BUSHRA v. MAIN LINE HEALTH, INC.

CourtDistrict Court, E.D. Pennsylvania
DecidedMarch 21, 2024
Docket2:23-cv-01031
StatusUnknown

This text of BUSHRA v. MAIN LINE HEALTH, INC. (BUSHRA v. MAIN LINE HEALTH, INC.) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
BUSHRA v. MAIN LINE HEALTH, INC., (E.D. Pa. 2024).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA

ELIZABETH BUSHRA, CIVIL ACTION Plaintiff,

v.

MAIN LINE HEALTH, INC., NO. 23-1031 Defendant.

MEMORANDUM OPINION

Plaintiff Dr. Elizabeth Bushra, a member of the Tenth Presbyterian Church, has sued Defendant Main Line Health, Inc. (“MLHI”) alleging violations of Title VII of the Civil Rights Act of 1964 (“Title VII”) and the Pennsylvania Human Relations Act (“PHRA”). Specifically, Dr. Bushra alleges retaliation, failure to accommodate, disparate treatment, and associational religious discrimination. These allegations stem from Dr. Bushra’s application for a religious exemption from the COVID-19 vaccination and MLHI’s termination of contract negotiations with her. MLHI moves for summary judgment on all counts under Federal Rule of Civil Procedure 56. Fed. R. Civ. P. 56(a). For the reasons that follow, MLHI’s motion will be granted. I. BACKGROUND After taking a hiatus from practicing medicine, Dr. Bushra joined a program offered by MLHI called the LifeGuard Physician Re-Entry Program. Its purpose was to encourage inactive physicians to return to the practice of medicine considering the exceptional need caused by the COVID-19 pandemic. As a participant, Dr. Bushra, in the spring of 2021, completed a two- month, unpaid preceptorship at the Emergency Department of Lankenau Medical Center, which is part of MLHI’s health system. Dr. Bushra testified that, as part of the preceptorship, she joined MLHI’s medical staff starting in early 2021. At the conclusion of the program, Dr. Bushra explored the possibility of becoming an urgent care physician with the related but distinct entity, Main Line Healthcare (“MLHC”).1 When she was interviewed by Dawn Rupp, the Administrator of Practice Operations for MLHC, for a possible position, Dr. Bushra told Rupp that “she wanted to work PRN (as needed) starting with two shifts per month, each shift lasting 8-12 hours.”2 She received a job offer, conditioned upon her completion of an onboarding process consisting of credentialing, a medical exam,

training in patient notes, and negotiation of a contract. Although Dr. Bushra began the onboarding process in early June, the process was delayed significantly. First, it took her a while to return the necessary credentialing forms. She was repeatedly contacted regarding the status of the forms, first in mid-June and then twice in early July. In the last of these reminders, Dr. Bushra was warned that her target start date of August 1, 2021 was approaching. Dr. Bushra testified that this was the first time that she learned that August 1 was supposed to be her start date. MLHC received Dr. Bushra’s credentialing materials on July 16, too late for her to start work on August 1, so MLHC pushed her start date back to August 15. Even after that, Dr. Bushra still had not returned the employment agreement

with MLHC. She informed Rupp on August 5 that she would “forward the agreement to [her] attorney, who reviews all of [her] potential employment documents.” A few days later, Dr. Bushra told Rupp that, due to family obligations, “mid-September is the earliest realistic start date.”

1 MLHC is not a party to this case. In light of that fact, MLHI argues that Dr. Bushra did not identify any adverse employment action by the actual defendant here. In response, Dr. Bushra argues that the two entities are joint employers for purposes of Title VII and the PHRA. See Faush v. Tuesday Morning, Inc., 808 F.3d 208, 213 (3d Cir. 2015). Without so holding, this opinion treats MLHI and MLHC as a single entity because all of Dr. Bushra’s claims fail on other grounds.

2 PRN stands for pro ne rata, a Latin phrase that essentially means “as needed.” Hassen v. Ruston La. Hosp. Co., 932 F.3d 353, 354 (5th Cir. 2019). Frustrated with Dr. Bushra’s delays, Rupp responded on August 23 that the initial employment offer had expired and asked Dr. Bushra for a firm start date. Dr. Bushra responded on August 25, informing Rupp that she could begin working on September 20. This new start date was reflected in the new draft of the employment agreement she was provided. At the end of September, Dr. Bushra emailed Rupp with revisions and questions about the contract, to

which Rupp responded the same day. Dr. Bushra never signed the agreement. In October, Rupp met with Michelle Delp, Vice President of Operations, expressing her frustration with Dr. Bushra’s lack of responsiveness. Rupp and Delp decided that negotiations with Dr. Bushra over the employment contract would be discontinued. The fact that, as Rupp testified, no vacancies for PRN (as opposed to part- or full-time) positions remained at this point reinforced their decision. Rupp shared this decision with Dr. Bushra on October 18, informing her that all the current PRN positions had been filled. In response, Dr. Bushra noted her “surprise[]” that these positions were filled given that Rupp “expressed on multiple occasions the significant staffing needs that you have” and that MLHI was trying to get emergency physicians

to pick up shifts at the system’s urgent care centers. Moreover, Dr. Bushra was “very concerned [Rupp’s] action constitutes retaliation in response to [her] submission of a COVID-19 vaccine religious exemption request, about which [she] ha[d] yet to receive a final ruling.” Rupp subsequently emailed Delp and said that she had “no idea whatsoever about her religious exemption nor would I ever hold that against anyone.” She also responded to Dr. Bushra and told her that her “lack of response . . . suggested that you did not want to come [work] with us.” The exemption requested by Dr. Bushra was to MLHI’s requirement that both new hires and employees receive the COVID-19 vaccine. The policy, which was instituted in July, provided that anyone seeking an exemption for “sincerely held religious belief[s],” would have to make a request by September 15. Exemption requests were to be made on a specific form for review by MLHC’s human resources department or the credentials committee at a MLHC hospital. Applicants were allowed to support their request with letters from religious leaders, which Dr. Bushra did. Applicants also had the right to appeal in case of a denial. Rupp was not involved in the evaluation of Dr. Bushra’s exemption request.

Dr. Bushra’s request was denied on September 24, and she submitted an appeal on September 29. She was notified on October 19 that her appeal had been denied, one day after Rupp informed Dr. Bushra that she was terminating contract negotiations. She was told that, if she did not receive the vaccine, she would be placed on “administrative suspension” from the medical staff. The suspension never came, however, because Dr. Bushra tendered her “resignation” from the medical staff on November 1. Among the other applicants for an exemption to the vaccination requirement was Dr. Bushra’s husband, Dr. Joseph Bushra, campus chief at Lankenau Medical Center. His application, too, was denied, and he was placed on administrative leave. Bushra v. Main Line Health, Inc., 2023 WL 9005584, at *3 (E.D. Pa. Dec.

28, 2023). He filed a lawsuit, similarly alleging religious discrimination under Title VII and the PHRA. Id. at *2. MLHI’s motion for summary judgment was granted in full in that case. Id. at *8. The following April, Dr. Bushra filed a discrimination complaint with the Equal Employment Opportunity Commission (“EEOC”) and the Pennsylvania Human Relations Commission (“PHRC”). The EEOC gave her a right to sue notice in December 2022. Dr. Bushra subsequently filed this lawsuit.

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