate, how they work, and how to read the results—including reviewing abnormal lab results through a functional medicine lens, Haggarty explains. For example, when testing for diabetes markers, the providers at Parsley have a much narrower range for what’s considered normal and what should be addressed through lifestyle changes, compared to conventional medicine.
“Our practitioners are taught to understand and treat the lifestyle factors that cause 86 percent of diseases,” Haggarty says. “We teach them how to track symptoms back to the root cause.” The fellowship also instructs providers to look beyond the symptoms and examine the health habits the member has been practicing for years, not just in the now, Haggarty says.
This in-depth education for all providers ensures every member at Parsley Health receives the same quality care that helps 97 percent of members see an improvement in symptoms.