When we seek out medical care—whether that’s for addiction treatment, for ongoing health conditions, or for urgent care—we generally call that “going to the doctor.” But nowadays, many of the experienced clinicians we see hold qualifications other than Doctor of Medicine degrees. Let’s talk about the kinds of providers you’re likely to visit here at Workit Health. Most often, you’ll be in appointments with nurse practitioners and physician assistants.
Nurse Practitioners
- Nurse practitioners’ training and education: Nurse practitioners (NPs) fall under the category of Advanced Practice Registered Nurse (APRN). NPs and other APRNs must have at least a Master’s degree, in addition to the initial nursing education and licensing required for all Registered Nurses. For many NPs, this means they:
- earn a Bachelor of Science in Nursing
- get their registered nursing license
- then go on to also earn a Master’s degree from an NP program
- How can they practice? NPs can treat and diagnose illnesses, prescribe medication, manage chronic and acute conditions, interpret lab results, and advise patients. NPs often specialize in a particular field of medicine.
- How much authority do NPs have to provide treatment? It depends on where you live. In the US, regulations are set at the state level. Depending on the state you’re in, your NP may be fully independent, need to work with the collaboration of a doctor, or need to be under the supervision of a doctor.
- In 27 states, NPs have “full practice authority,” and are not required to be supervised by a physician.
- In 12 states, NPs have “reduced practice authority,” which places some limits on what duties they can perform or requires them to collaborate with a physician to treat patients.
- In 11 states, NPs have “restricted practice authority,” and must be supervised by a physician.
Physician Assistants
- Physician assistants’ training and education: Physician assistants are licensed healthcare providers. PAs have at least a Master’s degree, in addition to their foundational college Bachelor’s degree. For many PAs, this means they:
- earn a Bachelor’s degree (usually in a field related to science or healthcare)
- then go on to also earn a Master’s degree from a PA program
- How can they practice? PAs can treat and diagnose illnesses, prescribe medication (contingent on their state’s regulations), manage chronic and acute conditions, interpret lab results, and advise patients.
- How much authority do PAs have to provide treatment? As with NPs, it depends on where you live and what kind of certification they hold. It can be really complicated, but some of the regulations around how PAs can practice include:
- Needing a co-signature – 20 states require a certain percentage or number of a PA’s charts to be co-signed by a physician
- Ratio requirements – 39 states limit the number of PAs a physician can supervise or collaborate with (so one single physician can’t be on record as supervising hundreds of PAs)
- Authority to prescribe
- PAs are authorized to prescribe Schedule II-V medication in 44 states (remember that buprenorphine is a Schedule III medication)
- PAs cannot prescribe Schedule II medications in 6 states
- In Kentucky, PAs cannot prescribe
- Requirements for collaborative or supervisory arrangement
- In 47 states, PAs are supervised by physicians
- In 2 states, (Alaska and Illinois) PAs work in collaboration with a physician
- 2 states have different and specific regulations. In New Mexico, PAs with less than 3 years of clinical experience and specialty care PA must be supervised by a physician. In Michigan, PAs work under a participating physician.
Medical Doctors
- Medical doctors training and education: Medical doctors go through longer and more intensive education than the other practitioners on our list. They:
- Earn an undergraduate Bachelor’s degree (usually in a field related to science or healthcare or a specific pre-med program)
- Complete four years of medical school to earn their Doctorate of Medicine
- Spend 3-9 years in advanced residency training under the supervision of experienced physicians
- Pass board-certification exams
- How can they practice? MDs can lead medical teams and supervise other doctors, PAs, and NPs. They can treat and diagnose illnesses, prescribe medication, manage chronic and acute conditions, interpret lab results, and advise patients. MDs often specialize in a particular field of medicine.
- How much authority do MDs have to provide treatment? MDs are subject to regulations and licensure requirements that vary from state to state, but they have the authority to practice independently. As long as they complete the training required by the DEA, they can prescribe controlled substances on all schedules.
So who will I see at Workit Health?
Most of the providers who work directly with our members are NPs and PAs, so that is who you will probably see in your video appointments. Each of our clinics also has supervising physicians who are MDs. They supervise and collaborate with the NPs and PAs on their team, so you might encounter them occasionally or see their names included on some of your paperwork. Our Chief Medical Officer, Dr. Justin Coffey, is an MD and neuropsychiatric. He doesn’t usually treat members directly, but he regularly meets with staff from all of our clinics to ensure consistent, high standards of treatment.
I also want to mention the medical assistants (MAs) who will be part of your care team. MAs won’t be the ones providing medical care to you, but they are the people who get on the phone with pharmacies to make sure your prescriptions are honored, who answer a lot of your questions in Medical Chat, and who do vital support tasks like updating medical records.
We’re proud of our team of hard-working NPs and PAs. Along with being well-trained and educated, licensed clinicians, the number one characteristic we look for in our providers is a compassionate, harm-reduction outlook. We are building medical teams that put our members first, and who don’t judge them.
