Written by Leila Jade Levi

Leila Jade Levi is a Senior Counsel for Reproductive Rights and Health at the National Women’s Law Center. This article is for educational purposes only. It does not create an attorney-client relationship and shall not be construed as legal advice.

Even before the Supreme Court overturned the constitutional right to abortion with Dobbs v. Jackson Women’s Health Organization, many clinicians who provide abortion care worked for more than one employer and/or in multiple states. Since Dobbs, dozens of abortion clinics have closed, and some clinicians have moved from abortion-ban states to states where abortion access is protected or at least less restricted.¹

As part of this movement of healthcare providers, clinicians may look for employers who would permit them to supplement their skills and income in other settings. For per diem contract employees, this is a common arrangement. For example, a clinician may want to work two days per month at an independent clinic providing abortion care and four days per week in a Federally Qualified Health Clinic providing primary care.

While clinicians may approach employment contracts with a sense that they don’t have much power to negotiate a contract, that is a misconception. Clinicians can and successfully do negotiate their contracts all the time, especially if a clinician is not working full time for the employer. Here are a few pointers you can keep in mind to feel empowered going into such a negotiation.

Get answers in writing. Ask whether an employer has a moonlighting policy. If the employer says that they do have a moonlighting policy, ask for the policy in writing. It is important to also ask any questions about how the policy operates, and, again, obtain the answers in writing.

Know your value. Given the current and projected shortage of clinicians, young clinicians often have more power than they think in contract negotiations.² Clinicians who have recently completed their medical training may be perceived to be more current on various treatments and procedures, and more capable of navigating the legal landscape if in a restrictive state. Ask yourself what value you bring to your employer, and ground yourself in that knowledge to feel confident in negotiating your contract.

Broaden your work in your current workplace. Patients are traveling to obtain abortions, and expanding access to abortion care in a range of medical settings is necessary to meet the demand.³ RHAP has prepared a toolkit directly on this point, specifically for primary care providers who would like to incorporate medication abortion into their primary care practice. If possible, you may ask your current employer to expand the healthcare services they provide to include medication abortion.

The National Women’s Law Center has a project focused on providing assistance and legal information to abortion providers – or clinicians who want to become abortion providers – who face employment or educational issues or barriers. Please contact us at providerintake@nwlc.org and we may be able to assist or put you in contact with a lawyer or an organization who can.

RHAP Resources:

Toolkit For Integrating Medication Abortion in Primary Care

Sources:

1. Rodriguez JO, Beard M. Care gaps grow as OB/GYNs flee Idaho. Washington Post. Published July 25, 2024. Accessed November 21, 2024. https://www.washingtonpost.com/politics/2024/07/25/care-gaps-grow-obgyns-flee-idaho/

2. Spoehr C. New AAMC Report Shows Continuing Projected Physician Shortage. Association of American Medical Colleges. Published March 21, 2024. https://www.aamc.org/news/press-releases/new-aamc-report-shows-continuing-projected-physician-shortage

3. Nadworny E, Simmons-Duffin S. Abortion is becoming more common in primary care clinics as doctors challenge stigma. NPR. Published June 21, 2024. Accessed November 21, 2024. https://www.npr.org/sections/shots-health-news/2024/06/21/nx-s1-4995771/abortion-primary-care-family-medicine

Pharma-free: The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or products. The information in the Insights is unbiased, based on science alone.

Sign-up to Receive Insights Monthly!

If you enjoyed this Insights, sign up to have them delivered to your inbox! Insights are released on the fourth Tuesday of every month!

Sign-up to Receive Contraceptive Pearls Monthly!

If you enjoyed this Insights article, then check out our Contraceptive Pearls! Contraceptive Pearls are monthly highlights focusing on best practices in patient-centered, evidence-based contraceptive care. Read our latest Pearl here. You can sign up to have Contraceptive Pearls delivered to your inbox! Contraceptive Pearls are released on the third Tuesday of every month!