Candace Napier has worked for nearly three decades at Banner Health.
Napier says she was the first nurse practitioner hired back before it was even called Banner.
But these days operations staff make most decisions, whereas clinicians used to have a bigger say.
The culture there now, Napier said, is depressing.
“People live in fear; they're afraid,” Napier said. “You know, when every moment somebody tells you what to do, you feel like you're walking on eggshells.”
Napier is the site lead at a clinic in Sun City West. She supports the unionization effort, calling it all about justice.
“They're not fair, so we have to bring them to task,” Napier said. “We have to say, ‘This is not right. This is bad for medicine. It's bad for the patient. It's bad for everybody.'”
An election is underway on whether to form a union at Banner Health, which calls itself Arizona’s largest employer. Doctors, nurse practitioners and physician assistants have about a week to return their ballots, which are scheduled to be counted on Sept. 2.
The vote now happening is in a right-to-work state where employees cannot be forced to join a union or pay dues. If successful, the next step would be to negotiate a labor contract.
Napier and like-minded colleagues allege they’re being forced to work for free. For this reason and more, they’re voting on whether to become members of the California-based Union of American Physicians and Dentists, which Dr. Justin Watkins contacted about 16 months ago.
“It was a long list of small little changes that happened. I would generalize them as being asked to do more with less,” Watkins said.
Banner union website
Banner did not reply to an interview request for this story but said in an earlier statement that it has a strong and positive team culture with highly collaborative leaders.
Banner has a website to educate employees about unions. A message from the president says Banner is committed to direct relationships between leaders and teams without union involvement.
“They're very vocal about trying to say, ‘We don't want you to unionize,’” Watkins said.
Banner operates 33 hospitals in six states. The roughly 250 providers are voting on whether to unionize work at 31 clinics throughout metro Phoenix.
Their employer is a nonprofit that took in almost $16 billion in revenue last year, a roughly $376 million increase from the year before.
Watkins practices family medicine at a Gilbert clinic.
“I certainly have felt overburdened and burnt out with the amount of work that I'm doing, but the real problem is what this does to patients,” Watkins said.
Watkins said there is no cap on the number of primary care patients he takes on, and the result is a three- or four-month wait to see him.
Another issue, he said, is the breakdown of the workweek: clinicians get only four hours to do administrative tasks, which have increased since the pandemic due to patient portal messaging. This forces Watkins to take paperwork home.
“We're not happy with the amount of unpaid work that we're being expected to do,” Watkins said.
'Eventually patients are being hurt'
Some primary care physicians at Banner end up putting in about 60 hours a week, according to Dr. Diana Elizalde. She called this unfair and said it’s not sustainable.
“The more overworked physicians are, the more exhausted they will become, the more likely that they will make clinical mistakes. And eventually patients are being hurt. And we don't want that,” she said.
Elizalde practices internal medicine and is a geriatric specialist at a Phoenix clinic. She said providers have been told there isn’t money to hire more medical assistants to help with administrative work.
Though organizing has gone on for about a year, Elizalde said it's still a touchy subject.
“Some people don't even want to talk about it at work because there's this fear (that) if you get on your employer's bad side, your life there is going to be miserable going forward,” Elizalde said.
To get around this, nurse practitioner Napier is sneaky. She also admits taking work home every weekend.
“My intention is to have the union pass. I'm very supportive in all ways,” she said.
For Napier, the drive is about doing right for patients and medicine.
“Banner is going to be Banner, but the patients. I mean, I've had patients for 25 years,” she said. “You can't walk away from that.”
Doctor files unfair labor claim alleging retaliation
An unfair labor practice lawsuit is near the center of an ongoing vote on whether to form a labor union of around 250 doctors, nurse practitioners and physician assistants at Banner Health in Arizona.
The Union of American Physicians and Dentists represents Dr. Syerra Lea in her case against Banner Health.
“Dr. Lea was an example of the conditions under which these clinicians have to work. Dr. Lea brought up a patient scheduling issue, and she was disciplined for it,” said Sebastian Gomez, a union organizer.
When she was the site lead at a Gilbert clinic, Lea said she was reprimanded and retaliated against for sending what management told her was an inappropriate group chat about providers having been wrongly scheduled to work every Saturday this year.
“It seemed to be just kind of an emotional response to me speaking up about something,” Lea said.
Months later, Lea filed a complaint with the National Labor Relations Board. Then, she gave 90 days notice that she’d found a new job.
Within a week, Lea said Banner made her leave the clinic, and cut her off from patients she knew for 15 years.
“That was probably the most upsetting and harsh reality of them just dismissing me and making me go home that day,” Lea said.
Banner did not reply to an interview request.
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