Nurse Practitioner vs. Doctor: In-Depth Career Comparison

Written By: Julie Monroe BSN, RN

Healthcare has been changing rapidly over recent decades. With these changes have come new models for providing patient care. While physicians still hold a crucial role in the practice of medicine, the rise of nurse practitioners is helping to fill a gap that is present in the healthcare system, especially within primary care. The roles of these two groups, nurse practitioner vs doctor, however, are fundamentally different. They require different education tracks and result in different approaches to illness, health, and patient interaction. In this article, we will look at the similarities and differences between these two types of healthcare providers. By parsing these out point by point, you will gain a clearer understanding of whether becoming a nurse practitioner or a doctor is the better option for you based on your educational and career goals.

What is a Nurse Practitioner (NP)?

Nurse practitioners are advanced practice nurses who have passed licensing exams after completing a Masters of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) degree. There are multiple nurse practitioner tracks available and licensing is based on these specializations and specific patient populations. The scope of practice for NPs varies from state to state, but in general, they have prescriptive authority and are able to practice healthcare either independently or through collaborative agreements with physicians. Nurse practitioners tend to focus on primary care, which is typically the entry point for patients into the healthcare system and involves day to day care and general illness prevention and health maintenance.

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What is a Doctor (Physician)?

Doctors are trained differently and more extensively than nurse practitioners, which influences the way they practice medicine. They obtain their degrees after graduating from medical school and then typically continue their education via an internship and residency in a specialization. There are two types of recognized physicians in the United States: an MD (Medical Doctor) and a DO (Doctor of Osteopathic Medicine). These both result in basically equivalent degrees, but the foundational premise and philosophies behind their educational paths differ somewhat. Doctors practice both in primary care as well as specialty fields, including various types of surgery.

What are the Key Similarities Between Nurse Practitioner and Doctor (Physician)?

Several key similarities exist when comparing doctors versus nurse practitioners. These include the ability and authority to take patient medical histories, evaluate symptoms, and diagnose diseases. They also both have prescriptive privileges and are able to order and review diagnostic tests for their patients. Both types of providers develop treatment plans for their patients, follow up with those plans, and refer patients out for specialty consults as needed.

What are the Key differences Between Nurse Practitioners and Doctors (Physicians)?

The most obvious difference between nurse practitioners and doctors is the extent of training that each receives. Most doctors complete an undergraduate science or liberal arts degree that is not nearly as focused as undergraduate nursing degrees. Then, they attend four years of medical school which is followed by an internship, residency, and sometimes further fellowships. Nurse practitioners start with an undergraduate nursing degree and then obtain a Masters of Science in Nursing degree, which is usually equivalent to about 2 -3 years of additional study. The end of each career track is at a different level of expertise: nurse practitioners culminate in a master’s degree unless they later choose to pursue a doctorate in nursing practice; medical doctors, at minimum, begin their practice with a doctoral-level degree.

A second key difference is the goal of practice. Nurse practitioners grow out of strong philosophies of nursing, which are rooted very strongly in preventative and holistic healthcare. Nurse practitioners also understand their role to be very much about patient advocacy and patient-centered care. Doctors do not value their patients any less, but their focus is often much more technical, based on the diagnosis and eradication of disease from a clinical and evidence-based scientific standpoint.

The Following is an In-Depth Comparison of Nurse Practitioner vs. Doctor (Physician).

1. Nurse Practitioner vs. Doctor: What Do They Do?

Nurse practitioners take the general knowledge that registered nurses have and, through advanced education, specialize further in a specialty or specific population of care. They often focus on primary care, prevention of disease, holistic healthcare, and patient advocacy. Nurse practitioners routinely examine patients and obtain health histories, order labs and tests, diagnose, and prescribe medications within the specific population of people they are focused on working with.

The duties of doctors go further than those of nurse practitioners and delve more deeply into disease diagnosis and treatment. While some doctors also specialize in primary care, many are trained to parse out complex health diagnoses and devise treatments that require more in-depth education. While nurse practitioners may be trained to do the most basic of procedures at the bedside, surgeons must be educated as physicians first and then complete additional, rigorous training.

Comparison:

One of the biggest differences between doctors and nurse practitioners is expertise and experience. At one time, nurse practitioners were understood to function somewhat as extensions of doctors, similar to physician’s assistants. Over time, though, they have begun to function more fully within their scope of practice and fulfill a role that is separate from but complementary to, the role of doctors. That being said, doctors typically still have more extensive and widespread knowledge and ability to practice than nurse practitioners do.

2. Doctor vs. Nurse Practitioner: Specialization Options

Both nurse practitioners and doctors have different areas where they can specialize. However, specializations for nurse practitioners are still very much rooted in primary care or functioning in general hospitalist roles in acute care settings. Their training, even with specialization, is still typically limited to 3-4 years following completion of their undergraduate nursing degree. When physicians specialize, they undergo 7 to 11 or more years of rigorous in-depth training and education. Their areas of specialization are more specific than nurse practitioner options as well.

3. Nurse Practitioner vs. Doctor: What Education is Required to Become?

Nurse practitioners are considered advanced practice nurses, meaning that they are licensed to provide patient care at a higher level than registered nurses. Nurse practitioners must first obtain a bachelor’s degree in nursing and pass the NCLEX examination to obtain their registered nurse licensure. After completion of their undergraduate degree, they must obtain an MSN in nursing with requisite courses preparing them to sit for the nurse practitioner licensing exams in a chosen specialty. That being said, more and more states are requiring nurse practitioners to hold a doctorate in nursing practice (DNP).

Doctors must start their education by completing a four-year undergraduate degree. If their degree does not include all the prerequisite courses necessary to apply for medical school, they must complete those, as well as pass the medical school entrance exam, known as the MCAT. Next, is completion of medical school, an internship, and a residency program. Some physicians will continue their learning through additional fellowship programs. Fellowships allow them to focus even further on a subspecialty, such as a clinical focus, education, or a specific area of research.

Comparison:

Education for physicians is significantly longer and more intense than training for nurse practitioners. The undergraduate degree required for nurse practitioners is specifically in nursing, while doctors can major in a variety of subjects as long as they complete the necessary courses required for medical school admission. The level of education acquired differs, too, in that physicians are allowed to practice with a doctoral degree, while nurse practitioners can practice with a master’s degree.

4. Doctor vs. Nurse Practitioner: How Long Does It Take to Become?

The time it takes to become a nurse practitioner varies based on whether or not a traditional or accelerated degree path is taken. It also depends on how one initially obtains their registered nurse license. Typically, the total education time will be about 6 -7 years. This includes about four years of undergraduate education to obtain a Bachelor’s of Science degree in nursing, and then approximately two years to obtain the master’s degree in nursing. This timeline can be sped up slightly if one goes through accelerated programs or slowed down slightly if they choose to study part-time instead of full time. For those states requiring a DNP to qualify to become a nurse practitioner, and additional three to four years of education will be required, bringing the total time commitment to ten to eleven years.

The total educational commitment for physicians is substantial and can easily span a decade or more of time investment. They must complete four years of undergraduate education, four years of medical school, and a yearlong internship. These are then followed by a residency, which can vary in length from about three to seven years, depending on the specialty that the doctor is intending to move into. Ultimately, those who wish to pursue the path to becoming a physician can expect a minimum of 12-16 years of education and advanced training.

Comparison:

Nurse practitioners can complete all of their nursing training within six to seven years depending on which specific path to a master’s degree that they take. For physicians, however, the educational path is typically a twelve-year commitment for only the minimum level of training to begin practice. When making the choice to become a doctor vs nurse practitioner, overall time commitment is a very important component to factor into consideration.

5. Nurse Practitioner vs. Doctor: How Much Does It Cost to Become?

The price tag for a master’s degree in nursing and nurse practitioner license can vary significantly, based on several factors. The biggest factor depends on which universities and nursing programs one decides to attend. Typically, it is cheapest to attend in-state public schools. Private or religious institutions are generally much more expensive and can cost tens of thousands more for the same degree. The total cost of being an NP will include undergraduate education, master’s education, and potentially doctoral-level education. The final price for a nurse practitioner education could easily range from $60,000-70,000 on the low end to well over $100,000 on the high end.

The cost to become a physician includes the cost of undergraduate education and medical school and includes a multitude of miscellaneous fees. Tuition costs for students will vary based on whether or not they are state residents for their undergraduate and medical school programs and the quality of the program they are hoping to be admitted to. The total cost of medical education can easily range from almost $200,000 to well over $400,000.

Comparison:

Becoming a nurse practitioner or doctor is not an inexpensive endeavor. There are multiple factors that contribute to high costs, including tuition rates, residency status, type of university, etc. Ultimately, it is much less costly to pursue a nurse practitioner degree, even at the doctoral level, than to attend medical school and become a doctor.

6. Doctor vs. Nurse Practitioner: Coursework

During undergraduate nursing programs, students take classes based on a generalized nursing curriculum. These include courses like pathophysiology, pharmacology, care of the adult patient, care of pediatric patients, and so on. Additional classes in subjects like leadership and ethics are also included. Specialization occurs at the master’s level, and while students will take a few of the same core courses, the bulk of their programs will be targeted at the population they are interested in working with. All MSN students will take basics like advanced pathophysiology and pharmacology, advanced health assessment and so on, but then begin to take classes that are specific to their program track. This specialization becomes even more specific at the doctoral level.

As mentioned earlier, undergraduate degrees for pre-med students can vary widely. However, the program of study during medical school is generally very similar across the board from medical school to medical school. The first two years of medical are typically a mix of didactic learning and lab time. Classes include anatomy, pharmacology, patient assessment, and basic life science courses. The third and fourth years of medical school are clinical focused, where students participate in specialty rotations in the hospital in various departments. Following medical school, students will begin a residency within the specialty they choose. The residency is not so much about coursework as it is about working under the supervision of and learning from more experienced physicians.

Comparison:

Nurse practitioners and physicians are both educated in sciences like anatomy, pharmacology, and pathophysiology. However, nurse practitioners-in-training take classes that are heavily steeped in the philosophy of nursing. Their medical science coursework generally does not delve as deeply as medical students. Coursework for physicians becomes very focused and heavily science-based in the first two years of medical school and then evolves into more hands-on practical training in the last two years and into the residency years.

7. Nurse Practitioner vs. Doctor: Clinical Hours

Nurse practitioners are required to complete a minimum of 500 direct and supervised patient-care hours to sit for licensure examinations. These hours can be split up in different ways and among different populations to achieve the competencies being focused on by the specific program track a student is pursuing. Some students may engage in simulation training or additional clinical hours that go above and beyond this minimum standard.

The amount of clinical experience is really what sets doctors apart from nurse practitioners during school. Doctor spend two full years of medical school completing rotations throughout the hospital and outpatient clinics and then spend three to seven years accumulating more clinical hours during their residency. Clinical rotations in medical school can be demanding, up to 16 hours long. Residencies are also rigorous, with long days. Ultimately, by the time a physician is practicing independently, they have thousands of hours of clinical training hours behind them.

Comparison:

Physicians complete a significantly larger number of clinical hours during training than nurse practitioners do. Hundreds of hours are completed by doctors in med school alone, and then they spend years more gaining further clinical experience. Nurse practitioners must have a minimum of 500 supervised clinical hours to sit for licensure exams, but some may complete more depending on the program they are in and what their particular school requires.

8. Doctor vs. Nurse Practitioner: Certification and Licensure Requirements

Every nurse who wishes to become a nurse practitioner must first hold an unencumbered registered nursing license and a bachelor’s degree in nursing. Next, they must complete an MSN degree and pass the nurse practitioner boards in their specialization track in order to be licensed as an NP. Many schools offer post-graduate tracks as well. This allows nurse practitioners to further specialize and gain certification within a specific population; it also allows those who have an MSN in a non-nurse practitioner track to complete prerequisite courses to sit for NP licensure exams. Nurse practitioner licenses are granted by each individual state, whereas certifications are granted by specific credentialing bodies within each specialty.

Doctors must pass medical board exams throughout medical school; these are known as the USMLE. These exams are broken into several parts and are completed over several years, including after a student has earned a medical doctor degree when finishing medical school. Students will take USMLE Step 1 at the end of the second year of medical school and are tested over the basic health sciences, nutrition, aging, and so on. Step 2 is usually taken in the fourth year of medical school and tests both clinical skills and clinical knowledge. Step 3 of the USMLE is taken after a year of residency and determines whether or not a student is ready to practice unsupervised as a physician. Many doctors will choose to become board certified in their specialty, which ensures that they are extremely knowledgeable and held to a high standard in that specific area of medicine.

Comparison:

Physicians are required to undergo more rigorous examination throughout their medical education than are nurse practitioners. Each are required to hold degrees in their fields and licensure to practice granted by the state that they live in. Both can choose to specialize, usually in a specific type of medicine for doctors and a specific population for nurse practitioners.

9. Doctor vs. Nurse Practitioner: Continuing Education Requirements

Continuing education (CE) requirements for nurse practitioners vary broadly according to state and need to be evaluated on a state by state basis when considering this health care career path. Some states have no CE requirements at all, while other states have very specific numbers of hours that must be completed to maintain an unencumbered license. Furthermore, some states may only require CE hours for nurse practitioners whose licenses give them prescriptive authority.

CE also varies from state to state for physicians. Some states require license renewal on a yearly basis, while for other states, a two-year cycle is used. Like the nurse practitioner requirements, some states do not ask for any additional CE hours each year, while other states have very specific requirements.

Comparison:

Continuing education requirements are different from state to state for both nurse practitioners and doctors. These should be researched and well understood by potential students looking to gain licensure in a particular state.

10. Doctor vs. Nurse Practitioner: Scope of Practice

The scope of practice can vary widely by state and is changing over time as the importance of nurse practitioners in filling a huge healthcare gap is better understood. In some states, nurse practitioners practice autonomously and have broad prescriptive privileges, while these are restricted to varying degrees in other states. Ultimately, nurse practitioners are held to the high standards of nursing and answer to the authority of their state nursing boards.

Nurse practitioners’ practice includes but is not limited to diagnosing and treating disease, educating and counseling patients, consulting, conducting research, and advocating for patients. This can occur in a variety of healthcare settings. However, the fundamental focus of the nurse practitioner is to meet the specific needs of each patient, family, or population they are working with.

There is no set scope of practice that is defined for physicians like there is for nurse practitioners or physicians’ assistants. Rather, the practice of medicine by doctors is governed by medical laws in each state. The responsibilities and privileges of doctors are developed more through credentialing bodies for hospitals, medical associations, specialties, and state and federal laws than through a scope. Physicians, generally speaking, are allowed to perform any duties that fall under the umbrella of medicine, including tasks that would typically be relegated to other health associates and staff.

Comparison:

Doctors have a very broad umbrella under which they can practice medicine. In general, they have the most authority out of all healthcare providers and have widespread privileges and responsibilities that fall within their licenses. Nurse practitioners have greater freedom to practice in their scope of practice compared to registered nurses, but they still have very defined boundaries for what they are allowed to do, even if they are practicing independently from physicians. When deciding to become an NP or doctor, you must consider how important autonomy and freedom to practice is to you.

11. Nurse Practitioner vs. Doctor: Where Do They Work?

Nurse practitioners work in a variety of settings. These range from hospitals and acute care settings, to outpatient clinics, schools, corporate settings, nursing homes, and more. Because they work as part of collaborative teams, nurse practitioners bring significant value to almost every type of health care setting where patient-centered care is emphasized.

Doctors also practice in a wide range of workplaces. Many practice in physician’s offices and private practices, while others work as generalists in the hospital setting. Some do both, spending time in a clinic and then rounding in the hospital to see patients there. Some physicians specialize in and focus more on clinical research than in direct patient care. Finally, doctors are also found working in government positions or in roles such as healthcare administration.

Comparison:

Nurse practitioners and doctors are both able to work in many types of settings and are able to contribute from their educational backgrounds and clinical experience. Many will change jobs throughout their careers, moving from direct bedside patient care to leadership, research, or education.

12. Doctor vs. Nurse Practitioner: Working Conditions & Work Hours

Unlike registered nurses, who work shifts for hourly pay, nurse practitioners are typically paid salaries. Their working hours will depend on the work setting and their particular role. For example, nurse practitioners practicing as hospitalists will often work long shifts. Others, working in clinics or in private practice, may adhere to more of a Monday-Friday, 8-5 schedule. Depending on the setting, nurse practitioners may be required to rotate being on-call for after-hours with fellow colleagues.

Work schedules and conditions for doctors are similar to nurse practitioners and depend on setting and role. Doctors who are working in hospitals typically work shifts but may need to stay longer than normal some days in order to finish rounding and treatment plans on all of their patients. Other doctors may work only eight or ten hours days if they are part of private practice or work in a non-patient care setting.

Comparison:

As with all careers, working conditions can vary broadly for both nurse practitioners and doctors. Conditions will depend on whether or not you work long shifts or within general business hours, what kind of setting you work in, the type of workplace culture, and how well you and your colleagues are able to partner and collaborate.

13. Nurse Practitioner vs. Doctor: Job Outlook

The job outlook for nurse practitioners is location dependent but is still an area of growth overall. Because nurse practitioners are able to fill a gap in healthcare and take far less time to train than medical doctors, they are currently in high demand.

Fewer people are going to medical school than in the past because of its high cost and the substantial-time commitment that is involved. However, as older doctors begin to retire and our population as a whole continues to grow sicker, doctors are needed more than ever to help shoulder the burden of the current healthcare system.

Comparison:

The career outlook and need for both nurse practitioners and doctors are growing because of our aging population. Nurse practitioners can begin their careers much quicker because of the shorter time commitment and their ability to fit in well to our current primary healthcare model. Doctors, however, are still needed to provide the extensive knowledge and expertise required to care for the sickest patients.

14. Doctor vs. Nurse Practitioner: Starting Salary

15. Average Hourly Wage

16. Nurse Practitioner vs. Doctor: Average Annual Salary

Occupation	Annual Salary
NP	$111,840
Doctor	$203,450
(Source: U.S. Bureau of Labor Statistics)

17. Doctor vs. Nurse Practitioner: Salary by Level of Experience

Earning potential between nurse practitioners and doctors is very different. Early on, nurse practitioners out earn doctors, but this doesn’t last very long. Once physicians complete their residency programs, their salaries increase sharply and they continue to make more than nurse practitioners throughout the length of their careers. Annual pay generally increases over time for nurse practitioners, too, but not at the same rate that it does for doctors.

Professional Organizations

The following is a list of Nurse Practitioner Organizations:

American Association of Nurse Practitioners
National Organization of Nurse Practitioner Faculties
American Family Nurse Practitioner
Gerontological Advanced Practice Nurses Association
National Association of Pediatric Nurse Practitioners (NAPNAP)
Association of Advanced Practice Psychiatric Nurses
Nurse Practitioners in Women’s Health
American Academy of Emergency Nurse Practitioners

The following is a list of Doctor (Physician) Organizations:

Association of American Physicians and Surgeons
Association of American Physicians
American College of Physicians
American Academy of Family Physicians
American Medical Association

The Bottom Line - Which Career Path is Right for Me?

When making the choice between a nurse practitioner vs doctor, you must evaluate multiple factors, including time commitment, cost, career outlook, and your overall goals. Nurse practitioners can be trained and ready to practice in much less time and for cheaper than a doctor can. However, doctors are granted far broader privileges than nurse practitioners, including prescriptive authority, types of procedures that can be performed, the extent of treatment plans, and more. In the short run, newly practicing nurse practitioners may make more money than new doctors. This pay scale changes over time, though, and doctors earning potential quickly surpasses that of nurse practitioners.

Ultimately, both nurse practitioners and doctors can have rewarding careers and are not limited to only direct patient care. Their knowledge and expertise allow them to thrive in various kinds of roles and in a vast array of settings. The choice to become one or the other will depend on which aspects of healthcare are most important to you, as well as the resources you are willing to invest to reach your end goal.