Healthcare Access Stalled at Red Cliff Reservation

Underscores Need for Modernized PA-Practice Laws

May 14, 2018

Khou Xiong has been practicing medicine as a PA at Red Cliff Community Health Center in Bayfield, Wisconsin, since 2012. The Red Cliff Community Health Center, a tribal clinic on the Red Cliff Reservation near beautiful Lake Superior, serves tribal members as well as patients in surrounding areas. For most, it’s the only option for healthcare for miles.

The clinic, a Federally Qualified Health Center, offers much-needed support including medical care, pharmacy services, laboratory services, radiology services, physical and occupational therapy, podiatry and chiropractic care, community health services for maternal child health, wellness programs, eye care, and mental health services.

Khou Xiong, Miranda Zuhlke and Colton Skenandore
L-R: Khou Xiong, Miranda Zuhlke, Colton Skenandore, honored during the WAPA-Foundation Annual Awards Dinner

As a Hmong immigrant to Wisconsin, Khou remembers being a child and feeling fearful during times when her family simply had no access to adequate healthcare. To her, it was these vivid memories which lead to her desire to become a PA. She wanted to be a healer and work with people on a personal level while doing her part to improve healthcare access issues in her community.

That’s why the sudden loss of the physician medical director at Red Cliff weighed even more heavily on her. Due to current practice laws in Wisconsin that require PAs to have a collaborating agreement with a physician, the sudden loss of the physician meant the clinic could not continue offering healthcare services to its more than 2,000 patients. For three days, Khou was legally not able to see her patients or offer the care she is trained to provide. Even in simple situations where patients needed a prescription refilled or a minor scrape or burn treated, Khou had to send them to the emergency room that was 30 minutes away. Fortunately, an outside physician stepped in temporarily so the clinic could get back to business as usual, but hiring a new full-time physician took several months.

Red Cliff Community Health Center
Red Cliff Community Health Center

“I love what I do, and I never want to be in another situation where I legally cannot treat and be there for my patients,” said Xiong. “My vision for the PA profession is that one day PAs will be able to work in collaboration with physicians at the site level so that PAs will not lose the ability to provide vital healthcare services.”

This situation can be avoided.

But it will require changes to outdated laws and regulations that can act as a barrier for patients and for the well-trained PAs who are willing and able to provide crucial healthcare to those who need it most.

When PAs, physicians, and other medical professionals can work together to provide quality care without burdensome administrative constraints, they can achieve Optimal Team Practice. One way to achieve this is to remove the requirement for PAs to have an agreement with a specific physician. This will strengthen healthcare teams, expand access to care, reduce healthcare costs, and enable PA Xiong the flexibility to care for her patients regardless of whether she has a formal agreement with a specific physician.

Find out how PAs can contribute to Optimal Team Practice.