By the Letters: MDs, NPs, and PAs

| Posted On Jan 06, 2012 | By:

Has this ever happened to you: you call the doctor’s office to make an appointment with your physician, but he or she is not available; instead, you’re offered an appointment with a nurse practitioner or a physician assistant. “What’s the difference?” you ask. “Can a nurse practitioner or physician assistant take care of me as effectively as my doctor?”

For many people, the answer is “yes.”  At Atrius Health, these providers are a vital part of our team-based approach to care, practicing collaboratively with physician partners. Below, we’ve outlined the medical training for nurse practitioners and physician assistants as well as what services they can provide to you.

Nurse Practitioners (NPs) are independently licensed registered nurses (RNs) with advanced training and certification who provide health care services similar to your physician. The first training program for nurse practitioners was started in1965 in response to a shortage of physicians. To become a nurse practitioner in the state of Massachusetts requires the completion of a master’s program and an APRN certification from a board-approved organization before applying for authorization to practice in Massachusetts. Nurse practitioner’s training focuses on health promotion, disease prevention, empowerment, and education to help patients lead healthier lives.

Nurse Practitioners provide many services:

NPs practice in all 50 states, but the rules and regulations for the scope of their job and prescriptive authority vary by state. In some states, they can have their own practice independent of a doctor.

At Atrius Health, NPs have a supervising MD with whom they collaborate on prescription writing. NPs provide high-quality healthcare for primary care, urgent care, and specialty care.

Physician Assistants (PAs) originated about 45 years ago, too, as a way to integrate highly skilled military/combat medics into the medical community when they returned from Vietnam. A typical training program is 27 months long, including intense classroom studies and clinical rotations. Most students graduate with a master’s degree in primary care and can choose to specialize after graduation. Earning a degree is only the first step: PAs must also earn state licensure, and all states require a PA to pass the Physician Assistant National Certifying Board Exam. To maintain certification, PAs must complete 100 hours of continuing medical education every two years and pass a re-certification examination every six years.

PAs are required to have a supervising physician and to work within mutually agreed upon practice and prescription guidelines to provide health care services similar to those provided by their physician partners. However, a physician assistant can also have a large degree of autonomy depending on his or her experience and the supervising doctor’s practice style.

PAs deliver a broad range of medical and surgical services, including:

Atrius Health employs highly skilled nurse practitioners and physician assistants in primary care, pediatrics, and specialties. Next time you’re offered an appointment with an NP or a PA, you can be assured you’ll receive quality medical care.

Print Friendly, PDF & Email


  1. Well done at explaining about NPs and PAs the preparation and function.
    It would have been even better if you’d include information about the midwives and how we function.
    I look forward to hearing your response.

    Comment by Monica Joyce on January 6, 2012 at 8:49 pm
  2. Hi, Monica. We actually dedicated an entire blog post to nurse-midwives over the summer – please see

    We believe that many misperceptions exist about the role of nurse-midwives in the care of women, and knowing how critical a role our certified nurse-midwives play in the care of our patients at Harvard Vanguard, we wanted to focus a blog post on this topic.

    Thanks for your comment!

    Comment by Harvard Vanguard on January 10, 2012 at 9:36 am

Your email address will not be published. Required fields are marked *