Dr. James Pendergraft makes no apologies for seeing abortion as a service industry and none for marketing his services aggressively. Like any other doctor, Pendergraft says, he went into a profession that he believes in, and it just happens to be profitable as well.

The troubled abortionist James Pendergraft in a local Orlando news broadcast

By Cynthia Barnett, Florida Trend

In the high-decibel atmosphere of abortion in Florida – noisy protests in Melbourne, murders in the Panhandle, acrimonious debates in Tallahassee – the 65 clinics in the state that offer abortion services have operated as quietly as they can. Most are grass-roots operations run by women who are driven by their passion for the cause, rather than the bottom line.

The clinics have kept low profiles amid daunting supply-and-demand statistics: The percentage of gynecologists willing to perform abortions has dwindled from 42% to 33%. More than half of the doctors who do are over 50. Meanwhile, demand has grown: Florida Department of Health statistics show that between 1990 and 1998, the number of abortions performed statewide increased nearly 25%, from 66,073 to 82,235 (the state’s population, by contrast, grew by around 16%).

Enter Dr. James S. Pendergraft, who looks at the numbers from the perspective of both an abortion provider and a shrewd businessman. The 42-year-old Orlando gynecologist has begun to build a chain of high-profile, physician-run abortion clinics throughout Florida. His approach has riled both the low-key providers of abortion and their high-volume opponents. Pendergraft makes no apologies for seeing abortion as a service industry. And none for marketing his service aggressively. “If you want to do a business right, you’ve got to show people you’re proud,” says Pendergraft, who says his pro-choice views were honed during training at Tuskeegee University in Alabama, where he saw women die after back-street abortions. “If I were hiding or hanging my head, women wouldn’t feel proud about coming to me, and they should – this is a moral choice for a woman who does not want to be a mother.”

Pendergraft also isn’t bashful about making money in his line of work. Like any other doctor, he says, he went into a profession he believes in, and it happens to be profitable. In three years, Pendergraft has opened five clinics: two in Orlando, one in Tampa, one in Ocala and most recently the Fort Lauderdale Women’s Center. Next, he plans to expand up the East Coast.

To market his clinics, Pendergraft rents highway billboards. He employs an aggressive public relations agency. He advertises in parts of the state where abortions aren’t easy to come by, and in countries all over the world where they are illegal. His clinics offer services other than abortions, including birth control, which Pendergraft says is his No. 1 priority. But abortions make up some 65% of his income. He will not reveal annual revenues, but says his clinics are “very economically viable.”

There is little question about Pendergraft’s competency as a physician. A board- certified ob-gyn with a specialization in maternal-fetal medicine and high-risk pregnancy, his record with state and national medical boards is spotless. Bulletin boards in his offices are tacked full of hand-written letters from women thanking him for his care and competence during a difficult time.

Pendergraft says access, not money, is his top concern. But his in-your-face salesmanship leaves many – including other clinic operators – uncomfortable. They wonder how much of his professed altruism is just a marketing pitch. Maggie Gifford, a spokeswoman for the Florida Coalition of Independent Abortion Providers, for nearly 20 years has run Alternatives of Tampa, a small abortion clinic that serves mostly lower income patients. Gifford calls Pendergraft, who once worked for her, “a new breed of cat.” She and other Florida clinic operators say every market Pendergraft has chosen was well-served by established clinics. And they say that when Pendergraft opens his doors in a new city, such as Tampa, he drops prices to spur competition. “If you’re going to be the kind of business person where you beat on your chest, do it honestly,” Gifford says. “Don’t say ‘I’m coming in here because there’s a need in this market’ when really the market is oversupplied.”

Pendergraft answers that his prices are competitive, but not predatory. He goes into new markets aggressively, he says, to attract patients who will respond to the level of care in his clinics and spread the word. He says he chooses locations based on evaluations of long-term supply and demand. Moreover, he says, he offers services that most clinics do not, specializing in second-trimester abortions, a procedure most often sought by women who have learned they are carrying a fetus with a severe abnormality.

Pendergraft and the doctors with whom he contracts performed more than 7,000 abortions last year; he says as many as 10% were free or reduced-cost procedures for women with low incomes referred to him by state and national nonprofit agencies. He charges between $335 and $3,600, depending on the length of the pregnancy and any complications.

His expansion mentality is not all about profits, he says, but giving women access to abortion in clinics distinguished by professionalism and the best-trained doctors. “I could have opened one clinic and had plenty of money,” he says. “Money is not the issue. It’s giving the best quality medical care to women.”

A complicated business

The politically charged nature of his work creates management problems for Pendergraft that most business owners probably couldn’t imagine. Some electricians have refused to install lights in Pendergraft’s clinics. Plumbers have declined to fix the sinks. A national advertising company yanked his billboard. Local TV and radio stations have turned down his ad copy. The city of Orlando tried to pull his occupational license. The Marion County Sheriff’s Office and Ocala Police Department fought against letting their officers moonlight for him.

And everywhere Pendergraft opens shop, there are those like Ed Martin, the president of Ocala/Marion County Right to Life, who put their all into shutting him down. They believe Pendergraft is a murderer. And they revile him even more than most abortion doctors because they believe he’s just in it for the money. “He’s got a great press agent,” Martin says, referring to Marti Mackenzie, the president of an Orlando public relations firm, Professional Profiles, which thrives on high-profile clients.

Most clinics routinely fight battles with local governments and protesters. Mackenzie turns Pendergraft’s fights into theater, calling press conferences or faxing statements to the news media at every turn. “The more press he gets, the more free advertising and the more business he gets,” charges Martin.

A self-described “God-loving Christian” with a wife and four kids, Pendergraft is well aware of the animosity his services generate. He keeps his upper body armored in a bulletproof vest. He has but one response for the Right-to-Life crowd: “We’re talking about a woman’s constitutional right,” he says. “Anyone who doesn’t like the Constitution should get the hell out of the country.”

As the grass-roots clinics fought battles in the 1970s and 1980s that allow him to operate now, Pendergraft says, it’s his turn to force governments such as the city of Orlando and the Marion County and Ocala law enforcement agencies to recognize that he’s operating a business that is perfectly legal. As for the critics within his field, he acknowledges being a new breed of cat. But he sees nothing wrong with bringing competition to a medical service that is in high demand. “It is as inappropriate for someone to take me to task as it is for a woman seeking an abortion to be turned down,” he says. “There’s a lot more work out there that needs to be done.”