By Ryan Basen

For working through the pandemic, Banner Health employees received a token of the company's appreciation recently. But the commemorative coin that they couldn't take to the bank left some feeling fired up, given the risk, temporary job loss, and mental health issues healthcare workers endured.

The silver coin read "Banner Strong" on one side, while the flip side said: "We kept each other safe to save as many lives as possible."

"That's disrespectful of patients and clinicians' experiences, burdens, and sacrifice," said Brian J. Miller, MD, MBA, a Johns Hopkins Medicine hospitalist and professor.

"Nice coin. Wonder how big their bonus will be," one commenter wrote on Meddit.

"Not what we meant when we said we want more 'coin' :')," another wrote.

Banner declined to answer questions regarding the coin.

A Banner spokesperson instead emailed a statement: "Our team members went to extraordinary lengths to care for the communities we serve during a time of great uncertainty. We are so grateful for their commitment and compassion," the spokesperson wrote. "We hope that [the coin] will be a reminder in years to come of what we were able to achieve together during this once-in-a-lifetime event."

Seven Banner executives signed an attached card. "Thank you for your steadfast commitment during what has truly been a once-in-a-lifetime event," it read. "Your knowledge, passion and contributions allowed us to save as many lives as possible during the COVID-19 pandemic, and showed that when we embrace adversity, extraordinary things can happen. We traveled this journey together, with a focus on safety and clinical excellence, and a newly found level of compassion and caring for each other. ..."

"We lived our Values, fulfilled our Mission, and showcased the greatness in our teams. Together, we have defined what it means to be Banner Strong. This coin commemorates all we achieved, and celebrates and honors all that you are. May you look back on this time, and the role you played, with pride."

Meddit commenters were frustrated.

"After all the bulls -- we had to deal with during the pandemic, they think that this is one of the best ways to 'thank us' for everything that we've been through. Unbelievable," one wrote.

"Did we support each other through horrible shifts and psychological trauma dealing with suffering at an unimaginable level," wrote another. "Yes which in many instances was the only thing that made dealing with 2020 and 2021 remotely bearable. I really don't get the statement or the Orwellian symbolism. I'd rather get a day old muffin and stale coffee."

"Does it at least work in a skee ball machine?" joked another.

Banner is not the only health system to issue a memento to commemorate the pandemic, according to Miller. Meddit posts suggested this, as well.

"We also got a coin," one wrote. "Several months after they said no raises due to being in the red thanks to COVID (slap in the face)."

Said another: "Some giggly HR rep came around and thanked us and gave us an 'appreciation medallion.'"

Several medical societies contacted either declined to comment or did not return queries by press time.

"This is a tricky one, because it was likely well-intentioned but so clearly not the right scale to honor the pandemic response," said a representative of one society, who asked not to be named because this person was not speaking for the society.

Like many U.S. health systems, Banner cut staffing burdens last spring. The 30-hospital, Arizona-based system announced in April 2020 it was furloughing 5% to 7% of its some 52,000 employees at the time across six states.

"The furlough only impacted a small number of workers whose work was reduced significantly -- or suspended altogether -- as a result of COVID," said a Banner spokesperson. Banner declined to specify the exact number.

Staff at the non-profit system "were given [the] option" to take 1 month of unpaid sabbatical, "which many chose because it assisted with challenging personal circumstances."

Banner also redeployed many healthcare workers. If workers declined to be redeployed, they either had to take paid time off or were assigned to sabbatical, according to a report, which also noted such employees were told their jobs might not be waiting for them when they returned.

Ultimately: "The jobs were protected for employees who elected to take a sabbatical," the spokesperson wrote.

In addition, Banner promised to cut executive pay by up to 20%, and leaders promised to contribute $100,000 to a pot for impacted employees facing extreme economic hardship and a bonus for healthcare workers giving direct care to COVID patients, according to media reports.

"Banner employees who worked in certain high-risk areas did receive additional compensation," the spokesperson wrote.

Banner soon began recovering financially, after most procedures were allowed again in Arizona -- where four of every five employees were based -- and the system accepted $1.1 billion in grants and loans from the federal government via the CARES Act. That financial figure was reported by Good Jobs First's COVID Stimulus Watch project.

Banner sought to hire 800 employees in June 2020, noting a shortage. This was the same month it was reported that Banner was concerned that rising state COVID cases "correlates with a rise in cases that we are seeing in our hospital ICUs." In July, Banner hired nearly 1,000 out-of-state nurses and respiratory therapists along with 49 per-diem physicians. It is unclear where Banner's workforce stands now.

Around the same time, Banner published a blog post entitled "Banner Redeploys Corporate Employees To Help Frontline Colleagues," underneath the tag "INSPIRE ME." It concluded by encouraging employees to "learn how to help those on the frontlines," linking them to a webpage that no longer exists.

Overall, 2020 was not a banner year financially for Banner. The system's net income dropped by 19.3% over 2019 to $586.7 million. Revenue was up about $1 billion to $10.4 billion, but expenses increased from $9.2 billion to $10.1 billion. Only the CARES Act funds, some of which the system has to refund, prevented Banner from losing money.

But conditions during the pandemic were sometimes brutal for healthcare workers, according to the report. Nurses were limited in overall PPE use and told to reuse N95 masks. Workers who felt COVID-19 symptoms reported having to use paid time off rather than sick leave; they were instructed they "should NOT report to [Banner Occupational Health Services] but should contact their medical provider for health-related questions." Securing a COVID test via Banner routes was "almost impossible."

The spokesperson said that Banner "followed CDC guidelines regarding N95 masks and other PPE" and emphasized that "infection rates of team members remained below that of the community."

But that statistic didn't appear to appease many of the commenters.

"Insanely insensitive," one doctor said. "WTF is all I can say."