Gilbert primary care doctor explains why he and his Banner Health colleagues voted to unionize

Banner Health has filed a challenge with the National Labor Relations Board, alleging problems with a recent vote by some providers to unionize.

A group of primary care providers voted earlier this month to join the Union of American Physicians and Dentists. This is the first time Banner employees have voted to unionize.

But in its challenge, Banner accuses union organizers of promising free legal counsel in exchange for their colleagues signing union authorization cards; groups need to collect a certain number of those cards to allow the vote on whether to unionize to move forward.

A hearing on that challenge is expected in September or October.

Earlier, The Show spoke with one of the organizers of the effort to unionize. Dr. Justin Watkins is a family medicine physician at Banner Medical Group in the Gilbert Health Clinic. He spoke with The Show more about the concerns that he and his colleagues had that led to the effort to unionize.

Full conversation

JUSTIN WATKINS: Sure. The primary thing that pushed us to attempt to form the union, which we’ve successfully done now, was a loss of autonomy, a loss of decision-making control over the way certain processes in the clinics are handled, the way our workflow is handled, the way our scheduling is handled and the size of our patient panels.

So that led to an enormous amount of administrative burden beyond what is contracted for us. Those were all concerns. The specific things in that led to that greater burden and the loss of autonomy: clinical decisions that are getting made by mid-level managers who are not qualified to make those decisions.

And then the downstream effects we saw from those things, which was a drop in quality of care, a length in how long it takes to come in and see us; the length of time it takes us to address concerns that come through the patient portal; messages; turnaround times on things like lab results, imaging results, etc. So it was negatively impacting us in our work lives, and it was negatively impacting our patients and the quality of care they’re getting from Banner.

MARK BRODIE: It sounds like you felt like you were not able to treat your patients in the way that you wanted to treat them in the amount of time that you wanted to treat them.

JUSTIN WATKINS: Right. Right, absolutely. And there’s a lot of burnout going on for myself and for many of my other colleagues. And we’d raised concerns, and our managers would tell us that they heard us and, you know, repeat back what we were expressing to them and acknowledge that there’s definitely some concerns there. And then nothing ever happened on almost any of those issues.

MARK BRODIE: So this vote affects about 270 or so primary care providers like yourself. Do you anticipate or have you heard from other specialists or other folks within Banner that they are looking at this and saying, "Oh, maybe we should do this also?"

JUSTIN WATKINS: Absolutely. What’s been also gratifying really is how many people have reached out to different members in the organizing group, to UAPD — people who are not physicians, people who are employed with Banner in other positions, people who are not employed with Banner ... that are our physicians in other, you know, health groups here in the Valley.

The response has been very, very positive. And there are quite a number of people who have had their eye on this since it went public about how it was going to go, which way the results would go. And we’ve shown many others that, you know, they’re not alone, that this is the business model that Banner’s using, and it takes advantage of all of us. And, you know, they have expressed that they feel about as voiceless and powerless as we did, and they’re very interested in, you know, coming to a negotiating table with Banner themselves to make similar improvements.

MARK BRODIE: So when you talk about the concerns that you had, some of them, it seems like, you know, for example, decisions being made by, you know, folks who are maybe not providers or clinicians or not taking your input — those seem like fairly in theory easy things to fix. But when you talk about, you know, not having enough time with your patients or having too many patients or too much lag time to get them lab results or things like that, like how would you like to see those addressed? What changes would you like to see so that those are not concerns and not problems?

JUSTIN WATKINS: Sure. Those those things are all manageable, very much manageable. They all have fairly straightforward solutions. An important part of that is going to be increasing the amount of support staff. So medical assistants, hiring them helps get through those messages quicker. More, you know, pharmacy assistants is a necessary thing that’s going to help a lot with simple management once we’ve initiated, you know, management of common problems like diabetes and high blood pressure, things like that. So pharmacy assistance is there.

Mid-level, you know, either nurses or nurse practitioners who are exclusively remote to handle simple inbox questions and normal results and that kind of thing, so that we can focus on the more challenging or complex things. All of those things can help a ton, but hiring more staff that do work that doesn’t actually bring income in isn’t what a business is, you know, wanting to do, but it is how you offer better patient care.

MARK BRODIE: So, I want to ask you about Banner challenging the vote with the National Labor Relations Board. They’re accusing you of basically offering your colleagues free legal advice in exchange for having them sign the authorization cards, basically the cards that allow the vote to join the union to be held. I’m assuming that you are denying that this happened, but what do you make of this?

JUSTIN WATKINS: This is a delay tactic. It’s a very common delay tactic used by anti-union lawyers to slow the process down. The longer that it takes to come to an agreement ... the longer Banner gets to keep the status quo where they’re, you know, making as much money as they are currently making, and they, you know, keep those costs down where they currently are, and that’s going to change.

We believe that the complaint stems from the website that UAPD put out after we went public, where it explains what Weingarten rights are. And ... that’s the name given to the basic rights provided to all Americans who are working inside of a union, not just a like a for physicians or what have you. Anybody working in a union has Weingarten rights, and one of those explicit rights is that they have access through their union to a union representative, including and up to legal counsel, should they, you know, be approached by their employer for correction or disciplinary action or even up to getting fired.

And so that’s just an explanation of what happens, what rights you have available to you as a union member after the union forms. And in no way, shape, or form does that communicate if they sign a card, they will be allowed free legal counsel, you know, in exchange for signing a card. It’s a simple explanation of Weingarten rights, and we don’t believe this is going to hold any water.

MARK BRODIE: Do you feel like the relationship is reparable? Like, assuming that the union goes forward, do you get the sense that you guys and hospital company management will be able to come to an agreement that will make everybody, if not happy, at least something that you can live with, and everybody can sort of go about their business and do their thing and be OK with it?

JUSTIN WATKINS: Absolutely. This is business, right? This isn’t personal. The struggle between employers and employees for power and pay and rights, etc. — all of that is a tale as old as time. Banner’s a very large employer, and they hold an enormous amount of power in the relationship between them and their employees. And the only real meaningful way that we could see to make our voices heard was to unionize, to come together.

But that’s just business, right? We’re just going to turn into a business expense. And they’re wise. They’re going to turn this around, you know, once we’ve, you know, secured better working conditions and better pay and better support in our clinics, and they’re going to say, "Oh, well, this is great. Come come work for Banner. Look at how well we take care of our doctors." And they’ll just pretend that they didn’t fight tooth and nail against that. So we can we can make this work. I don’t think that’s going to be personal animosity.

MARK BRODIE: All right, that is Dr. Justin Watkins, a primary care provider with Banner Health based in Gilbert. He also led the effort to unionize primary care providers there. Dr. Watkins, thanks so much.

JUSTIN WATKINS: Thank you for having me.

The Show also reached out to Banner Health. Here is the company's full statement:

The majority of AZ Banner Medical Group clinicians who participated in the recent union election voted to be represented by the Union of American Physicians and Dentists. We respect that decision, and if the results are certified by the National Labor Relations Board we’ll consider our next steps in meeting our obligations to the Union, our clinicians and the community we serve.

We remain deeply committed to the culture we have built together, which is grounded in trust, respect and a shared dedication to our patients and communities. The contributions our clinicians and team members make every day are what make Banner exceptional, and that will not change.

Our focus remains where it has always been: Delivering outstanding care to the patients and communities we are privileged to serve.