From 1993 to 2006, Dr. Christine Leitgen was a physician in the Department of Obstetrics and Gynecology at a hospital owned by Franciscan Skemp Healthcare. She was one of the busiest and highest paid doctors in the department. She also served as chair of the Department from 1999 to 2004. The Hospital distributed the revenue it received for deliveries equally among the physicians in the department, regardless of the number of deliveries each performed. Since the female physicians usually performed more deliveries, they were generally unhappy about the Hospital's compensation scheme. Leitgen herself complained to the Department chair several times. The issue came up while Leitgen herself was the Department chair, as well. She chose not to address the issue for fear that it would affect morale. Leitgen and another female physician complained to Dr. Sandy, Leitgen's successor as chair. She claims that she identified the flaws in the compensation system as gender discrimination. The issue was discussed several times at department meetings but never voted on -- and never changed. Leitgen complained to the Hospital's CFO in August and September of 2006. Again, she alleges that she framed the issue as one of gender discrimination. Throughout her employment, Leitgen's was the subject of numerous complaints from both staff and patients. In fact, as early as 2003, one of the Hospital's managers recommended that she be fired. In her March 2006 performance review, Leitgen was told that she had shown "some improvement" in the area. In July of 2006, a nurse complained that Leitgen humiliated her in front of the patient. The complaint prompted Sandy to consider discipline. The complaints continued through September. In early September, Sandy and Leitgen's supervisor began to prepare a termination recommendation. The collected information about all the complaints. Sandy made a recommendation to the executive committee that Leitgen be terminated on October 31, 2006. On November 14, Leitgen was told to resign or be fired. She resigned the following day. She brought suit under Title VII of the Civil Rights Act, claiming that her termination was in retaliation for her complaints about gender discrimination. Judge Crabb (W.D. Wis.) granted summary judgment to the defendants. Leitgen appeals.

In their opinion, Judges Rovner, Sykes, and Tinder affirmed. As Leitgen proceeded under the direct method of proof, she was required to establish that she engaged in protected conduct, that she suffered an adverse employment action, and that there was a causal connection. In order to establish protected conduct, she need not prove that the Hospital’s compensation system was discriminatory, but she must prove that she had a reasonable and good faith belief that it was. At this summary judgment stage, the Court concluded that there was sufficient evidence that she had such a belief and that her conversation with the CFO was therefore protected conduct. With respect to the causal connection, however, the Court concluded otherwise. In order for her to meet that requirement, she must show that her complaints were a "substantial or motivating factor" in the Hospital's decision. Her reliance on the temporal proximity between the communication with the CFO and her termination did not persuade the Court. First, suspicious timing is almost never enough. Second, her conversation with the CFO was not the first time she raised the complaint. Third, the conversation was not even the first time she raised the complaint outside her department. Fourth, Sandy and Leitgen's supervisor began their discipline discussions before Leitgen's meeting with the CFO. Leitgen failed to establish the required causal connection and summary judgment was appropriate.