Document ID: ./input/supremecourt_opinions/opinions/19pdf/18-1323_c07d.pdf
Page Number: 27.0

22 

JUNE MEDICAL SERVICES L. L. C. v. RUSSO 

Opinion of BREYER, J. 

lose the privileges for failing to use them.  Doe 6, a board-
certified OB/GYN practitioner with roughly 50 years’ expe-
rience, provides only medication abortions.  Id., at 1308.  Of 
the thousands of women he served over the decade before 
the  District  Court’s  decision,  during  which  he  also  per-
formed surgical abortions, just two required a direct trans-
fer to a hospital and one of them was treated without being
admitted.  Id., at 1309.  That safety record would make it 
impossible  for  Doe  6  to  maintain  privileges  at  any  of  the
many  Louisiana  hospitals  that  require  newly  appointed
physicians  to  undergo  a  process  of  “focused  professional 
practice evaluation,” in which they are observed by hospital
staff  as  they  perform  in-hospital  procedures.  See  Record
2635, 2637, 2681, 9054; Brief for Medical Staff Profession-
als as Amici Curiae 28–29 (describing this practice); cf. Rec-
ord 10755 (requiring an “on-going review” of practice “in the 
Operating Room”).  And it would likewise disqualify him at
hospitals that require physicians to admit a minimum num-
ber of patients, either initially or on an ongoing basis.  See, 
e.g., id., at 9040, 9068–9069, 9150–9153; cf. App. 1193, 1182 
(provider with no patient contacts in first year assigned to 
“Affiliate” status, without admitting privileges). 

The  evidence  also  shows  that  opposition  to  abortion 
played a significant role in some hospitals’ decisions to deny 
admitting privileges.  250 F. Supp. 3d, at 48–49, 51–53 (col-
lecting  evidence).  Some  hospitals  expressly  bar  anyone
with  privileges  from  performing  abortions.  App.  1180, 
1205.  Others are unwilling to extend privileges to abortion 
providers as a matter of discretion.  Id., at 1127–1129.  For 
example, Doe 2 testified that he was told not to bother ask-
ing for admitting privileges at University Health in Shreve-
port because of his abortion work.  Id., at 383–384.  And Doe 
1 was told that his abortion work was an impediment to his
application.  Id., at 1315–1316. 

Still other hospitals have requirements that abortion pro-
viders  cannot  satisfy  because  of  the  hostility  they  face  in