Labor & Employment Law Daily Wrap Up, DISCRIMINATION—AGE—7th Cir.: Neurosurgeon, hired at 75, fired three years later, failed to show discrimination, (Jul 30, 2026)

By Jason Albright, J.D.

A supervising physician told him he needed to work from home during the pandemic “because of [his] age and because of the risk of contracting COVID, and if [he] was on a ventilator, [he]’d be a goner.”

A neurosurgeon for Northwestern Medicine Regional Medical Group, hired at age 75 and fired three years later based in part on the medical group’s growing reliance on advanced practice professionals (APPs), failed to establish a violation of the ADEA, the Seventh Circuit affirmed. Although a supervising physician’s statements to him in July 2020 indicated that his age was a factor in the employer’s decision to keep him at home during the COVID-19 pandemic, and he was terminated 60 days later, this alleged “suspicious timing,” was not enough to create an inference of discrimination on its own, and in the employer’s view, because the neurosurgeon’s role was more akin to that of an APP, his productivity was significantly lower than that of other neurosurgeons and was inconsistent with its new business model (Richardson v. Northwestern Memorial HealthCare, No. 25-1782 (7th Cir. July 29, 2026)).

RMG and its neurosurgeons. Northwestern Medicine Regional Medical Group (RMG) is a medical group working at Northwestern Medicine Central DuPage Hospital (CDH) and Northwestern Medicine Delnor Hospital. As Level II trauma centers, the hospitals require on-call neurosurgeons to review any cases requiring urgent evaluation or surgical intervention independently and to perform any necessary surgeries. RMG neurosurgeons share a call pool so that any neurosurgeon “on call” would typically cover both hospitals.

APPs. In addition to the neurosurgeons, RMG also staffs APPs at CDH and Delnor. APPs include advanced nurse practitioners and physician assistants to assist the neurosurgeons. During the relevant period, APPs were paid between $110,000 and $160,000.

Board-certified neurosurgeon. The plaintiff is a board-certified neurosurgeon, and he was hired by RMG around 2017 to work with another neurosurgeon, a new hire, with whom the plaintiff had previously worked in the other neurosurgeon’s practice. At the time he was hired, the plaintiff was 75 years old, and he earned only $180,000, well below what a typical neurosurgeon made at RMG. This was because, according to RMG’s president’s understanding, the plaintiff was essentially hired to be his former colleague’s assistant, similar to an APP. The plaintiff reported to the medical director of neurosurgery, who in turn reported to a supervising physician, who in turn reported to RMG’s president.

Covered only one hospital. RMG’s neurosurgeons covered on call duties at both hospitals, but the plaintiff worked exclusively at Delnor. The parties also disputed the scope of his capabilities and whether he could cover calls independently and work on his own as the other neurosurgeons did.

APP-type role? The supervising physician and president both believed that he did not perform operations by himself like RMG’s other neurosurgeons, choosing instead to work in an APP-type role.

New policy. In 2018, the supervising physician discussed with his colleagues his desire to have neurosurgeons “practice at the top of their license” by independently covering calls and performing surgeries, while having APPs perform all supportive tasks. This policy was implemented in piecemeal fashion over the next few years.

RVUs. RMG measured the productivity of its neurosurgeons and other professional staff by using what it called Relative Value Units (RVUs). RMG assigned different RVU values to the various services and procedures its staff performed. Although these RVU amounts vary, the role of a primary surgeon was always associated with higher RVUs than that of an assisting role. A neurosurgeon’s financial contribution to RMG was calculated based on the surgeon’s anticipated RVU production, the individual’s actual RVU production, and the total expenses RMG incurred for employing the surgeon, including salary and malpractice insurance. As compared to surgeons, APPs were typically paid less and did not require malpractice insurance.

Work from home. On March 18, 2020, at the onset of the COVID-19 pandemic, RMG instructed the neurosurgeon to work from home. In May and July 2020, he asked for permission to return to work in person, but the supervising physician denied the requests. When denying the latter request, he told the neurosurgeon that he needed to work from home “because of [his] age and because of the risk of contracting COVID, and if [he] was on a ventilator, [he]’d be a goner.”

Lower RVUs. Over time, the supervising physician came to believe that the neurosurgeon’s RVUs were much lower than those of other RMG neurosurgeons, and in the president’s view, an APP at RMG could perform “most” of the duties that the neurosurgeon performed but at much lower costs by, for example, eliminating the need for malpractice insurance. Because the plaintiff was categorized as a neurosurgeon, the president also believed that his employment lowered the overall productivity of the neurosurgeons, undercutting the case for hiring additional ones.

Fired. On September 2, 2020, the supervising physician and president informed the neurosurgeon that his employment was being terminated, effective December 31, 2020. They based the discharge decision, they said, on RMG’s growing reliance on APPs and their desire to hire a neurosurgeon to cover calls at both hospitals.

RMG hired another neurosurgeon about a year later.

Lawsuit, decision below, and appeal. The plaintiff sued, alleging that RMG discriminated against him based on his age in violation of the ADEA. After discovery, RMG filed a motion for summary judgment, which the district court granted. The neurosurgeon then appealed to the Seventh Circuit.

Age discrimination. Affirming, the federal appeals court noted that nobody disputes that the neurosurgeon was over 40 at the time of his firing or that his firing was an adverse event. Nor did the parties dispute that the president and supervising physician were the relevant decisionmakers. The only issue before the court was causation: whether a reasonable jury could find that the neurosurgeon’s “advanced age caused his employment termination.”

Causation. To show that his advanced age was a but-for cause of his firing, the neurosurgeon relied heavily on the way RMG treated him during the early months of the COVID pandemic. He argued, for example, that he was the only person in the neurosurgery department whom RMG sent home in March 2020. And when he asked to return in July 2020, the supervising physician told him that he could not return to work on account of his age, even remarking that the neurosurgeon would be a “goner” if he had to be placed on a ventilator. However, the record did not support his assertion that he was the only RMG neurosurgeon who had to work remotely. Rather than singling him out, noted the court, RMG had implemented a general mandate that all personnel should stay at home to the extent possible.

The comments? As for the supervising physician’s comments about his age and COVID risk, the Seventh Circuit found that those statements “indicate that his age was a factor in RMG’s decision to keep [him] at home.” Where his claim faltered, however, was in connecting those statements, made in July 2020, to his announced termination on September 2, 2020. The supervising physician made his comments on July 4, 2020, and because the record did not indicate when RMG decided to fire the neurosurgeon, the court was “left with September 2, 2020, as the best approximation of the date the decision was made.” Even if this span of 60 days were enough to constitute “suspicious timing,” as the neurosurgeon argued, concluded the appeals court, “it is not enough to create an inference of discrimination on its own.” And he offered nothing else.

For its part, RMG also argued that it had a nondiscriminatory reason for firing him: it was trying to implement a staffing model that relied more heavily on APPs, thus allowing its neurosurgeons to become more productive and increase revenue. In RMG’s view, because the neurosurgeon’s role was more akin to that of an APP, his productivity was significantly lower than that of other neurosurgeons and inconsistent with the new business model.

The judgment of the district court was accordingly affirmed.

The case is No. 25-1782.

Judge: Lee, J.

Attorneys: Elizabeth M. Bartolucci (Bartolucci Law) for Robert R. Richardson. Kara Elizabeth Cooper (Winston Taylor) for Northwestern Memorial Healthcare and Central DuPage Physician Group dba Northwestern Medicine Regional Medical Group.

Companies: Northwestern Memorial Healthcare; Central DuPage Physician Group; Northwestern Medicine Regional Medical Group

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