A group of doctors and advanced practice providers who work for Phoenix-based Banner Health is trying to form a union within the state's largest health system while the company is discouraging the effort.
About 268 primary care doctors, nurse practitioners and physician assistants (also known as physician associates) who work for Banner Medical Group in the Valley are voting for whether or not to unionize under representation by the Union of American Physicians and Dentists, UAPD, lead campaign organizer Sebastian Gomez said.
If the unionization effort is successful, it would become the first union formed in Arizona that includes physicians, Gomez said.
Providers in favor of unionization say they need limits on patient numbers and improved clinical
support to avoid excessive work that is compromising patient care and causing burnout and high turnover. The providers say that non-clinical executives are making too many decisions about health care delivery without input from the frontline workers providing the care. They also want to be protected from retaliation by Banner Health leadership.
"Everyone has too much to do," said Dr. Justin Watkins, a primary care physician who works for Banner Health in Gilbert and was part of the initial union organizing effort that began about 18 months ago. "I was burning out fast, feeling really taken advantage of."
Banner Health officials did not respond to The Arizona Republic's questions about the unionization effort and instead sent a statement. The statement says the unionization effort is coming from "the concerns of a few" and is not reflective of the workforce as a whole. The company is urging employees to vote no on unionizing, "so Banner can remain strong as one team."
The unionization effort is indeed coming from a minority of Banner Health workers, though those supporting it point out that it involves the backbone of any health system, which is primary care. Watkins said he's heard from Banner employees outside of primary care who are supportive of organizing, too.
"Only a small handful of people have been putting their names and faces to the movement," Watkins said. "There's enormous concern about retaliation."
Banner Health cites 87% retention rate. Union organizers disagree
Banner Health has locations in multiple states, but Arizona comprises its largest workforce, with about 46,700 employees statewide as of 2025. Banner Health in 2025 was the largest nongovernment employer in the state, according to rankings from The Republic.
At least one-third of the affected Banner Medical Group employees or about 80 people, already signed an authorization card, which was needed to put the unionization effort in motion. The votes are scheduled to be counted Sept. 2 in Phoenix and the deadline for receiving the votes at the Phoenix National Labor Relations Board office is Aug. 26, Gomez said. A simple majority of votes casts is required to organize, he said.
In the company's statement about the union effort, Banner Health lists an 87% retention rate that the company says is "significantly outperforming the industry," though Watkins and other supporters of unionizing say that statistic lumps primary care in with all other staff in the company and is not reflective of what primary care providers are seeing in the Phoenix area.
"We fundamentally disagree with that statistic," Gomez said.
The effort is about primary care providers whose patient loads are so high that Watkins said he's booking appointments four months out, all while being expected to do "more with less."
"We certainly feel like they (Banner Health leadership) are not afraid to burn us out," Watkins said. "We have no voice. They are not listening to us."
When they filed for union representation June 22, the clinicians released a statement that says there's a broader workplace culture at Banner "that prioritizes productivity metrics over meaningful clinician input."
Longtime Banner Health nurse practitioner Candace Napier is supportive of unionizing because she wants frontline health providers to "have a collaborative seat at the table to make decisions together" with executives, she said.
"This isn't about money. It's about doing the right thing for the patient. ... If you are in the trenches you know what it's like," Napier said. "Primary care doctors are the smartest, hardest working people I know. No one is out there buying Jaguars or playing golf. They are lucky if they are able to get off their computers long enough to say hi to their kids."
Napier works at a primary care clinic in Sun City West, and has been a Banner Health employee going back to when the nonprofit was formed out of a merger between Samaritan Health System and Lutheran Health System in 1999.
Union representation and a legally binding collective bargaining agreement would establish enforceable protections that allow clinicians to advocate for high-quality patient care without the fear of retaliation, she said.
Pro-union arguments include workplace safety, economic equality
Banner Health officials have a website called Banner Health Strong Journey intended to inform its employees about unions, while also citing its position discouraging them.
Citing U.S. Department of Labor Statistics data, Banner Health officials say on the site that only 5.9% of the private workforce in the U.S. is in a union, that unions need more members to survive, and that they aren't social organizations, clubs or charities, but rather, "they are businesses."
"We’re an attractive target for labor unions because we have a large workforce and rapid regional growth," the website says.
Conflating the number of people participating in unions with their value is "morally flawed," Gomez said.
Unions have declined in numbers as a result of workers' rights being dissolved, he said, not because they aren't effective. The workers who are unionizing are exercising their federal rights, he said, and framing the union as something workers should not join, Banner Health is driving a "clear division" in the company.
The UAPD was established in 1972, says it represents more than 7,000 private and public sector health care practitioners, and is affiliated with AFSCME and the AFL-CIO. One of the most recent group of providers to join the UAPD were pediatricians in the Packard Children’s Health Alliance, which is part of Stanford Medicine Children’s Health.
Arguments in favor of unions include workplace safety, economic equality and an improved standard of living for people in the middle class. The reason that union numbers have dropped since the 1980s, according to the left-leaning Economic Policy Institute, is because of an erosion of workers' rights and bargaining power under U.S. law and interpretations of the law.
As workers rights declined, top CEO salaries across all industries have jumped by more than 1,000% since the 1970s compared with a 26% increase in typical worker compensation, Economic Policy Institute research says.
One of the ways to counteract a trend of excessive compensation and a "winner take all society" is if typical workers increase their leverage to secure higher pay, "leaving less left over for CEOs and other executives to claim," the institute says.
Reach health-care reporter Stephanie Innes at stephanie.innes@usatodayco.com or follow her on X: @stephanieinnes or on Bluesky: @stephanieinnes.bsky.social.
This article originally appeared on Arizona Republic: Banner Health doctors want to form union. 'They don't listen to us'
