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Contracts can restrict medical practice

Physicians do not have to perform certain procedures that conflict with their religious beliefs under federal conscience protection rules enacted over 40 years ago. Religious hospitals may also have contracts restricting doctors, for example, from engaging in birth control practices at the hospitals. These employment contracts for medical professionals may also prohibit them from performing certain procedures in other practices.

Many times, these prohibitions are contained in morality clauses and other restrictions used by religious and nonreligious hospitals and practices that list activities that can lead to the termination of the physician. These clauses are often vague and generally address anything that the physician does that can bring the hospital or practice into disrepute.

Religious-affiliated hospitals use these clauses to forbid certain medical procedures. All employers have also invoked them to sanction doctors who engage in political activity or publish controversial posts on social media.

As health care is increasingly provided by larger entities, such as Catholic-affiliated providers, these restrictions are impacting physicians who want to provide birth-control or perform abortions in side jobs or at unaffiliated clinics. According to a 2016 report on hospital consolidation, the number of Catholic-owned or affiliated hospitals rose by 22 percent between 2001 and 2016 even though the total number of those facilities fell by six percent.

Outpatient physicians, in particular, engage in part-time work. These restrictions often interfere with a physician's own personal beliefs or the care they want to provide. Many clinics who rely on part-time practitioners have difficulties finding physicians.

Legally, it is difficult to overcome these clauses. However, physicians can take steps to diminish their use through negotiations. An attorney can help negotiate and review these contracts.

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