A cost-driven staffing overhaul decided the case, not one physician's ventilator warning
A 75-year-old neurosurgeon lost his age discrimination case against Northwestern Medicine - despite a warning he'd be a "goner" on a ventilator.
The US Court of Appeals for the Seventh Circuit affirmed a ruling for the employer on July 29, 2026, ending the case before trial and showing how far an age-related comment carries.
The neurosurgeon was hired at 75 to work for Central DuPage Physician Group, which operates as Northwestern Medicine Regional Medical Group. He earned about $180,000, well below the group's other neurosurgeons, and filled a limited role closer to that of an advanced practice professional, or APP - the assistants who support surgeons. Three years later, the group fired him. He sued under the Age Discrimination in Employment Act.
His case leaned heavily on the early months of the COVID-19 pandemic. In March 2020, the group sent him to work from home. When he asked to return that July, a senior physician refused. According to the ruling, the physician said he had to stay home "because of [his] age" and the risk of COVID, adding that if he was "on a ventilator, [he]'d be a goner."
The court assumed, for argument's sake, that age factored into the decision to keep him home. But it drew a sharp line between that call and his firing about sixty days later. "Suspicious timing," the court noted, "will rarely be sufficient in and of itself."
The group offered a business reason for the firing. It was shifting to a model that leaned more on APPs, who cost less and need no malpractice insurance, freeing surgeons to do more operations. The group tracked output through Relative Value Units, a productivity metric, and believed the neurosurgeon's numbers ran below his peers'. Unlike the group's other neurosurgeons, who handled on-call duty at both of its hospitals, he worked at just one. The group hired another neurosurgeon about a year later.
To win, he had to show those reasons were a cover for age bias. The court said he could not. Even if managers misjudged his abilities, being mistaken is not the same as lying. Citing precedent, the court noted a poorly considered decision "is not enough to establish pretext."
He also pointed to his contract, which he said required the group to confer before firing him. But the court found that clause applied only to for-cause terminations. His was without cause, requiring ninety days' notice - which he got. The decision turned on causation and the documented business case, not the comment.
