Dr. Syerra Lea watched carefully as an official with the National Labor Relations Board plopped more than 200 yellow ballots onto a wooden table. As one of the leaders, she knew more than anyone what those ballots represented. They would decide the fate of an 18-month historic effort: unionizing physicians at Arizona’s largest private employer.
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Officials of the independent federal agency counted the ballots inside a small room with a courtroom-like setup. Their count would determine the fate of the Phoenix-area primary care physicians and advanced care practitioners.
If the majority of clinicians voted in the affirmative, employees would have the power to collectively bargain with Banner Health for better pay, working conditions and patient protections. Arizona’s first physicians’ union would be created at the state’s largest private employer.
It was a long, anxious two-and-a-half hours for Lea. She nervously sat down on a wooden bench between her husband and Dr. Justin Watkins, another physician instrumental in the unionizing effort. The results were about to be announced.
“We have had this on our brains every day for the last 18 months,” Lea told Phoenix New Times in the lobby of the central Phoenix building where NLRB’s Region 28 offices are located.
It was a landslide. Banner physicians voted to form a union with the union of American Physicians and Dentists, with 149 ballots in favor and only 66 against.
“Just to watch it live and see how many of our colleagues agreed with us that this was needed for a long, long time and enough was enough,” Lea said. “We all stood together and it is amazing.”
As news of the vote broke, community members, online commenters and even U.S. senators shared their support and excitement for the newly unionized physicians.
“This is a really amazing development,” Sen. Ruben Gallego told New Times in a phone interview. “Time and time again, I have talked to doctors, nurses that feel that they are basically pushed around and treated like a commodity instead of an integral part of our healthcare complex. This is a great way for them to have the power to negotiate.”
A tedious process
That morning, more than a dozen people shuffled into the NLRB Region 28’s offices on the 14th floor of a central Phoenix office building to watch the ballot counting. Two representatives with the UAPD sat next to two Banner Human Relations employees to oversee the NLRB officials’ ballot counting. In two wooden pews parallel to the action, Banner’s attorneys and several current and former Banner physicians and nurse practitioners watched the count with anticipation.
Lea, a 15-year Banner primary care physician who was walked out of her practice after putting in her 90-day notice, described the five Banner clinicians who sat in on the vote as “like siblings to me,” but also “war veterans,” having survived the unionizing process, and practicing medicine in general.
Banner Health attorneys challenged 11 ballots, arguing that those employees were in the process of leaving the company when they voted. Those ballots, including that of union leader Lea, were set aside. Two ballots were void because they lacked the required signatures.
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To ensure voters’ confidentiality, the two NLRB officials opened each of the remaining 215 envelopes individually and removed a blue envelope. They set the external yellow envelopes aside while mixing the large pile of blue envelopes.
Then the counting began. An official opened each blue envelope and pulled out a green slip, which recorded the ballot vote—yes or no to forming a union. The official turned each slip toward Banner and the union’s representatives and read the vote aloud. He showed the representatives the now-empty blue envelope.
It didn’t look like a strong start for the union. The official read two “Nos” back-to-back, but that quickly changed. In the wooden pews, physicians and their spouses counted each vote through apps on their phones. The union kept an online counter of the tally. A Banner attorney in the first row of pews kept a physical tally going on his steno pad notebook.
In a group chat of more than 100 people, Lea communicated with physicians watching the virtual tally. The physicians were hoping for 114 “yes” votes to gain the majority. ”This is happening,” a physician wrote in the chat. “My hands are so sweaty,” Lea whispered to New Times amid the count.
Shortly after 12:30 p.m., the “yes” votes sailed past physicians’ hopeful 114-vote count. The NLRB official counted 149 “yes” votes and 66 “no” votes in both the initial and recount. The challenged ballots didn’t matter. Both union and Banner representatives signed off on the result.
Outside the office by the elevator doors, physicians and union representatives hugged and high-fived. It had paid off. Their faces were plastered with smiles as they packed into an elevator and rode it to the button floor.
“I’m elated,” said Watkins, a Banner family medicine practitioner who initially reached out to UAPD in February 2025. “We felt like we had the support we needed to win, but it’s really gratifying to see it come through. It was an overwhelming victory.”
“It was exhilarating,” said Candace Napier, a nurse practitioner who has worked for Banner for 27 years. “It’s gonna make a big difference for us to be at the bargaining table.”
After the NLRB officially certifies the election, the union will request to begin the collective bargaining process with the company, UAPD organizer Sebastian Gomez told New Times. Physicians like Napier and Watkins said they hope the union can reach a contract with Banner to improve physicians’ workflow and lives. That would include factors like improving pay, enshrining workplace protections so clinicians can safely speak about patient safety without fear of retaliation, adding staff to handle administrative work so physicians can focus on patient care, and allowing practitioners more control over their schedules and workflows so they can spend more time with patients, if needed.
“Patient outcomes are going to end up being better when these union members are going to be able to represent themselves and advocate for themselves with a better working environment,” Gallego said.
Read more Doctors at Banner Health make history, vote to unionize