‘It’s time to bury the hatchet” and improve the relationships between Physician Assistants (PAs) and Nurse Practitioners (NPs)

Now, in our uncharted era of health care reform, is the time to bridge the gap and bury the hatchet of distrust and superiority between PAs and NPs. Now is the time to turn our collective attention to a unified advanced practice care model that highlights the strengths, training and uniqueness of each profession.

PAs have traditionally had a home in medicine through their medical training approach, but realistically have never been fully accepted within the confines of academic medicine; NPs have historically found refuge in their Nursing background, but in certain arenas have found themselves cast out. Over the past 40 years, the two professions have emerged out of virtual obscurity to now become the number 2 (PA) and number 4 (NP) top jobs in the United States and yet, that prestige notwithstanding, you can easily palpate a recalcitrant perception of competition, distrust, provisional superiority and individual grandstanding between both professions, despite having more in common than not.   

One central point in the ongoing and soon to be historically changing health care reform is the use and training of PAs and NPs. The references to these disciplines in the Affordable Care Act are vast and imply recognition of the contributions of these professionals to the herculean task of providing health care coverage to every American. It is time for the leadership of both disciplines, both at the organizational and the academic level, to unite common resources, establish common practices and standardize common policies that will maintain viability and marketability of each profession. PA and NP leaders should take the bold step of developing and harmonizing a common nomenclature, common practice models, and centralize education and academic training model. The unification between PAs and NPs should be geared towards highlighting the strengths’ of both professions and eliminating competition and professional backlashing. PA and NP educational leaders should collaborate on education and training programs, share and align common resources in an attempt to expand curriculum development, increase clinical site rotations and foster academic growth.  

PAs and NPs have to take each unique professional strength and capitalize on them to promote economic and academic growth. For example, NP's have a strong emphasis on chronic disease management while PA's have excellent surgical skills, these attributes could easily be shared and mitigated in academic development of each profession to where each discipline gets the best of both worlds in their training.   If the two professions can co develop curricular that capitalize on their strengths, a stronger profession of health care delivery can be formulated and initiated.

Traditions are extremely hard to break and this suggestion is tantamount to heresy in some professional circles, but no great change in society has come without criticism. I'm willing to be the greater fool to suggest such radical thinking with the hope that some visionary impression supersedes our present beliefs and lays a foundation for our future.



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