You’re at a medical appointment, and everything is going as expected. Your provider takes your vitals and asks about your medical history. Then you glance at their nametag: They’re a nurse practitioner, not a doctor.
Don’t fret — these providers are very similar, though there are some key differences. Here’s what you ought to know about each.
First, the basic definitions.
A nurse practitioner (NP) has undergone post-graduate education and training in nursing and can perform certain duties that registered nurses (RNs) cannot, like prescribing medicine, ordering tests and making diagnoses.
A doctor (in the US, usually an MD or DO) has completed medical school, residency and often additional training to specialize in a field, like neurology or obstetrics and gynecology.
How does their training differ?
The length and cost of training is a major difference between the two roles. Nurse practitioners must earn a bachelor of science in nursing (BSN) and pass an exam to become a registered nurse. They then go a step further and complete a graduate degree in nursing.
To become a doctor, a person attends medical school and completes some form of residency program, working in a hospital or other healthcare setting for supervised on-the-job training in their chosen speciality. Some fields of medicine, like gastroenterology and cardiology, require additional training. In total, it takes an average minimum of 11 years to become a doctor.
Both doctors and nurse practitioners must pick a specialty, but the process for doing so differs. NPs choose their specialization early, meaning that their education is tailored from the get-go.
Doctors, on the other hand, choose a specialty toward the end of their third year of medical school. Practically, this means doctors are trained on a wider range of healthcare topics than NPs. They can switch to a new specialty if they want, while a nurse practitioner who chooses to do so will need additional education and training.
What can both a nurse practitioner and a doctor do?
Nurse practitioners and doctors perform many of the same duties. They both see patients in the exam room and can make diagnoses. They also both order and analyze labs, create treatment plans and refer patients to specialists. Furthermore, they often collaborate closely.
“I work with two nurse practitioners every day,” says Dr. Jesse Houghton, medical director of gastroenterology at Southern Ohio Medical Center in Portsmouth, Ohio. “They’re an invaluable resource and an extension of my own care. We work very closely and discuss patients every day, often several times.”
How does their work differ?
The two types of practitioners practice a subtle but notable difference in focus. Nurse practitioners take a patient-centric approach centered on disease prevention, patient education and holistic health. Doctors tend to focus on understanding and curing diseases, and spend more time on tasks other than direct patient care, such as attending medical conferences, writing or reviewing research and supervising residents. Nurse practitioners are also more involved in the hands-on aspects of patient care, like moving and lifting patients.
Doctors have more universal autonomy than nurse practitioners. In 22 states and the District of Columbia, NPs can practice as well as prescribe medication independently. In other areas of the US, they work and prescribe under the supervision of a physician. Doctors are authorized to independently practice and prescribe in all 50 states.
It’s also worth recognizing physician assistants (PAs), whose duties significantly overlap with both doctors and NPs. The main differences are that PAs do not have specialty fields and must always work under the care of a physician.
When should you see a nurse practitioner over a doctor or vice versa?
The costs of seeing a nurse practitioner are similar to those of a doctor. A systematic review of 11 clinical trials and 23 observational studies found that health status, treatment practices and prescribing behavior were consistent between nurse practitioners and physicians.
With that said, patients can often see a nurse practitioner sooner than a doctor, which makes them a great resource for urgent issues. “It’s easier to see a nurse practitioner than a doctor, and nurse practitioners are becoming increasingly employed to meet rising healthcare demands,” says Dr. Sean Ormond, an anesthesiologist in Phoenix.
There are some cases in which it’s best to wait for an appointment with a physician. If you have an unclear or complex diagnosis or are seeking experimental treatment, a physician is your best bet. The same is true for complex or invasive surgery, as well as toxic treatments like chemotherapy.
Overall, both providers offer great treatment, particularly in general circumstances. You may prefer one or the other in special cases, but you can expect high-quality and professional healthcare from both.