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Concentra Managed Care

Welcome to the NJ Concentra section of the PRN website. We will be using this site to post information and correspondance for the Concentra physicians. Since this part of our website is not password-protected, only non-sensitive information will be posted here. Any sensitive material will be sent directly to physicians involved in this organizing effort.

The following index will chronicle the documents distributed in conjunction with this organizing efffort. Please click on the date/title that interests you:

Updates:
October 18, 2002: NLRB Grants Concentra's Request for Review
March 8, 2002: PRN brief opposing Concentra's request for review (PDF file)
February 1, 2002: PRN Scores Major Victory With NLRB Decision
January 31, 2002: NLRB Decision: January 31, 2002 (PDF file)

Chronology:
July 27, 2000 - Congratulations Concentra Physicians: PRN files petition with NLRB
July 28, 2000 - Summary of PRN meeting with physicians
August 8, 2000 - Press Release
August 10, 2000 - NLRB Hearing Summary
August 14, 2000 - PRN Response to Dr. Pagano's August 4 Letter
August 17, 2000 - Letter to Dr. Pagano
August 24, 2000 - Petitioner's Brief in Support of Physician Collective Bargaining
August 28, 2000 - Employer's Post-Hearing Brief
August 29, 2000 - Response to Mr. Thomas, President and CEO of Concentra
September 5, 2000 - Letter to Dr. Pagano
September 18, 2000 - Response to "Concentra, You, and PRN" Literature
September 21, 2000 - PRN Brief in Opposition to Concentra's Appeal of NLRB Decision
September 21, 2000 - Letter to Dr. Anderson
September 25, 2000 - PRN Negotiations in Detroit
March 1, 2001 - Letter to Dr. Pagano
September, 2001 - Update
September 28, 2001 - PRN Post-Hearing Brief



July 27, 2000

Congratulations NJ Concentra Physicians!

WHAT’S HAPPENED?

Physicians for Responsible Negotiation (PRN) has taken the important first step that you requested. On Thursday, July 27, 2000, PRN filed a formal Petition for a secret ballot election with the National Labor Relations Board (NLRB).

The Petition advises the NLRB of your desire for a collective bargaining representative and of PRN’s willingness to be that representative. Concentra will get a copy of the formal Petition PRN filed, but it will not get a copy of the Petition you signed.

WHAT’S NEXT?

The NLRB will require Concentra to provide it an updated and accurate list of all of your names and positions so that it can independently determine that the names on your Petition are authentic. The NLRB officials do this and Concentra does not see the Petition you signed. The NLRB keeps your signatures private just to make sure there’s no discrimination or even threats by Concentra over the filing of this Petition. Click here to read Your Rights Under the Law .

After the NLRB authenticates the Petition, the next step is determining who gets to vote in the election. It’s clear that all non-supervisory and non-managerial physicians get to vote, so we hope that Concentra doesn’t try to have a trial over who is a supervisor or manager. If they do, we’re ready and we’ll make sure you all get to vote.

WHEN’S THE ELECTION?

That depends on whether Concentra tries to fight over who is a supervisor. If they fight, the election could be delayed until late September or even October. If they do the right thing and acknowledge that none of you hire or discipline other employees, the election could be as soon as late August. Either way, PRN is ready.

WHEN DO WE START BARGAINING?

We start right after the election! That’s why Concentra may try to drag things out and may try to influence your vote. If Concentra really wanted input from its physicians (which is what it will get at the bargaining table), it wouldn’t leave you out of the decision process every day regarding how many of your patients need physical therapy. PRN has filed this Petition to get you the seat you deserve at the bargaining table - to give you the voice you deserve in the decisions that are affecting how you care for your patients. PRN will be at the bargaining table with Concentra as soon as the election is over. If Concentra thinks it can influence or intimidate you to vote NO , they seriously underestimate you and PRN.






JULY 28, 2000

TO: Concentra Physicians
FROM: Jill Poznick, JD Director of Field Operations
RE: July 27, 2000 Meeting
DATE: July 28, 2000


On July 27, PRN held a meeting to inform physicians about what you can expect now that a formal petition has been filed with the National Labor Relations Board (NLRB).

Administration Reaction

Upon filing of the petition with the NLRB, PRN faxed a letter to Dr. Pagano informing him that we have been selected as the collective bargaining representative by a substantial majority of the non-supervisory physicians employed at the Concentra NJ locations. The letter formally requests that Occupational Health Centers of NJ voluntarily recognize PRN as the representative and begin bargaining. In the event that Occupational Health Centers of NJ is unwilling to expedite the bargaining process through voluntary recognition, PRN is ready to proceed with the election process initiated by the filing of the petition.

Mark Flaherty, PRN’s legal counsel, advised the group that Administration will likely question you about PRN and your involvement with our group. They may approach you and inquire about the issues of concern, the petition that was filed, etc. The Administration has no right to question you about any PRN-related item and you are under no obligation to provide them with any information. PRN recommends that you do not answer any questions about the organizing effort. The Administration does not know and will never know who signed the petition. They simply know that more than 30% of the physicians signed a petition in order to file with the NLRB.

The Administration may begin making promises to certain physicians in exchange for your sympathy. If you hear of such promises being made, please notify PRN immediately as this is an "Unfair Labor Practice" under the National Labor Relations Act (NLRA).

Finally, the Administration may threaten physicians with termination. This is clearly illegal and a violation of the NLRA. Should you experience such threats, please notify PRN immediately so we may file charges against them for "Unfair Labor Practices".

PRN requests that you document any conversations that revolve around questioning, promises or threats by Administration and notify us immediately.

Next Step

The NLRB will set a hearing date immediately. The hearing will probably occur sometime between August 8 and August 14, 2000. The hearing is your employer’s opportunity to contest the unit (i.e. argue that you are supervisors and, thus, ineligible to be represented). PRN will not know if your employer will contest our petition on the scheduled date of the hearing. In anticipation of a hearing, PRN may subpoena some of you to attend the hearing and testify about your job duties or other matters related to your employment. Should we deem it necessary to subpoena you for the hearing, we will work with you in advance to prepare you for the questioning. If you are subpoenaed by PRN, your employer must permit you to be absent from work and provide coverage for your clinic.

We will continue you communicate with you via email. Our website will also have updates.

Thank you for your commitment to PRN.






August 8, 2000
FOR IMMEDIATE RELEASE

NJ PHYSICIAN GROUP SEEKS PRN REPRESENTATION TO ADDRESS CONCERNS WITH CONCENTRA


CHICAGO - Responding to requests from physicians employed by Concentra Managed Care, Inc. in New Jersey, Physicians for Responsible Negotiation (PRN) has filed a petition with the National Labor Relations Board (NLRB) to serve as the collective bargaining representative for the group.

The NLRB will hold a hearing tomorrow to determine which Concentra physicians are eligible to vote on the representation request and to schedule an election. If PRN wins that election, PRN will immediately initiate contract negotiations with Concentra on behalf of the physicians.

PRN is seeking to represent all full-time, non-supervisory, employed occupational medicine physicians at Concentra's 10 New Jersey clinics. Concentra operates the nation's largest network of occupational healthcare centers, managing the practice of approximately 350 physicians located in over 200 centers in 32 states. While only the New Jersey physicians are petitioning for PRN representation, the results of their petition could impact eligible Concentra physicians elsewhere.

"Concentra physicians contacted PRN because they fear some of the company's corporate policies interfere with physicians' ability to properly prescribe services for their patients," said Susan Hershberg Adelman, M.D., president of PRN and a pediatric surgeon from Southfield, Mich. "They have made their concerns known to management, but nothing has changed. Now they believe it is time to take a stand so they can take care of patients in the manner in which they were trained."

If PRN wins the election, the New Jersey physicians' group would become the second local bargaining unit represented by PRN. PRN currently represents physicians employed by the Wellness Plan - a Medicaid HMO - in suburban Detroit. PRN was founded by the American Medical Association last year to offer a professional alternative for doctors seeking help in advocating for patients and quality care.



For more information:
Robert T. Bernat, JD, MD
Executive Director, PRN
312-464-4PRN (4776)





AUGUST 10, 2000

NLRB Hearing Summary

On August 9 and August 10, 2000, the National Labor Relations Board held a hearing in Newark, NJ to determine which Occupational Health Centers of NJ doctors will be entitled to vote.

At the onset, PRN and Occupational Health Centers of NJ agreed to two important stipulations:
  • PRN is a labor organization representing employees; and
  • The appropriate unit will consist of non-supervisory physicians at all 10 NJ clinics operated by Occupational Health Centers of NJ. Other licensed professional employees of Occupational Health Centers of NJ are excluded from the unit.
Occupational Health Centers of NJ then introduced evidence in support of its contention that all physician employees are supervisors and, therefore, ineligible for collective bargaining. Occupational Health Centers of NJ called two witnesses to support this argument. Dr. Pagano testified to many instances of physicians allegedly exercising supervisory authority. He argued that physicians, particularly Center Medical Directors, played roles in hiring staff, evaluating staff, and terminating medical staff. PRN cross-examined Dr. Pagano and poked holes in his arguments with examples of physicians not having meaningful, effective input into the decisions of hiring, evaluating or firing staff.

Occupational Health Centers of NJ also called Mr. Parr to testify. Mr. Parr is the Executive Vice President and General Counsel of Concentra. He also serves as Secretary to the Boards of Concentra Managed Care, Inc. and Concentra Health Services, Inc. Mr. Parr spoke about the "affiliation" between Concentra Managed Care and Occupational Health Centers of NJ. He explained that Occupational Health Centers of NJ is "under common control" with Concentra Managed Care. During cross-exam, PRN sought to prove that the two are separate entities and, thus, Occupational Health Centers of NJ employees can only be considered supervisors over other Occupational Health Centers of NJ employees and there are no instances of such supervisory authority. Any proof of physicians "supervising" Concentra employees is not relevant since they are do not work for the same employer and would not be part of the same bargaining unit.

PRN then called six physicians from Occupational Health Centers of NJ to testify: Dr. Shastry, Dr. Blumenthal, Dr. Chou, Dr. Samuel, Dr. Paz and Dr. Salvo. These physicians refuted every example of supervisory authority and were convincing, articulate and credible. Occupational Health Centers of NJ cross-examined each witness, though they did not get any information to bolster their argument.

Briefs are to be submitted by both parties by August 24, 2000, per an extension requested by Occupational Health Centers of NJ. The NLRB will issue an opinion approximately one week after briefs are submitted (August 31) and an election date will be set at the time the opinion is issued. (We expect an election date around September 28).

We will notify you once a decision has been issued.





AUGUST 14, 2000

PRN Response to Dr. Pagano's August 4 Letter

William G. Pagano, MD, MPH
Regional Medical Director
Occupational Health Centers of New Jersey, P.A. (Employer)
405 County Avenue
Secaucus, NJ 07094

Dear Dr. Pagano:

Your letter dated August 4, 2000 to the Concentra (NJ) Physicians contains two major warnings: 1) the Concentra NJ physicians should give careful thought before "surrendering" their right of "self-representation"; and 2) PRN may make promises it may not keep. When you talk to the physicians, you will find that they have already carefully considered each of these points and have overwhelmingly concluded that collective bargaining can only enhance their present situation.

During your testimony before the NLRB last week, you candidly acknowledged that Concentra tells its customers, "The best case is one where, after a single physician treatment/consult, the employee immediately returns to work with no need for recheck or physical therapy". Though the physicians agree with you, they all know the reality. Concentra does not make money from that "best case" scenario, so Concentra harangues, harasses and threatens clinic staff when their "quality indicators" fall below the company's arbitrarily-imposed "quota." This "one size fits all" approach to the practice of medicine is not what caused the physicians to follow their calling. This strategy is, in fact, so offensive to them that they finally recognized that their one-on-one dealings with Concentra were resulting in rapid erosion of the ethical principles they have all sworn to uphold.

In this context, exactly what concern should they have about loss of self-representation? Until now, self-representation has gotten the Concentra NJ physicians: 1) Noncompetes that make them virtual prisoners to Concentra; 2) "Quality Indicator" quotas that put revenue before patient concerns. Clearly, self-representation has not served them or their patients very well.

We also want to address the warning in your August 4 letter about PRN "promises" that might not be kept. If you ask any of the physicians, you will learn that PRN has made only one promise: When collective bargaining with Concentra starts, we will be their voice to negotiate over every issue they want raised and we will use every lawful means short of a strike to get them the best contract possible. That's the promise and it's the only promise that has been or will be made. And, it will be kept.

Concentra's New Jersey physicians are not deterred, or even concerned about the messages in your August 4 letter. They are puzzled, however, by your claim of a "direct positive relationship" and by Concentra's phobia about collective bargaining.

Thank you for your time. We will be in touch again soon.

Sincerely,
Jill Poznick, JD
Director, Field Operations





AUGUST 17, 2000

Letter to Dr. Pagano

August 17, 2000

William G. Pagano, M.D., M.P.H.
Regional Medical Director
Occupational Health Centers of New Jersey, P.A.
405 County Avenue
Secaucus, NJ 07094

Dear Dr. Pagano:

This letter serves as our advice and warning to you concerning your actions and your violations of important National Labor Relations Board (NLRB) rules. We are certain that Concentra's lawyers have already explained to you the basic NLRB ground rules that are already in effect and have been in effect since PRN filed the Petition for the New Jersey physicians:
  • No promises (this includes a prohibition on solicitation of grievances);
  • No interrogation;
  • No threats; and
  • No spying.
These four NLRB ground rules merely supplement the ever-present prohibition on interference with the physicians' rights to join and support a labor organization like PRN. This means Concentra cannot assign the physicians' new and additional job duties because they have expressed their desire to be represented by PRN. We have been made aware of instances of violations of these NLRB mandates and we will not tolerate further abuse.

First, it has been brought to our attention that you have directed Scott Carey, Center Administrator, to have Dr. Salvo interview all candidates for the vacant Concentra positions at the South Plainfield clinic. The physicians have never had responsibility for the preliminary screening and interviewing of potential Concentra employees nor have they ever had responsibility for supervising Concentra employees. It is a violation of the NLRB rules to impose these new duties as a result of the physicians requesting an NLRB election. Please remember that you testified that you are the physicians' only supervisor, and, as such, you have not yet "ordered" the physicians to conduct these interviews. Unless and until you issue that order, the status quo will continue: physicians will not be interviewing any Concentra employees beyond the minor involvement they had before the Petition was filed.

If you issue an "order", the physicians will comply to the extent of being present at the time of the scheduled interview, advising the interviewee that they have been "ordered" to be present, and will otherwise be generally polite to the interviewee. The physicians will not be able to make hiring recommendations for Concentra employees since these physicians do not work for Concentra and have no basis for determining what Concentra is looking for when it hires its employees. If and when you issue this order, PRN will immediately file charges with the NLRB seeking all available remedies against you and Concentra for this assigning new job duties after the filing of the Petition.

In addition, we have been informed that you and other management representatives are meeting with physicians to "calm things down" and ascertain the groups "issues". As stated above, the NLRB rules prohibit interrogation or solicitation of grievances from the physicians. If you persist in conducting meetings with the physicians where you attempt to question them about their PRN sympathies or the source of their present dissatisfaction, you will hear only silence in response. The physicians will sit through your meetings, as ordered by you, but they will not respond to your unlawful questioning of them. In addition, if you continue this unlawful interrogation, PRN will file all appropriate legal proceedings against both you and Concentra.

Our final advice to you is to listen to Concentra's lawyers and adhere to the important NLRB guidelines. We do not wish to turn this simple NLRB election proceeding into a major lawsuit over your unlawful actions.

PRN will faithfully observe each and every NLRB rule during this election proceeding. If you and Concentra do the same, we will all be at the bargaining table by early October and we can productively address the issues at the core of this organizing effort.

Thank you for your time.

Sincerely,
Jill Poznick, JD
Director, Field Operations





AUGUST 24 and AUGUST 28

The Petitioner's Brief in Support of Physician Collective Bargaining and the Employer's Post-Hearing Brief are detailed on separate pages.





AUGUST 29, 2000

Response to Mr. Thomas, President and CEO of Concentra

Mr. Thomas
Dr. Fogarty
Dr. Anderson
Dr. Pagano
Concentra Health Services
5080 Spectrum Dr. Suite 400W
Addison, TX 75001-4648


Dear Mr. Thomas, Dr. Fogarty, Dr. Anderson, and Dr. Pagano:

When Concentra acquired OccuSystems, it exploited the transition to force unconscionable non-competition and non-solicitation agreements on virtually all of the OccuSystem New Jersey physicians. "Take it or leave" was the unmistakable message. When Dr. Mangahas followed her Hippocratic oath and complained about Concentra physical therapists trying to practice medicine, Concentra corporate refused to renew her contract. "Don't rock the boat" was the unmistakable message. When virtually all of Dr. Mangahas colleagues requested, through Dr. Fogarty, that Concentra corporate reconsider its treatment of Dr. Mangahas, "Shape up or ship out" was the unmistakable message.

These doctors have had enough of Concentra's threats, heavy-handed tactics and physical therapy quotas. This collective bargaining effort is not about pay or benefits; it's about patient care and it's about for-profit companies trying to tell doctors how to treat their patients. These doctors have come together over core issues of medical ethics and professional respect.

Concentra cannot reduce any of these physicians, compensation benefits or conditions of employment, unless PRN agrees and that will not happen! These physicians gained substantial job protections the day they signed the petition for the election and those job protections will only increase. The non-competition agreements become officially unenforceable in the New Jersey courts as soon as the physicians confirm their desire for collective bargaining by voting Yes at the NLRB election. We know that Concentra is aware of these facts and we know Concentra will do anything to try to recover the leverage it once had over these physicians.

We also want to set the record straight concerning the issues raised in Mr. Thomas' letter dated August 24, 2000. First, Mr. Thomas' statement that "Concentra opposes any and all groups which do not promote the interest of the organization (Concentra) and its employees . . ." is exactly the kind of corporate philosophy that caused the State of New Jersey to prohibit corporations from practicing medicine. Practicing medicine means much more than getting paid and doctors know that; corporations do not. Mr. Thomas' focus on corporate profits has caused him to overlook the reality that physicians are ethically bound to place the care and treatment of their patients above all other considerations, including personal gain and corporate profits. If Mr. Thomas can begin to understand this important point, he will also begin to understand why re-check and physical therapy quotas are so distasteful to these doctors. Second, the promotion of the art and science of medicine and the improvement of patient care are the very ideals that PRN was formed to uphold. Thus, Mr. Thomas need not worry that PRN will ever cause or even condone a labor dispute that would interfere with the delivery of patient care.

Since it has been brought to our attention that Concentra is intentionally ignoring the rules, PRN will commence all necessary and appropriate legal and other action to insure that the New Jersey physicians are protected and that Concentra's legal violations cease. The doctors' decision to speak with a collective voice means that the time of Concentra's unilateral corporate dictates is over.

Sincerely,
Jill Poznick, JD
Director, Field Operations




SEPTEMBER 5, 2000

William G. Pagano, M.D., M.P.H.
Regional Medical Director
Occupational Health Centers of New Jersey, P.A.
405 County Avenue
Secaucus, New Jersey 07094

Dear Dr. Pagano:

The effort, time, money and credibility that Concentra is expending to oppose the New Jersey physicians' collective bargaining efforts could be far better spent at the negotiating table with PRN.

PRN is not here to destroy Concentra or create any problems. We are here to represent the New Jersey physicians and get them a fair contract that protects their rights and assures that they can provide the highest quality care for their patients, consistent with medical ethics. Unfortunately, Concentra's continuing disregard of the physicians' rights and of the federal labor laws makes it clear why these physicians need the protections of collective bargaining.

We know that Dr. Anderson has told some physicians that he knows who signed the petition in support of PRN. Dr. Anderson's threats of retaliation in this circumstance are serious violations of the National Labor Relations Act. We will not tolerate this unlawful conduct and Dr. Anderson will now have to answer to the National Labor Relations Board for his actions.

The propaganda that Concentra has been distributing is truly insulting to the physicians who you intend to affect. Once again, we remind you that these physicians are all highly trained scientists who will not be influenced by slanted questions and ridiculous answers. PRN concludes that it is unnecessary to even respond to this blatantly ineffective propaganda. The physicians are not worried about union dues or assessments because they trust PRN and they know that PRN membership is voluntary - like memberships in the AMA or MSNJ. Ironically, Concentra's stated concern seems to be that PRN's dues are too low.

You forget that neither PRN nor the rest of the federation of medicine are "for-profit" entities. We are not in business to make a profit. We exist to advance the art and science of medicine. PRN accomplishes its mission by representing physicians in their collective bargaining and we do not expect to make a profit. Although dues have been set at a reasonably low level, PRN has alternative sources for money and resources. As the results of the trial before the NLRB have already shown, it is not the number of lawyers or the amount of resources you use that makes the difference - it is how you use the resources available. Physicians know that because they are trained to triage any difficult situation. PRN knows that because we are an organization formed by and run by physicians.

Collective bargaining is not a form of warfare - it is a well-regulated collaborative process intended to reach optimal results through informed decision making. As the NLRB decision issued last week shows, collective bargaining between the New Jersey physicians and Concentra should begin in October. Accordingly, we repeat our request that Concentra shift its focus to the positive opportunities at the bargaining table and cease the unfair labor practices and battling that have marked your efforts to date.

Very truly yours,

Jill Poznick, JD
Director, Field Operations





SEPTEMBER 18, 2000

William G. Pagano, M.D., M.P.H.
Chief Medical Officer
Occupational Health Centers of New Jersey, P.A.
405 County Avenue
Seacaucus, New Jersey 07094

Dear Dr. Pagano:

Concentra received bad news on August 31 when the NLRB ruled in PRN's favor and held that all nineteen of the New Jersey physicians are eligible for collective bargaining. Concentra received more bad news when the NLRB ruled that, except for Dr. Kansagra at the Voorhees Clinic, all of the physicians get to vote at their own clinics on September 28. Concentra received even more bad news last week when it received notice from the NLRB that the NLRB is investigating Concentra's violations of the National Labor Relations Act for fabricating what looked like an official NLRB document and for threatening the physicians. PRN hopes that Concentra will approach the concept of collective bargaining in a somewhat more constructive manner in the future.

Your September 12 memo is the most negative and misleading document we have seen. In order to correct the misleading information, we have documented each claim and spelled out the truth:

1. "Bargaining for a contract is a risk. There is a perception that a vote for the union means more job security . . . more staff, etc. This is not true."

Truth - How could the New Jersey physicians' job security get any worse? They are currently employees "at-will", which means that they can be fired at any time. Even worse, they can't get another job if they are fired, because Concentra coerced them to sign outrageous non-competition agreements. PRN will correct both of these situations and things will be better, not worse.


2. "Only a small number of people are involved in negotiations. Both Concentra and the union will choose a negotiating team to participate in the collective bargaining process. Generally, not more than a handful of individuals participate in negotiations for the union. You don't know who would be representing you, how they would be chosen, or what their agenda or motivation might be."

Truth - The New Jersey physicians will pick their own negotiating team and PRN hopes that they all choose to be on the team. PRN will supply a professional negotiator to help the physicians, but they can act as a committee of the whole, and they, not PRN, will set the agenda. This truth is probably what Concentra is most frightened about.


3. "Concentra has every right to say "no" to any union proposal. The only obligation Concentra would have is to meet and confer with the union. Concentra does not have to agree to a single union proposal."

Truth - Once the votes are counted and PRN has been selected, Concentra is legally required to do a lot more than "meet and confer." Concentra will be required to negotiate, in good faith, concerning all matters related to compensation, benefits and working conditions for the purpose of reaching a comprehensive written collective bargaining agreement. Not only is this claim false, but it is also violates the National Labor Relations Act.


4. "It can take months - even years - before a first contract is reached. While negotiations continue, wages, benefits and working conditions are frozen. There is no requirement for retroactive changes if a contract is ever settled."

Truth - Concentra can attempt to drag out the process (just as it has by filing an appeal from the NLRB ruling on supervisory status) but PRN will not tolerate any delay. If Concentra drags its feet, PRN will bring a Federal Mediator to every bargaining session and will pursue all legal remedies to stop such bad faith bargaining tactics. Moreover, wages and benefits are not "frozen." In fact, although Concentra cannot reduce any wages or benefits during bargaining, it must award all increases per its prior practices. That's the law.


5. "The union does not add to available financial resources. Concentra operates with a limited amount of resources. Any increases or improvements the union is able to negotiate would have to be paid out of existing funds currently targeted for other purposes."

Truth - If Concentra will simply start listening to its New Jersey physicians, there will be more financial resources because those physicians have many great ideas and strategies that can improve Concentra's competitive position. Sitting down to have this meaningful dialogue is the point of collective bargaining.


6. "The union cannot respond to the Individual, it only listens to the majority. If one person or a small group does not like a contract, but the majority of voting members does, the majority position is taken. If enough people do not share a specific concern, it will not be addressed in negotiations."

Truth - This claim is nothing less than an insult to these physicians. It assumes that they are unable to prioritize and collaborate as a group, which is exactly the opposite of the truth.


7. "Voting to ratify a contract is a "package deal" - not line by line, or clause by clause. During a union meeting to ratify a contract, the dues paying members vote on the contract as a whole. Members do not have the ability to pick and choose those items they like, and discard those they do not like. The contract terms will apply to all physicians whether they voted for the union or not, and whether they are members of PRN or not."

Truth - Once again, Concentra dramatically underestimates the New Jersey physicians and PRN. As bargaining progresses, all of the New Jersey physicians will participate in all key decisions, through consensus. Collective bargaining is not anarchy. With PRN, it is a professional decision-making process that is quite familiar to the trained scientist/physicians we represent.


8. "If Concentra and the union cannot agree, the union has only three options:
  • Continue working without a contract under current terms and conditions;
  • Accept Concentra's last offer; or
  • Strike."
Truth - PRN has many options in the event Concentra takes unreasonable positions at the bargaining table. The selection of those options will be entirely up to the New Jersey physicians and they include:
  • Oversight of the bargaining by the Federal Mediation and Conciliation Service;
  • Remedial Orders from the NLRB and the Federal Courts if Concentra bargains in bad faith;
  • Involvement of the entire Federation of Medicine in redressing any unfair labor practices or bad faith bargaining;
  • Publication of Concentra's actions to the local community, and local and national press; and;
  • Progressively more serious actions
What PRN won't do is engage in any strike or other activity that interferes with patient care. There are more effective means at our ready disposal of obtaining the cooperation we used for Concentra at the bargaining table.


We hope this level of detailed response to Concentra's propaganda will change Concentra's tone. Collective bargaining is an extraordinary opportunity for Concentra once Concentra shows a willingness to include its doctors in important decisions.

Sincerely,

Jill Poznick, JD
Director, Field Operations





SEPTEMBER 21, 2000

Dr. Anderson
c/o William G. Pagano, M.D., M.P.H.
Regional Medical Director
Occupational Health Centers of New Jersey, P.A.
405 County Avenue
Secaucus, New Jersey 07094


Dear Dr. Anderson:

We have been advised by a number of the New Jersey physicians that you are continuing to commit unfair labor practices and continuing to make threats and false misrepresentations to them concerning their rights under the National Labor Relations Act. In particular, last week you advised each and every Center Medical Director that, in light of the National Labor Relations Board ruling on their nonsupervisory status, Concentra intended to hire ten "new" Physician Managers who would exercise supervisory authority. You further advised them that this round of hiring would result in excess capacity of ten Center Medical Directors and you invited the Center Medical Directors to "figure it out for themselves" as to what would happen with the excess capacity.

We again remind you that Concentra may not make any changes in the status quo prior to the election, and that, once a majority of the physicians have voted for representation by PRN, changes from the status quo may be made only after such changes have been fully negotiated with PRN. Further, this threat of hiring "new" Center Medical Director/Managers is blatant retaliation for the NLRB's ruling on the supervisory status of the current Center Medical Directors.

The status quo is that the Center Medical Directors have undertaken certain important responsibilities beyond those of the other staff physicians. Further, the status quo is working since the responsibilities that the Center Medical Directors already perform have permitted Concentra to operate successfully. The only change is that the National Labor Relations Board has ruled that these additional duties do not make the Center Medical Directors "supervisors" as that term is defined by the National Labor Relations Act. The law simply will not permit you to threaten to defeat these physicians' collective bargaining rights by hiring a new round of physicians who you claim to meet the "supervisor" definition.

We have, therefore, filed additional unfair labor practice charges because of your blatant violation of the National Labor Relations Act and we are poised to take whatever additional action may be necessary to ensure that this unlawful threat remains unfulfilled. If you or Concentra persist in this threat or take any actions to attempt to fulfill it, we will join the National Labor Relations Board in obtaining extraordinary injunctive relief to immediately cease and desist those actions.

Your blatant disregard of the law and your blatant disrespect of the New Jersey physicians merely strengthens their resolve to protect themselves through the exercise of their collective bargaining rights.

Sincerely,

Jill Poznick, JD
Director, Field Operations





SEPTEMBER 25, 2000

Dear New Jersey Physicians:

We have heard that Concentra's latest argument against organizing is that "PRN doesn't have a contract for the Detroit Wellness Plan physicians yet, so why should you think they can get one here?"

PRN is pleased to address this issue because the reality is that we quickly negotiated every major goal The Wellness Plan physicians asked us to obtain. The top three concerns of the Wellness Plan physicians were quite like your own: 1) direction of patient care issues by non-physicians; 2) no job security (employment was "at-will" just as yours is now); and 3) no voice in important decisions that affect patient care and no representation on important committees. Economic issues weren't even on their list of concerns.

The Wellness Plan election was in mid-March, 2000, and we were at the bargaining table by early April. By the end of July, just four months later, PRN had negotiated agreement on each of the three key issues: 1) a patients rights clause that insures that physicians and their patients make the medical decisions; 2) a "for just cause" requirement, determined by a neutral arbitrator, for all discipline or terminations; and 3) a joint medical/staff committee structure that insured physician participation in all major decisions that affect patient care. We're proud of that record and those accomplishments and The Wellness Plan physicians are happy as well. Even though economic issues weren't on The Wellness Plan physicians' list, PRN wanted to secure long-term economic security for them as well. That is the only reason for the delay in signing a final contract. The Wellness Plan requested an opportunity to conduct a compensation survey before signing the contract to insure that the physicians' pay and benefits were adequate to guarantee their ability to recruit and retain the highest quality physicians. After discussing this request with all of the physicians, PRN concluded that this was a positive effort that would bring positive results.

That compensation study is now complete and PRN is headed back to Detroit in early October to finish these economic issues and sign the contract.

We invite you to contact one of the physician leaders at Wellness Plan, Prashant Dixit, M.D., home telephone number (248) 442-8941 for his assessment of PRN's speed in accomplishing every major goal the physicians set for the negotiation.

Thank you for the opportunity to respond to the misleading information put forth by Concentra.

Sincerely,

Jill Poznick





MARCH 1, 2001

William Pagano, MD, MPH
Regional Medical Director
Occupational Health Centers of New Jersey
405 County Ave.
Secaucus, NJ 07094

March 1, 2001

Dear Dr. Pagano:

I am writing to express our concern over statements you have made to Dr. Blumenthal regarding your decision to reduce his workweek and salary. This decision on your part is clear retaliation for Dr. Blumenthal's active and visible support for PRN. The proffered excuse - that there is a low IME load at the Secaucus Center, which Dr. Blumenthal covers every Wednesday - is obviously fabricated in an attempt to hide the true motivation. The fact is that Dr. Blumenthal continues to carry a heavy IME load at other clinics to compensate for the artificially low amount of exams scheduled at Secaucus. This ruse to attempt to inflict retribution on Dr. Blumenthal will not work. PRN is filing unfair labor practice charges over these events and we are confident that the National Labor Relations Board (NLRB) will promptly take all necessary action to cease this unlawful retaliation.

PRN is also in possession of a copy of the new "Center Medical Director" job description being distributed in connection with the performance reviews of those physicians. As stated in our December 19, 2000 communication to you, after a full and fair hearing before an officer of the NLRB, the Regional Director determined that none of the "Center Medical Directors" are "supervisors" as defined by the National Labor Relations Act. The evidence adduced at that hearing was clear: Concentra's "Center Medical Directors" have no meaningful authority to hire or fire employees of Concentra or Occupational Health Services. The new job description, combined with your threat of no future salary increases for those "Center Medical Directors" who refuse to "acknowledge" their supervisory duties and otherwise acquiesce to Concentra's unlawful actions is another blatant and unlawful attempt to assign new and additional duties and responsibilities to these "Center Medical Directors".

We repeat that the Center Medical Directors never have and never will, as long as they are represented by PRN, have the final say on hiring or firing any personnel. Since, contrary to our warnings, you have persisted in attempting to force these new duties on the "Center Medical Directors", PRN is filing the promised additional unfair labor practice charges against you and Concentra concerning these actions. This letter is your continuing notice that no "Center Medical Directors" will voluntarily make any hiring, firing or other supervisory decisions or even recommend such decisions. Any action by "Center Medical Directors" in that regard is performed only pursuant to this protest.

Sincerely,

Jill Poznick, JD
Director, Field Operations




SEPTEMBER 28, 2001

I. Remand Hearing - July, 2001
On June 20, 2001, the National Labor Relations Board in Washington DC remanded the PRN case against Concentra back to the Regional Director in NJ. The main questions at the hearing were: whether Concentra and Occupational Health are joint employers and whether any physicians are supervisors. The hearing began on July 18 and concluded on August 17. During those days, there was testimony from a Concentra corporate HR professional from Dallas concerning the question of joint employers and testimony from a Concentra Center Administrator concerning the direction of work of other center employees by physicians. A physician-employee testified for Concentra regarding "independent judgment" and the Regional Medical Director testified on all the issues.

II. Next steps
Briefs were due on September 28, 2001. There will likely be a decision from the NLRB Regional Director within 3-4 days after briefs are received. If PRN wins, Concentra will likely appeal to the NLRB in DC and PRN will know within a week (by mid-October) whether they will grant review of the decision. If they do not grant appeal, the original ballots will be counted and we could get to the bargaining table in October or November.




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