NP vs. PA • BY ANNE, PA & CLAUDIA, NP
Nurse Practitioners vs Physician Assistants – Funding, Employment & Opportunities for Growth (Part 3 of 4)
Welcome to Part 3 of our series on comparing the Nurse Practitioner (NP) to Physician Assistant (PA) profession in Canada with a focus of NP vs. PAs in Ontario.
Last updated February 1, 2019. Written by Anne Dang, Physician Assistant and Claudia Mariano, Nurse Practitioner.
In this Article:
- NP vs. PA: Funding & Job Opportunities
- Opportunities for Growth
PA vs. NP – Funding
Physician Assistant Funding – PA funding can come from several different areas: out of physician pocket (whether this is solo physician practice or a group practice where several MDs share cost of hiring a PA), grants from the government, hospital budget, department budget (within a hospital), grants from specialty associations/organizations, and LHIN funding just to name a few. PA jobs can be funded by one source, a combination of the above.
PAs cannot bill OHIP independently (they do not have billing numbers) and according to the Ontario Schedule of Benefits which is a document that outlines how Ontario physicians are paid in a fee-for-service model – a physician cannot bill for the service rendered by a PA unless they had meaningful participation in that patient encounter.
Nurse practitioners work in positions that are funded by the Ministry of Health, and include Community Health Centres, Family Health Teams or Nurse Practitioner-led clinics. The funding for those positions in the community has been relatively stable for a few years as well. So unless someone leaves a stable position, new grads are in waiting to take that position.
NP vs PA – Employment
Physician Assistant Job Outlook – We have seen some growth in the PA profession with regards to jobs, especially for new PA graduates. However, like most publicly funded health care positions, funding and budgeting available for health care impacts availability of jobs. Most employment opportunities are found through networking and internal job postings (many are not listed on public job listing sites like Indeed).
Nurse Practitioners – It is also common for NPs to obtain hospital positions, as there are extended benefits that may be more competitive than community or private settings. These positions may or may not be cut in order to save money in a certain area or to balance a budget. This can occur whenever hospitals cut nurses, as NPs can be part of that too. Hospital positions may also be unionized. Opportunities also exist in LTC, rehab, addiction and mental health facilities, home care, and palliative care.
NP vs. PA – Opportunities for Growth
Physician Assistants can be involved in teaching, research, medical writing, administrative, leadership, advocacy, entrepreneurship and more.
Nurse Practitioners are able to get involved teaching through NP programs which is certainly an area. Many NPs work in long term care, and palliative care. In Ontario, NPs can provide medical assistance in dying, providing very important work to those who choose to end their lives at a certain time. Some palliative care teams have Nurse Practitioners as well.
FINAL NOTES
This article was a collaboration between Anne and Claudia:
Anne is a Canadian Certified Physician Assistant working in Orthopaedic Surgery and Physical Medicine and Rehabilitation in Ontario. She is the founder and a writer at canadianpa.ca. She is long time blogger and web graphic designer, and loves to use social media and tech as a medium to promote medical education and the PA Profession.
Claudia Mariano graduated from the University of Toronto in 1986 with her Honours Bachelor of Science in Nursing. After working in medical-surgical nursing and public health nursing, she returned to U of T and obtained her Master of Science in Nursing in 1992.
In 1999 she graduated from the Primary Care Nurse Practitioner Program, also from U of T. Since that time she has embraced primary care and chronic disease management, working at the East End Community Health Centre in Toronto for 10 years, and for the past 10 years at the West Durham Family Health Team in Pickering. Claudia is a Certified Diabetes Educator and has obtained her certificate in Intensive Smoking Cessation Intervention. She is also a trainer for the Ottawa Model for Smoking Cessation. Her clinical practice is heavily focused on health promotion and self-management of chronic disease.
Claudia is a Past President of the Nurse Practitioners’ Association of Ontario and current NPAO Board member, past Board member of the Association of Family Health Teams of Ontario, current Adjunct Lecturer at the University of Toronto Lawrence S. Bloomberg Faculty of Nursing, and author/editor of ‘No One Left Behind: How Nurse Practitioners are Changing Canada’s Health Care System’.
