What’s in a Title: Different Types of Healthcare Providers & What They Do

When we think of healthcare providers in America, we often think that healthcare establishments revolve around the expertise of a medical doctor (M.D.). However, there are many different types of professionals who are qualified to oversee your health and wellbeing, especially in the primary care setting.

Choosing an experienced primary care physician is an important decision that can be both intimidating and confusing. In your search, you will probably come across providers who have different titles and hold different licenses and certifications that you may not fully understand.  For example, what is the difference between an M.D. and a D.O.?  Is a nurse practitioner (N.P.) or a physician's assistant (P.A.) qualified to manage your care? To help clear up the confusion, we have outlined the differences between the various types of providers you may encounter. 

Medical Doctor (M.D.) vs. Doctor of Osteopathic Medicine (D.O.) 

When we think of a doctor or physician, we typically think they are all M.Ds. Many are not familiar with the term "doctor of osteopathic medicine." Both M.Ds. and a D.Os. are licensed physicians that have similar pathways to becoming board certified doctors, but the difference is their perspective and management of care. 

An M.D. follows an allopathic system of care, which focuses on medicine and surgical interventions to treat illness and disease, whereas a D.O. is trained using an osteopathic approach to care, which focuses on the whole person rather than just treating specific symptoms and disease. 

Although schools differs between an M.D. and a D.O., both can practice in all 50 states, receive similar education and training, and complete residencies in the same hospitals and often work as collaborators and colleagues during their careers. 

M.D. education, training, and board certification

The educational path to become an M.D. consists of:

• Four years of medical school
• Four to five years in a residency program
• One to three years in an optional specialized fellowship program
• Medical license - M.D. students become licensed after passing the USMLE Step 3. Requirements are state-dependent.
• Board Certification - specific to specialties and is voluntary. Requirements dependent on specialty. 

D.O. education, training, and board certification 

The educational path to become a DO consists of:

• Four years of osteopathic medical school
• Extra training in the musculoskeletal system to perform Osteopathic Manipulative Treatment
• One year in a general internship
• Three to six years in a residency program
• One to three years in an optional specialized fellowship program
• Medical License - D.O. doctors can become licensed after passing the COMPLEX-USA Level 3 exam. Requirements are state-dependent. 
• Board Certification - specific to specialties and is voluntary. Requirements dependent on specialty. 

Nurse Practitioner (N.P.) and Physician Assistant (P.A.) 

An N.P. and a P.A. can each work in both the medical office and the hospital settings. With a growing population, better access to healthcare, and many physicians retiring from primary care, these two professions are growing with the number of N.Ps and P.As expected to grow an estimated 45% and 31% respectively over the next 10 years. 

Within these professions, there are a variety of specialties ranging from family care, acute care, mental health, and many specializations in between. The two perform work similar to an M.D. and D.O., with the exception of performing surgical procedures. They are qualified and trained to:

• Diagnose and treat acute conditions
• Order diagnostic tests like X-rays or lab work
• Manage a patient's overall care
• Serve as a primary care provider
• Be board-certified in specialties like family practice or women's health
• Write prescriptions (depending on state)

While N.P. licenses come from a nursing board, doctors and P.As are licensed by a medical board. Another difference is level of access. It is oftentimes easier to get an appointment with an N.P. or a P.A., and they are a more cost-effective option compared to an M.D. or D.O.

Depending on state law, an N.P. can work independently or under the supervision of a licensed physician, while a P.A. must work under a collaborative agreement with a licensed physician. 

N.P. education, training, and board certification

The educational path to becoming an N.P. consists of:

• Bachelor of science in nursing degree (BSN) as well as an R.N. license
• Graduate of a nursing program in desired specialty (length of program is typically 2-5 years)
• 500-800 clinical hours 
• Specialty certification 
• State licensed as an advanced practice registered nurse (APRN) through the board of registered nursing

Although the scope of work is similar for an N.P. and a P.A., they are trained using two different patient care models. The N.P. profession is rooted in the nursing model with a focus on patient care, while the P.A. profession is rooted in the medical model and is more disease-centered. 

P.A. education, training, board certification

The educational path to becoming a P.A. consists of:

• Bachelor degree
• 2000 hours of healthcare and patient care experience
• Graduate from a P.A. program (typically 2 years)
• The second year (clinical year) students typically spend four months in the primary care setting, and one month rotating in other specialities
• Pass the Physician Assistant National Certification Exam (PANCE)
• Optional P.A. Certification, which signifies a higher level of clinical knowledge

When choosing a medical provider, you should look beyond the title and degree. Just because their white jacket doesn’t say M.D. doesn’t mean they are not experienced and qualified to provide excellent medical care.

At Tripment, we believe that healthcare can be done better, and it starts with helping people understand the different types of healthcare professionals that are qualified to manage your health and wellbeing. Contact us to learn more about the services we provide to pair you with a trusted primary care physician, nurse practitioner, or physician's assistant in your area.