PHYCOR INC /TN/
SC 13D/A, 1999-09-10
OFFICES & CLINICS OF DOCTORS OF MEDICINE
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<PAGE>


                       SECURITIES AND EXCHANGE COMMISSION
                             Washington, D.C. 20549

                                  SCHEDULE 13D
                                (Amendment No. 6)

                    Under the Securities Exchange Act of 1934



                                  PhyCor, Inc.
- --------------------------------------------------------------------------------
                                (Name of Issuer)


                           Common Stock, no par value
- --------------------------------------------------------------------------------
                         (Title of Class of Securities)


                                    71940F10
- --------------------------------------------------------------------------------
                      (CUSIP Number of Class of Securities)


                               Patrick T. Hackett
                         E.M. Warburg, Pincus & Co., LLC
                              466 Lexington Avenue
                            New York, New York 10017
                                 (212) 878-0600
- --------------------------------------------------------------------------------
                  (Name, Address and Telephone Number of Person
                Authorized to Receive Notices and Communications)

                                   Copies to:

                             Steven J. Gartner, Esq.
                            Willkie Farr & Gallagher
                               787 Seventh Avenue
                             New York, NY 10019-6099
                                 (212) 728-8000

                                September 3, 1999
- --------------------------------------------------------------------------------
                          (Date of Event which Requires
                            Filing of this Schedule)

     If the filing person has previously filed a statement on Schedule 13G to
report the acquisition which is the subject of this Schedule 13D, and is filing
this schedule because of Rule 13d-1(b)(3) or (4), check the following: [ ]



<PAGE>


                                  SCHEDULE 13D

- ------------------                                            ------------------
CUSIP No. 71940F10                                            Page 2 of 13 Pages
- ------------------                                            ------------------

- ----------- --------------------------------------------------------------------
    1       NAME OF REPORT PERSON
            S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON

            Warburg, Pincus Equity Partners, L.P.               I.D. #13-3986317
- ----------- --------------------------------------------------------------------
    2       CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP             (a) [X]
                                                                         (b) [ ]

- ----------- --------------------------------------------------------------------
    3       SEC USE ONLY

- ----------- --------------------------------------------------------------------
    4       SOURCE OF FUNDS*

            WC
- ----------- --------------------------------------------------------------------
    5       CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDING IS REQUIRED PURSUANT
            TO ITEMS 2(d) or 2(e)                                            [ ]

- ----------- --------------------------------------------------------------------
    6       CITIZENSHIP OR PLACE OF ORGANIZATION

            Delaware
- --------------------- --------- ------------------------------------------------
                         7      SOLE VOTING POWER

                                21,347,022
                      --------- ------------------------------------------------
  NUMBER OF SHARES       8      SHARED VOTING POWER
 BENEFICIALLY OWNED
 BY EACH REPORTING              0
    PERSON WITH
                      --------- ------------------------------------------------
                         9      SOLE DISPOSITIVE POWER

                                21,347,022
                      --------- ------------------------------------------------
                         10     SHARED DISPOSITIVE POWER

                                0
- ----------- --------------------------------------------------------------------
    11      AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH PERSON

            22,589,441
- ----------- --------------------------------------------------------------------
    12      CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN
            SHARES*                                                          [ ]

- ----------- --------------------------------------------------------------------
    13      PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

            24.8%
- ----------- --------------------------------------------------------------------
    14      TYPE OF REPORTING PERSON*

            PN
- ----------- --------------------------------------------------------------------

                      *SEE INSTRUCTIONS BEFORE FILLING OUT!
          INCLUDE BOTH SIDES OF THE COVER PAGE, RESPONSES TO ITEMS 1-7
      (INCLUDING EXHIBITS) OF THE SCHEDULE, AND THE SIGNATURE ATTESTATION.



<PAGE>


                                  SCHEDULE 13D

- ------------------                                            ------------------
CUSIP No. 71940F10                                            Page 3 of 13 Pages
- ------------------                                            ------------------

- ----------- --------------------------------------------------------------------
    1       NAME OF REPORT PERSON
            S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON

            Warburg, Pincus & Co.                               I.D. #13-6358475
- ----------- --------------------------------------------------------------------
    2       CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP             (a) [X]
                                                                         (b) [ ]

- ----------- --------------------------------------------------------------------
    3       SEC USE ONLY

- ----------- --------------------------------------------------------------------
    4       SOURCE OF FUNDS*

            N/A
- ----------- --------------------------------------------------------------------
    5       CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDING IS REQUIRED PURSUANT
            TO ITEMS 2(d) or 2(e)                                            [ ]

- ----------- --------------------------------------------------------------------
    6       CITIZENSHIP OR PLACE OF ORGANIZATION

            New York
- --------------------- --------- ------------------------------------------------
                         7      SOLE VOTING POWER

                                22,589,441
                      --------- ------------------------------------------------
  NUMBER OF SHARES       8      SHARED VOTING POWER
 BENEFICIALLY OWNED
 BY EACH REPORTING              0
    PERSON WITH
                      --------- ------------------------------------------------
                         9      SOLE DISPOSITIVE POWER

                                22,589,441
                      --------- ------------------------------------------------
                         10     SHARED DISPOSITIVE POWER

                                0
- ----------- --------------------------------------------------------------------
    11      AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH PERSON

            22,589,441
- ----------- --------------------------------------------------------------------
    12      CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN
            SHARES*                                                          [ ]

- ----------- --------------------------------------------------------------------
    13      PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

            24.8%
- ----------- --------------------------------------------------------------------
    14      TYPE OF REPORTING PERSON*

            PN
- ----------- --------------------------------------------------------------------

                      *SEE INSTRUCTIONS BEFORE FILLING OUT!
          INCLUDE BOTH SIDES OF THE COVER PAGE, RESPONSES TO ITEMS 1-7
      (INCLUDING EXHIBITS) OF THE SCHEDULE, AND THE SIGNATURE ATTESTATION.



<PAGE>


                                  SCHEDULE 13D

- ------------------                                            ------------------
CUSIP No. 71940F10                                            Page 4 of 13 Pages
- ------------------                                            ------------------

- ----------- --------------------------------------------------------------------
    1      NAME OF REPORT PERSON
           S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON

           E.M. Warburg, Pincus & Co., LLC                      I.D. #13-3536050
- ----------- --------------------------------------------------------------------
    2       CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP             (a) [X]
                                                                         (b) [ ]

- ----------- --------------------------------------------------------------------
    3       SEC USE ONLY

- ----------- --------------------------------------------------------------------
    4      SOURCE OF FUNDS*

           N/A
- ----------- --------------------------------------------------------------------
    5       CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDING IS REQUIRED PURSUANT
            TO ITEMS 2(d) or 2(e)                                            [ ]

- ----------- --------------------------------------------------------------------
    6      CITIZENSHIP OR PLACE OF ORGANIZATION

           New York
- --------------------- --------- ------------------------------------------------
                         7      SOLE VOTING POWER

                                22,589,441
                      --------- ------------------------------------------------
  NUMBER OF SHARES       8      SHARED VOTING POWER
 BENEFICIALLY OWNED
 BY EACH REPORTING              0
    PERSON WITH
                      --------- ------------------------------------------------
                         9      SOLE DISPOSITIVE POWER

                                22.589,441
                      --------- ------------------------------------------------
                         10     SHARED DISPOSITIVE POWER

                                0
- ----------- --------------------------------------------------------------------
   11      AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH PERSON

           22,589,441
- ----------- --------------------------------------------------------------------
   12       CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN
            SHARES*                                                          [ ]

- ----------- --------------------------------------------------------------------
   13      PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

           24.8%
- ----------- --------------------------------------------------------------------
   14      TYPE OF REPORTING PERSON*

           OO
- ----------- --------------------------------------------------------------------

                      *SEE INSTRUCTIONS BEFORE FILLING OUT!
          INCLUDE BOTH SIDES OF THE COVER PAGE, RESPONSES TO ITEMS 1-7
      (INCLUDING EXHIBITS) OF THE SCHEDULE, AND THE SIGNATURE ATTESTATION.



<PAGE>


                                  SCHEDULE 13D

- ------------------                                            ------------------
CUSIP No. 71940F10                                            Page 5 of 13 Pages
- ------------------                                            ------------------

- ----------- --------------------------------------------------------------------
    1      NAME OF REPORT PERSON
           S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON

           Warburg, Pincus Netherlands Equity Partners I, C.V.
- ----------- --------------------------------------------------------------------
    2       CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP             (a) [X]
                                                                         (b) [ ]

- ----------- --------------------------------------------------------------------
    3       SEC USE ONLY

- ----------- --------------------------------------------------------------------
    4      SOURCE OF FUNDS*

           N/A
- ----------- --------------------------------------------------------------------
    5       CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDING IS REQUIRED PURSUANT
            TO ITEMS 2(d) or 2(e)                                            [ ]

- ----------- --------------------------------------------------------------------
    6      CITIZENSHIP OR PLACE OF ORGANIZATION

           The Netherlands
- --------------------- --------- ------------------------------------------------
                         7      SOLE VOTING POWER

                                677,683
                      --------- ------------------------------------------------
  NUMBER OF SHARES       8      SHARED VOTING POWER
 BENEFICIALLY OWNED
 BY EACH REPORTING              0
    PERSON WITH
                      --------- ------------------------------------------------
                         9      SOLE DISPOSITIVE POWER

                                677,683
                      --------- ------------------------------------------------
                         10     SHARED DISPOSITIVE POWER

                                0
- ----------- --------------------------------------------------------------------
   11      AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH PERSON

           22,589,441
- ----------- --------------------------------------------------------------------
   12       CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN
            SHARES*                                                          [ ]

- ----------- --------------------------------------------------------------------
   13      PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

           24.8%
- ----------- --------------------------------------------------------------------
   14      TYPE OF REPORTING PERSON*

           PN
- ----------- --------------------------------------------------------------------

                      *SEE INSTRUCTIONS BEFORE FILLING OUT!
          INCLUDE BOTH SIDES OF THE COVER PAGE, RESPONSES TO ITEMS 1-7
      (INCLUDING EXHIBITS) OF THE SCHEDULE, AND THE SIGNATURE ATTESTATION.



<PAGE>


                                  SCHEDULE 13D

- ------------------                                            ------------------
CUSIP No. 71940F10                                            Page 6 of 13 Pages
- ------------------                                            ------------------

- ----------- --------------------------------------------------------------------
    1      NAME OF REPORT PERSON
           S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON

           Warburg, Pincus Netherlands Equity Partners II, C.V.
- ----------- --------------------------------------------------------------------
    2       CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP             (a) [X]
                                                                         (b) [ ]

- ----------- --------------------------------------------------------------------
    3       SEC USE ONLY

- ----------- --------------------------------------------------------------------
    4      SOURCE OF FUNDS*

           N/A
- ----------- --------------------------------------------------------------------
    5       CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDING IS REQUIRED PURSUANT
            TO ITEMS 2(d) or 2(e)                                            [ ]

- ----------- --------------------------------------------------------------------
    6      CITIZENSHIP OR PLACE OF ORGANIZATION

           The Netherlands
- --------------------- --------- ------------------------------------------------
                         7      SOLE VOTING POWER

                                451,789
                      --------- ------------------------------------------------
  NUMBER OF SHARES       8      SHARED VOTING POWER
 BENEFICIALLY OWNED
 BY EACH REPORTING              0
    PERSON WITH
                      --------- ------------------------------------------------
                         9      SOLE DISPOSITIVE POWER

                                451,789
                      --------- ------------------------------------------------
                         10     SHARED DISPOSITIVE POWER

                                0
- ----------- --------------------------------------------------------------------
   11      AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH PERSON

           22,589,441
- ----------- --------------------------------------------------------------------
   12       CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN
            SHARES*                                                          [ ]

- ----------- --------------------------------------------------------------------
   13      PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

           24.8%
- ----------- --------------------------------------------------------------------
   14      TYPE OF REPORTING PERSON*

           PN
- ----------- --------------------------------------------------------------------

                      *SEE INSTRUCTIONS BEFORE FILLING OUT!
          INCLUDE BOTH SIDES OF THE COVER PAGE, RESPONSES TO ITEMS 1-7
      (INCLUDING EXHIBITS) OF THE SCHEDULE, AND THE SIGNATURE ATTESTATION.



<PAGE>


                                  SCHEDULE 13D

- ------------------                                            ------------------
CUSIP No. 71940F10                                            Page 7 of 13 Pages
- ------------------                                            ------------------

- ----------- --------------------------------------------------------------------
    1      NAME OF REPORT PERSON
           S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON

           Warburg, Pincus Netherlands Equity Partners III, C.V.
- ----------- --------------------------------------------------------------------
    2       CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP             (a) [X]
                                                                         (b) [ ]

- ----------- --------------------------------------------------------------------
    3       SEC USE ONLY

- ----------- --------------------------------------------------------------------
    4      SOURCE OF FUNDS*

           N/A
- ----------- --------------------------------------------------------------------
    5       CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDING IS REQUIRED PURSUANT
            TO ITEMS 2(d) or 2(e)                                            [ ]

- ----------- --------------------------------------------------------------------
    6      CITIZENSHIP OR PLACE OF ORGANIZATION

           The Netherlands
- --------------------- --------- ------------------------------------------------
                         7      SOLE VOTING POWER

                                112,947
                      --------- ------------------------------------------------
  NUMBER OF SHARES       8      SHARED VOTING POWER
 BENEFICIALLY OWNED
 BY EACH REPORTING              0
    PERSON WITH
                      --------- ------------------------------------------------
                         9      SOLE DISPOSITIVE POWER

                                112,947
                      --------- ------------------------------------------------
                         10     SHARED DISPOSITIVE POWER

                                0
- ----------- --------------------------------------------------------------------
   11      AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH PERSON

           22,589,441
- ----------- --------------------------------------------------------------------
   12       CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN
            SHARES*                                                          [ ]

- ----------- --------------------------------------------------------------------
   13      PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)

           24.8%
- ----------- --------------------------------------------------------------------
   14      TYPE OF REPORTING PERSON*

           PN
- ----------- --------------------------------------------------------------------

                      *SEE INSTRUCTIONS BEFORE FILLING OUT!
          INCLUDE BOTH SIDES OF THE COVER PAGE, RESPONSES TO ITEMS 1-7
      (INCLUDING EXHIBITS) OF THE SCHEDULE, AND THE SIGNATURE ATTESTATION.



<PAGE>


     This Amendment No. 6 amends the Schedule 13D filed on December 28, 1998
(the "Initial Filing"), as amended by Amendment No. 1 to the Schedule 13D filed
on January 4, 1999, Amendment No. 2 to the Schedule 13D filed on January 13,
1999, Amendment No. 3 to the Schedule 13D filed on March 8, 1999, Amendment No.
4 to the Schedule 13D filed on June 17, 1999 and Amendment No. 5 to the Schedule
13D filed on August 27, 1999 (collectively with the Initial Filing, the
"Schedule 13D"), on behalf of Warburg, Pincus Equity Partners, L.P., a Delaware
limited partnership ("WPEP"), Warburg, Pincus & Co., a New York general
partnership ("WP"), and E.M. Warburg, Pincus & Co., LLC, a New York limited
liability company ("EMW"). In addition, Warburg, Pincus Netherlands Equity
Partners I, C.V. ("WPNEPI"), Warburg, Pincus Netherlands Equity Partners II,
C.V. ("WPNEPII") and Warburg, Pincus Netherlands Equity Partners III, C.V.
("WPNEPIII" and, together with WPNEPI, WPNEPII and WPEP, the "Investors") are
included as Reporting Entities in this Amendment No. 6.

     Unless otherwise indicated herein, each capitalized term used but not
defined herein shall have the meaning assigned to such term in the Initial
Filing.

     Item 4
     ------

     Item 4 is hereby amended by adding the following:

     On September 3, 1999, the Investors and WP consummated the purchase of
certain Notes of the Company pursuant to the terms


                                  8 of 13 Pages

<PAGE>


of a Securities Purchase Agreement, dated as of June 15, 1999, by and among the
Company and the Investors, as amended by an Amendment to Securities Purchase
Agreement, dated as of August 23, 1999 (the "Purchase Agreement"). Upon
consummation of the transactions contemplated by the Purchase Agreement, the
Company issued and sold and the Investors purchased Series A Zero Coupon
Convertible Subordinated Notes due 2014 in the total principal amount at
maturity of $266,389,621 (the "Series A Notes") which are convertible into
14,992,441 shares of Common Stock, subject to customary antidilution
adjustments.

     Item 5
     ------

     Paragraph (a) of Item 5 of the Schedule 13D is hereby amended by adding the
following:

     As of September 3, 1999, after giving effect to the purchase of the Series
A Notes, the Reporting Entities beneficially owned 22,589,441 shares of Common
Stock. By reason of their respective relationships with the Investors, each of
the Reporting Entities may be deemed under Rule 13d-3 under the Exchange Act to
own beneficially all of the shares of Common Stock which each of the Investors
beneficially owns. As of September 3, 1999, 22,589,441 shares of Common Stock
represented beneficial ownership of approximately 24.8% of the outstanding
shares of Common Stock.


                                  9 of 13 Pages

<PAGE>


     Item 6
     ------

     Item 6 of the Schedule 13D is hereby amended by adding the following:

     The information set forth in Item 4 is incorporated herein by reference.

     Item 7
     ------

     Item 7 of the Schedule 13D is hereby amended by adding the following:

     6. Amendment to Securities Purchase Agreement, dated as of August 23, 1999,
by and among the Company, Warburg, Pincus Equity Partners, L.P., Warburg, Pincus
Netherlands Equity Partners I, C.V., Warburg, Pincus Netherlands Equity Partners
II, C.V. and Warburg, Pincus Netherlands Equity Partners III, C.V.


                                 10 of 13 Pages

<PAGE>


                                   SIGNATURES


     After reasonable inquiry and to the best of our knowledge and belief, the
undersigned certify that the information set forth in this statement is true,
complete and correct.



Dated: September 10, 1999               WARBURG, PINCUS EQUITY
                                        PARTNERS, L.P.

                                        By: Warburg, Pincus & Co.,
                                            General Partner


                                        By: /s/ Stephen Distler
                                            ------------------------------
                                            Stephen Distler
                                            Partner


Dated: September 10, 1999               WARBURG, PINCUS & CO.


                                        By: /s/ Stephen Distler
                                            ------------------------------
                                            Stephen Distler
                                            Partner


Dated: September 10, 1999               E.M. WARBURG, PINCUS & CO., LLC


                                        By: /s/ Stephen Distler
                                            ------------------------------
                                            Stephen Distler
                                            Member


Dated: September 10, 1999               WARBURG, PINCUS NETHERLANDS
                                        EQUITY PARTNERS I, C.V.

                                        By: Warburg, Pincus & Co.,
                                            General Partner


                                        By: /s/ Stephen Distler
                                            ------------------------------
                                            Stephen Distler
                                            Partner


                                 11 of 13 Pages

<PAGE>


Dated: September 10, 1999               WARBURG, PINCUS NETHERLANDS
                                        EQUITY PARTNERS II, C.V.

                                        By: Warburg, Pincus & Co.,
                                            General Partner


                                        By: /s/ Stephen Distler
                                            ------------------------------
                                            Stephen Distler
                                            Partner


Dated: September 10, 1999               WARBURG, PINCUS NETHERLANDS
                                        EQUITY PARTNERS III, C.V.

                                        By: Warburg, Pincus & Co.,
                                            General Partner


                                        By: /s/ Stephen Distler
                                            ------------------------------
                                            Stephen Distler
                                            Partner


                                 12 of 13 Pages

<PAGE>


                                  Exhibit Index
                                  -------------

     6. Amendment to Securities Purchase Agreement, dated as of August 23, 1999,
by and among the Company, Warburg, Pincus Equity Partners, L.P., Warburg, Pincus
Netherlands Equity Partners I, C.V., Warburg, Pincus Netherlands Equity Partners
II, C.V. and Warburg, Pincus Netherlands Equity Partners III, C.V.


                                 13 of 13 Pages


<PAGE>


                                  AMENDMENT TO
                          SECURITIES PURCHASE AGREEMENT


     This Amendment dated August 23, 1999 (the "Amendment") is an amendment to
the Securities Purchase Agreement dated as of June 15, 1999 (the "Agreement") by
and among PhyCor, Inc., a Tennessee corporation (the "Company"), and the
Investors whose names appear on the signature pages to the Agreement.

     WHEREAS, the parties have entered the Agreement;

     WHEREAS, the parties hereby agree to amend the Agreement as stated herein;
and

     WHEREAS, the parties wish to set forth their understanding in respect to
the terms and conditions relating to the Amendment.

     NOW THEREFORE, in consideration of the provisions hereof and for other good
and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the parties hereby agree as follows:

     1. Authorization; Conversion of Notes into Common Stock; Etc. The first
sentence of Section 1.1 is deleted in its entirety and replaced with the
following:

          The Company has duly authorized the issue and sale of Series A Zero
     Coupon Convertible Subordinated Notes due 2014 (the "Series A Notes") and
     Series B Zero Coupon Convertible Subordinated Notes (the "Series B Notes"),
     each such Note to be substantially in the form of Exhibit A attached
     hereto.

     2. Purchase and Sale of Notes; the Closing. Section 1.2 is deleted in its
entirety and replaced with the following:

          1.2. Purchase and Sale of Series A Notes; the Closing.

          Subject to the terms and conditions hereof, the Company hereby agrees
     to sell to each Investor, and each Investor agrees to purchase from the
     Company, Series A Notes in the aggregate Principal Amount at Final Maturity
     as set forth opposite such Investor's name in Schedule I attached hereto.
     Each Series A Note will be issued at an issue price of $375.39 per $1,000
     Principal Amount at Final Maturity. The closing of such purchase shall be
     held at 10:00 A.M., New York time, on September 3, 1999 provided all the
     conditions set forth in Sections 4 and 5 hereto are satisfied or have been
     waived, or on such later Business Day as may be agreed to by you and the
     Company (the "Closing Date"), at the offices of Waller Lansden Dortch &
     Davis, A Professional Limited Liability Company, 511 Union Street, Suite
     2100, Nashville, Tennessee 37219.



<PAGE>


          On the Closing Date, the Company will deliver to each Investor one or
     more Series A Notes, dated the Closing Date and registered in such
     Investor's name or in the name of one or more of such Investor's nominees,
     in any denominations (in a minimum amount of $500,000) and in the aggregate
     principal amount to be purchased by the Investors, all as the Investors may
     specify by timely notice to the Company (or, in the absence of such notice,
     one Series A Note registered in each Investor's name), in each case against
     delivery to the Company of immediately available funds in the amount of the
     purchase price of such Series A Notes, such delivery to be by wire transfer
     to such account as the Company may direct in writing.

     3. Purchase and Sale of Series B Notes; Series B Closing; Shareholder
Approval. Section 1.3 shall be inserted in the Agreement and shall read as
follows:

          1.3. Purchase and Sale of Series B Notes; Series B Closing;
     Shareholder Approval.

          A. Subject to the terms and conditions hereof, unless otherwise
     mutually agreed by the parties, the Company shall sell to each Investor,
     and each Investor agrees to purchase from the Company, Series B Notes up to
     the aggregate Principal Amount at Final Maturity as set forth opposite such
     Investor's name in Schedule II attached hereto. Each Note will be issued at
     an issue price of $375.39 per $1,000 Principal Amount at Final Maturity.
     The closing of such purchase shall be held at 10:00 A.M., New York time, on
     the third Business Day following the receipt of shareholder approval of the
     Series B Transaction, provided all the conditions set forth in Sections 4
     and 5 hereto are satisfied or have been waived, or on such later Business
     Day as may be agreed to by you and the Company (each, a "Series B Closing
     Date") at the offices of Waller Lansden Dortch & Davis, A Professional
     Limited Liability Company, 511 Union Street, Suite 2100, Nashville,
     Tennessee 37219.

          B. On the Series B Closing Date, the Company will deliver to each
     Investor one or more Notes, dated the Series B Closing Date and registered
     in such Investor's name or in the name of one or more of such Investor's
     nominees, in any denominations (in a minimum amount of $500,000) and in the
     aggregate principal amount to be purchased by the Investors, all as the
     Investors may specify by timely notice to the Company (or, in the absence
     of such notice, one Series B Note registered in each Investor's name), in
     each case against delivery to the Company of immediately available funds in
     the amount of the purchase price of such Series B Notes, such delivery to
     be by wire transfer to such account as the Company may direct in writing.

          C. Subject to the satisfaction or waiver of all the conditions set
     forth in Sections 4 and 5 hereto, upon approval of the Series B Transaction
     (as defined in Section 6.16) by the shareholders of the Company, unless
     otherwise


                                       -2-

<PAGE>


     agreed by the parties, the Company shall sell all of the Series B Notes to
     the Investors, and the Investors shall be obligated to purchase the Series
     B Notes from the Company. In the event the shareholders of the Company fall
     to approve the Series B Transaction, the Company shall have no obligation
     to sell the Series B Notes to the Investors, and the Investors shall have
     no obligation or right to purchase Series B Notes from the Company.

     4. Use of Proceeds. The first sentence of Section 6.4 is deleted in its
entirety and replaced with the following:

          The Company will use the proceeds of the issuance of the Note to repay
     existing debt, to repurchase shares of Common Stock and for general
     corporate purposes; provided, however, that any repurchases of shares of
     Common Stock hereunder (i) will be approved by the Board of Directors, (ii)
     will be made in compliance with all applicable law, (iii) will be made
     within 12 months of the Special Meeting and (iv) will not exceed
     $10,000,000 in the aggregate and, in the event of a Series B Closing Date,
     will not exceed the sum of $10,000,000 plus aggregate proceeds to the
     Company from the sale of Series B Notes; and provided further that nothing
     herein shall prohibit, restrict or otherwise limit the Company's ability to
     effect its $75,000,000 securities repurchase program previously adopted by
     the Company as long as such securities repurchase program is completed
     within 24 months of the later of (a) the Closing Date and (b) the Series B
     Closing Date.

     5. Additional Purchases of Common Stock. Sections 6.6A and 6.6B shall be
deleted in their entirety and replaced with the following:

          6.6. Additional Purchases of Common Stock.

          In the event the Company and the Investors mutually determine that the
     Company shall sell less than all of the Series B Notes or the Series B
     Transaction is not approved by the Company's shareholders at the Special
     Meeting, the Investors may acquire additional shares of Common Stock in
     open-market purchases or otherwise ("Permitted Acquisitions") provided that
     (i) the Permitted Acquisitions are made no later than six months after such
     determination or the Special Meeting, (ii) the number of shares of Common
     Stock acquired pursuant to this Section 6.6 shall not exceed the product of
     (a) 15,000,000 (subject to appropriate adjustment for any stock split or
     similar event) multiplied by (b) one minus the quotient of the aggregate
     Principal Amount at Final Maturity of Series B Notes sold to the Investors
     divided by $266,389,621, (iii) the aggregate consideration for such
     Permitted Acquisitions does not exceed the difference between $100,000,000
     and the original issue discount value of the aggregate principal amount of
     the Series B Notes sold by the Company to the Investors and (iv) the
     Maximum Amount shall not exceed that number of shares which is equal to 46%
     of the sum of the then outstanding


                                       -3-

<PAGE>


     Common Stock plus the number of shares issuable upon conversion of the
     issued and outstanding Notes.

     6. Covenants. Sections 6.16 and 6.17 shall be inserted in the Agreement and
shall read as follows:

          6.16. Shareholders' Meeting.

          The Company covenants and agrees that (i) its Board of Directors will,
     as soon as reasonably practicable after the Closing Date, call a special
     meting of its shareholders (the "Special Meeting") to consider and vote
     upon the sale of Series B Notes pursuant to the terms of this Agreement
     (the "Series B Transaction") and (ii) its Board of Directors will duly
     recommend to the Company's shareholders that the Series B Transaction and
     the transaction contemplated thereby be approved unless the Board of
     Directors determines in good faith, after consultation with and based upon
     the advice of its financial and legal advisors, that such a recommendation
     would constitute a breach of its fiduciary duties.

          6.17. Proxy Statement.

          The Company covenants that the information with respect to the
     Company, its officers and directors and its subsidiaries contained in the
     definitive proxy material that will be distributed to the Company's
     shareholders in connection with the Special Meeting (the "Proxy Statement")
     will not, and the Investors and WP covenant that the information supplied
     by the Investors and WP and their representatives for inclusion in the
     Proxy Statement will not, on the date the Proxy Statement is first mailed
     to shareholders, contain any untrue statement of a material fact or omit to
     state a material fact required to be stated therein or necessary to make
     the statements therein, in the light of the circumstances under which they
     are made, not misleading subject to the terms and conditions herein
     provided. The Company further agrees to file with the Commission as soon as
     practicable after the Closing Date the Proxy Statement with respect to the
     Special Meeting to consider approval of the Series B Transaction, use its
     best efforts to resolve as promptly as practicable any comments of the
     staff of the Commission to such Proxy Statement and promptly thereafter
     mail the Proxy Statement to its shareholders. The Proxy Statement shall
     conform, at the date of mailing, as to form in all material respects with
     applicable requirements of the Exchange Act, or any regulation or rule
     issued thereunder.

     7. General Terms of Notes. (a) The second sentence of Section 7.1A shall be
deleted in its entirety and replaced with the following sentences:

          The aggregate Principal Amount at Final Maturity of the Series A Notes
     to be issued hereunder is $266,389,621. The aggregate Principal Amount at


                                       -4-

<PAGE>


     Final Maturity of the Series B Notes that may be issued hereunder is
     $266,389,621.

     (b) Section 7.1 is hereby deleted in its entirety and replaced with the
following:

          C. The Notes shall be issued at an Issue Price of $375.39 per $1,000
     Principal Amount at Final Maturity. There shall be no periodic payments of
     interest on the Notes. The calculation of the accrual of Original Issue
     Discount in the period during which each Note remains outstanding shall be
     on an annual basis using a 360-day year composed of twelve 30-day months,
     and such accrual shall commence, with respect to the Series A Notes, on the
     Closing Date and, with respect to the Series B Notes, on each Series B
     Closing Date. In the event of the maturity, conversion, purchase by the
     Company at the option of a Holder or redemption of a Note, Original Issue
     Discount, if any, shall cease to accrue on such Note, under the terms and
     subject to the conditions of this Agreement and the Notes.

     8. Purchase of Notes at the Option of the Holder. The introductory clause
of Section 7.4A is deleted in its entirety and replaced with the following:

          A. General. On the tenth anniversary of the Closing Date with respect
     to the Series A Notes and each Series B Closing Date with respect to the
     Series B Notes (the "Purchase Date"), at the purchase price specified in
     paragraph 6 of the Notes (the "Purchase Price"), a Holder of Notes shall
     have the option to require the Company to purchase any outstanding Notes
     held by such Holder, upon:

     9. Adjustments to Conversion Rate. Section 7.7F is deleted in its entirety
and replaced with the following:

          A. In the event the litigation referred to in Schedule 7.7 (the
     "Subject Litigation") is settled by the Company or a final judgment is
     entered against the Company or the Company otherwise is liable to make
     payments (whether pursuant to indemnification arrangements or otherwise),
     which payments shall include fees and expenses payable by the Company, in
     an amount on an after-tax basis in excess of the Company's current
     insurance coverage ($10 million pre-tax) plus any supplemental insurance
     coverage acquired by the Company (the "Adjustment Amount"), provided,
     however, if the Company acquires a supplemental insurance policy, the
     Adjustment Amount shall also include the after-tax costs of obtaining such
     supplemental policy (a "Special Adjustment Event"), then the Conversion
     Rate then in effect shall be further adjusted pursuant to this Section
     7.7F. Upon the occurrence of a Special Adjustment Event, the Conversion
     Rate shall be adjusted to the Conversion Rate obtained by dividing $375.39
     by the New Factor. For purposes hereof, the "New Factor" shall be equal to
     the difference between (x) the quotient obtained


                                       -5-

<PAGE>


     by dividing $375.39 by the Conversion Rate in effect immediately prior to
     the Special Adjustment Event and (y) the Adjustment Factor. For purposes
     hereof, the "Adjustment Factor" shall equal the product of (A) the "Note
     Factor", which is the quotient of (i) $1 million divided by (ii) the sum of
     (a) 76,292,550 (the outstanding shares of Common Stock as of June 10, 1999)
     and (b) the number of shares then issuable upon conversion of the issued
     and outstanding Notes (the "Conversion Shares") for each $1 million of the
     Adjustment Amount, times (B) the "Stock Factor" which is the sum of (i) one
     plus (ii) the quotient of (1) the Permitted Acquisitions divided by (2) the
     Conversion Shares (with adjustments to the Adjustment Factor by linear
     interpolation for amounts greater than or less than $1 million, as the case
     may be).

     10. Definitions. (a) The following definitions shall be added to Section
8.1 where appropriate:

          "Conversion Shares" has the meaning specified in Section 7.7F.

          "Note Factor" has the meaning specified in Section 7.7F.

          "Proxy Statement" has the meaning specified in Section 6.17.

          "Series A Notes" has the meaning specified in Section 1.1.

          "Series B Notes" has the meaning specified in Section 1.1.

          "Series B Closing Date" has the meaning specified in Section 1.3.

          "Series B Transaction" has the meaning specified in Section 6.16.

          "Special Meeting" has the meaning specified in Section 6.16.

          "Stock Factor" has the meaning specified in Section 7.7F.

     (b) Clause (iii) of the definition of "Maximum Amount" shall be deleted in
its entirety and replaced with the following:

          (iii) during a period of six months from the earlier of (a) the date
     the Company and the Investors mutually determine to sell less than all the
     Series B Notes or (b) the date of the Special Meeting at which the
     shareholders fail to approve the Series B Transaction, the number of shares
     of Common Stock that the Investors may purchase in accordance with the
     provisions of Section 6.6.

     (c) The definition of Permitted Acquisitions shall be deleted in its
entirety and replaced with the following:

          "Permitted Acquisitions" has the meaning specified in Section 6.6.


                                      -6-

<PAGE>


     (d) The definition of Adjustment Threshold shall be deleted in its entirety
and replaced with the following:

          "Adjustment Amount" has the meaning specified in Section 7.7.

     11. Expenses. Section 17.1 is deleted in its entirety and replaced with the
following:

          The Company shall pay up to $2,000,000 of the Investors' expenses in
     connection with the transactions contemplated hereby, including the fees
     and disbursements of counsel, provided such fees are reasonable and the
     Investors submit verification of such expenses. With the exception of the
     foregoing sentence, each of the parties hereto shall pay its own expenses.

     12. Amendment and Ratification. The parties agree that the Agreement is
hereby amended in accordance with the foregoing provisions of this Amendment The
parties agree that the Agreement, as amended as provided herein, shall remain in
full force and effect.

     13. Defined Terms. Capitalized terms used in this Amendment shall have the
same meanings as in the Agreement unless otherwise defined herein.


                                       -7-

<PAGE>


     IN WITNESS WHEREOF, the parties hereto have signed this Amendment to the
Agreement as of the date first above written.



                                        PHYCOR, INC.

                                        By: /s/ Joseph C. Hutts
                                            ------------------------------
                                            Title: Chairman of the Board

WARBURG, PINCUS EQUITY PARTNERS, L.P.

By: Warburg, Pincus & Co.,
         General Partner


By: /s/ Joel Ackerman
    ------------------------------



WARBURG, PINCUS NETHERLANDS EQUITY PARTNERS I, C.V.

By: Warburg, Pincus & Co.,
         General Partner


By: /s/ Joel Ackerman
    ------------------------------



WARBURG, PINCUS NETHERLANDS EQUITY PARTNERS II, C.V.

By: Warburg, Pincus & Co.,
         General Partner


By: /s/ Joel Ackerman
    ------------------------------



WARBURG, PINCUS NETHERLANDS EQUITY PARTNERS III, C.V.

By: Warburg, Pincus & Co.,
         General Partner


By: /s/ Joel Ackerman
    ------------------------------


                                       -8-

<PAGE>


For purposes of Section 6.5 only:

WARBURG, PINCUS & CO.


By: /s/ Joel Ackerman
    ------------------------------





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