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What those badges mean: Understanding medical credentials

You’re in the pediatrician’s office, and your child has already been seen by an LPN and a CNA. Who are these people, what training do they have and what are they allowed to do with regards to our health care?

Nurse checking child's ears


  • DO — doctor of osteopathic medicine
  • M.D. — medical doctor

Which one is better? For your family’s healthcare, the DO and M.D. are essentially the same. Both have completed four years of undergraduate studies, four years of medical education and three to seven years of residence training.

M.D.s take the U.S. Medical Licensing Examination, and DOs take the Comprehensive Osteopathic Medical Licensing Examination. In addition, M.D.s and DOs take licensing examinations in the state in which they plan to practice medicine.

What you need to know: If you want a physician or surgeon, then you must look for the DO or M.D. designation.

Physician Assistants

  • PA — Physician Assistant
  • PA-C — Certified Physician Assistant

What they do: Certified physician assistants can prescribe medicine and perform many of the same duties that doctors do. A physician assistant practices under the supervision of an MD or DO, but the doctor need not be present when the PA performs his or her duties.

A PA has a minimum of a bachelor’s degree, and many medical institutions prefer their PAs to hold a master’s degree. Each state has its own license and practice restrictions for PAs, but most require PAs to pass the National Commission on Certification of Physician Assistants certification exam.

What you should know: Do not confuse the highly-trained, licensed physician assistant with a medical assistant, who is trained to support doctors, nurses and PAs with basic administrative and clinical tasks.


Each state has its own regulations regarding nursing — even regarding who can and cannot be referred to as a “nurse.” These are the caretakers you are most likely to encounter in your family’s healthcare:

  • LPN — Licensed Practical Nurse
  • LVN — Licensed Vocational Nurse

An individual can generally become an LPN with one year of training and successful completion of the National Council Licensure Examination-Practical Nurse.

What LPNs can do: An LPN (LVN in California and Texas) cares for patients under the direction of registered nurses and physicians. LPNs can measure vital signs, collect test samples, prepare and administer medicines and injections, assist with personal hygiene and help keep patients comfortable.

  • RN — Registered Nurse

A registered nurse coordinates and provides patient care, including — but certainly not limited to — recording symptoms, administering medicines and treatments, performing and analyzing diagnostic tests and consulting with doctors. An individual can choose one of three paths to become an RN:

  1. The associate degree in nursing (ADN) is currently the most common training for registered nurses. While the ADN is classified as a two-year degree, it may take three or more years to complete.
  2. Graduates of a four-year bachelor of science in nursing (BSN) program have more classroom and clinical hours of study than the ADN grad. An individual with a BSN is professionally degreed and referred to as a “professional nurse.”
  3. A three-year diploma in nursing training program begins with college credit hours in anatomy, chemistry and similar subjects and is followed by intensive nursing classes. Prior to 1996, most RNs were educated at diploma schools of nursing but, as of the year 2000, only about six percent were trained this way.

What you need to know: Any one of these three educational routes prepares a nurse for the national licensing exam (NCLEX-RN) to become a registered nurse.

  • NP-C Certified Nurse Practitioner

A nurse practitioner is a nurse with extensive clinical training beyond that of an RN. Most NP-Cs have master’s degrees, and some hold doctorate degrees. NP-Cs have completed a practitioner training program and taken a certification exam.

What NP-Cs can do: A nurse practitioner can diagnose and treat health problems and, in some states, provide medication.

Nursing Assistants

  • NA — Nursing Assistant
  • CNA — Certified Nursing Assistant

Nursing assistants provide basic patient care under the direction of an RN or LPN. They perform duties such as feeding, bathing and moving patients and changing linens.

A nursing assistant (NA) — or certified nursing assistant (CNA), patient care assistant (PCA) or state-tested nurse aid (STNA) — has typically completed a four- or six-week training course at an online school, community college or vocational institution.

What NAs cannot do: A nursing assistant is not a nurse and does not perform clinical duties.

Bottom line

Read the badges of medical staffers who tend to you and your family. If you see something you don’t understand, question it. Not everyone who wears a badge has the credentials to provide the medical services you need.

More on your family’s health

How to pick a pediatrician
Organize your family’s health information
How to be a good patient

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