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Tue, Feb. 25

MDs and RNs are known designations, but what are NPs and PAs?

To most people, the letters that follow the name of a healthcare professional may seem a bit like alphabet soup.

Let's test your knowledge of these medical professional acronyms starting with three professions that most people know: DO, MD and RN. Physicians use "DO" or "MD" after their names to signify "doctor of osteopathic medicine" or "medical doctor," respectively. The letters "RN" following a name indicate the individual is a "registered nurse." But do you know which medical professionals use "NP" or "PA" after their names? Congratulations if you answered "nurse practitioner" for "NP" and "physician assistant" for "PA."

These relatively new healthcare professions were created in the mid-1960s to address a nationwide shortage of physicians. The first NP program focused on pediatrics. Fast-forward nine years and there were 65 pediatric NP programs in the U.S., as well as NP programs specializing in women's health and family health. The founder of the first PA program based the curriculum on his knowledge of the fast-track training of doctors during World War II.

"PA programs are very competitive," said Jeremy Platt, PA-C (certified PA), who works with Harvey G. Thomas, MD, the Quad Cities' only neurosurgeon. "The first year of the program, you're in the same classes as the medical school students, but you finish the courses in one year, rather than two years. PAs then complete one year of clinical rotations in their second year. After that, PAs complete the rest of their training with a physician, if they are going into a specialty."

What role do both NPs and PAs play in the delivery of healthcare? Let's begin with NPs. According to the Arizona State Board of Nursing, Arizona has more than 3,800 active NPs. These licensed NPs work in a variety of medical specialties, including: acute care, adult care, family medicine, geriatrics, pediatrics, psychiatry and women's health. Many also practice in sub-specialty areas, such as immunology, cardiology, pulmonary and rheumatology.

NPs are RNs who have earned a master's degree in order to diagnose and manage many common health problems, both chronic (ongoing) and acute (short term). NPs conduct health histories and physical exams. They also order and interpret tests and X-rays as well as prescribe and manage medications and other therapies. NPs may admit patients to hospitals, skilled nursing facilities and other healthcare facilities. They may refer patients to other medical professionals, too.

"I really enjoy the medical aspect of helping people, especially in cardiology," said Jim Smith, FNP-C (certified family nurse practitioner), who works with Prescott area cardiologist George Rizk, MD. "You can sometimes see dramatic changes during follow-up visits after you've implemented an action plan."

Where will you find NPs? They work in community health centers, hospitals, physician offices and other healthcare facilities. A hallmark of the NP is a commitment to educating patients about their health and promoting preventive healthcare.

Now let's take a look at the role of the PA. Arizona has more than 2,000 PAs, according to the National Commission on Certification of Physician Assistants. Most PA programs offer master's degrees in Physician Assistant Studies or other related degrees.

PA students complete more than 2,000 hours in "clinical rotations" during which they help care for patients. This classroom-clinical combination prepares PAs to work with physicians specializing in emergency medicine, family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry or surgery.

"I'm Dr. Thomas' first assist in the operating room," Platt said. "I also see new patients, organize and establish a treatment plan for new patients, and visit patients in the hospital."

PAs may also conduct physical exams, diagnose and treat illnesses, order and interpret tests, write prescriptions, and counsel patients.

Both NPs and PAs undergo rigorous credentialing. These professions require continuing education as well as re-testing in order to ensure skills and knowledge are current.

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