Differentiating Between Doctors, Medical Doctors (MD), and Physician Assistants
Even with the advancements in healthcare, the roles and responsibilities of healthcare professionals can be confusing. One such scenario unfolded years ago when my son had an upper respiratory infection (URI) and started pulling his ear. Initially, I was inclined to prescribe antibiotics, a common practice at the time. However, my wife, who is a medical doctor (MD), suggested seeing a pediatrician for a proper assessment.
Our regular pediatrician was not available, so we turned to her partner, a physician assistant (PA) named Mary Poppins. Despite being efficient and highly professional, her approach was markedly different. Within minutes, she determined that we should not jump to antibiotics without a proper diagnosis. This interaction stood out as a stark contrast between the training and scope of practice of a physician (MD) and a physician assistant (PA).
Understanding the Roles of Physicians and Physician Assistants
A physician, or medical doctor (MD or DO), undergoes extensive training, including four years of undergraduate education, four years of medical school, and a residency program. After passing various state exams, they obtain a state license to practice medicine. This confers the title of 'Doctor' and represents approximately 13 years of formal education after high school.
In contrast, a physician assistant (PA) typically has an undergraduate degree and undergoes approximately three to four years of specialized PA school training. Although PAs receive a thorough practical education, it is not as intense and extensive as that of a medical doctor. Most states require PAs to work under the supervision of a physician.
Scope of Practice and Supervision
PAs often see patients independently in clinics but must be supervised by a physician, either in the same clinic or nearby. As for Nurse Practitioners (NPs), they hold degrees in nursing and can practice independently, making decisions and managing patients' care. However, both PAs and NPs must consult with physicians for cases that fall outside their scope of practice.
Academic Background and Salaries
A PhD, or Doctor of Philosophy, is often undertaken after a medical doctorate but can also be obtained in various fields. In healthcare, medical doctors like myself use the title ‘Doctor’ as we have completed medical school and have gained the necessary qualifications to do so. My official title is Dr. Mark Johnson, M.D., and I specialize in internal medicine and provide primary care for adults.
Physician Assistants (PAs) have studied medicine for about three to four years after obtaining a bachelor’s degree. They are trained to diagnose and treat medical conditions, order diagnostic tests, and manage pharmacotherapy. While highly skilled, the salaries of PAs are generally lower than those of medical doctors, sometimes as low as two-thirds of what a medical doctor earns. Nurse Practitioners (NPs) have their own salary schedules but typically earn less than medical doctors as well.
Despite the differences in their educational backgrounds and salaries, medical doctors, PAs, and NPs share a common goal: to provide high-quality care to their patients. Throughout my career, I have had the privilege of working with many talented and compassionate PAs and NPs, and I have always appreciated their contributions to the healthcare team.
Whether it's a PhD researching viruses and human cancer mechanisms, or a PA providing direct patient care, each professional plays an essential role in the healthcare system. Understanding the distinctions between these roles can help ensure better access to quality care for patients in need.