Donna Trask v. Secretary, Department of Veterans Affairs ( 2016 )


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  •          Case: 15-11709     Date Filed: 04/05/2016   Page: 1 of 31
    [PUBLISH]
    IN THE UNITED STATES COURT OF APPEALS
    FOR THE ELEVENTH CIRCUIT
    ________________________
    No. 15-11709
    ________________________
    D.C. Docket No. 8:13-cv-00536-MSS-TBM
    DONNA TRASK,
    ANITA TRUITT,
    Plaintiffs-Appellants,
    versus
    SECRETARY, DEPARTMENT OF VETERANS AFFAIRS,
    Defendant-Appellee.
    ________________________
    Appeal from the United States District Court
    for the Middle District of Florida
    ________________________
    (April 5, 2016)
    Case: 15-11709       Date Filed: 04/05/2016       Page: 2 of 31
    Before HULL, JULIE CARNES, and CLEVENGER, * Circuit Judges.
    HULL, Circuit Judge:
    Plaintiffs Donna Trask and Anita Truitt (the “plaintiffs”) appeal the district
    court’s order granting summary judgment in favor of the Secretary for the
    Department of Veterans Affairs (“VA”) in their employment discrimination action
    brought pursuant to Title VII of the Civil Rights Act of 1964 (“Title VII”), 42
    U.S.C. § 2000e et seq., and the Age Discrimination in Employment Act of 1967
    (the “ADEA”), 
    29 U.S.C. § 626
    . On appeal, the plaintiffs argue that the district
    court erred by making improper fact determinations and incorrectly applying the
    relevant law. After review, and with the benefit of oral argument, we affirm. 1
    I.     RELEVANT BACKGROUND FACTS
    In this case the plaintiffs sued their employer, the VA, for gender and age
    discrimination. The plaintiffs are pharmacists who have worked for the VA for
    over a decade. In 2010, the VA announced a nationwide treatment initiative that
    resulted in the reorganization of several VA treatment facilities, including the
    facility where the plaintiffs worked. This reorganization involved the creation of
    *
    Honorable Raymond C. Clevenger, United States Circuit Judge for the Federal Circuit,
    sitting by designation.
    1
    We review de novo the district court’s grant of summary judgment, viewing all evidence
    in the light most favorable to the non-moving party. Owen v. I.C. Sys., Inc., 
    629 F.3d 1263
    ,
    1270 (11th Cir. 2011). Summary judgment is proper “if the movant shows that there is no
    genuine dispute as to any material fact and the movant is entitled to judgment as a matter of
    law.” Fed. R. Civ. P. 56(a). We may affirm on any ground that finds support in the record.
    Thomas v. Cooper Lighting, Inc., 
    506 F.3d 1361
    , 1364 (11th Cir. 2007).
    2
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    new pharmacist positions requiring an “advanced scope of practice,” to be filled
    internally, and the elimination of certain pre-existing pharmacist positions,
    including the positions that the plaintiffs held.
    The plaintiffs claim they were not selected to fill the new pharmacist
    positions due to their gender and age and were similarly denied opportunities to
    train and qualify for those positions due to their gender and age. The VA’s non-
    selection of the plaintiffs for the new pharmacist positions, along with its
    reorganization and elimination of the plaintiffs’ then-current positions, resulted in a
    reassignment of the plaintiffs’ positions and job duties. The plaintiffs claim their
    reassignments resulted in losses of prestige and responsibility. The plaintiffs have
    suffered no decrease in pay and are still employed by the VA.
    We recount below the plaintiffs’ training and credentials, as well as their
    experience and performance as pharmacists. We then discuss the VA’s creation
    and implementation of the treatment initiative that gave rise to the new pharmacist
    positions and discuss the objective qualifications required to fill those positions.
    Finally, we recount the plaintiffs’ unsuccessful attempts to qualify for and fill the
    new pharmacist positions.
    A.    The Plaintiffs and their Supervisors
    Dr. Donna Trask, a female born in 1953, is a licensed clinical pharmacist.
    At the time of the events material to this appeal, Dr. Trask was approximately 58
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    years old. Dr. Trask obtained a Bachelor of Pharmacy Degree in 1975, and a
    Doctor of Pharmacy Degree in 2002. Over her decades-long career as a clinical
    pharmacist, Dr. Trask has gained extensive experience monitoring medication
    distribution, establishing drug handling procedures, maintaining prescription
    records, training pharmacy personnel, educating and consulting patients, and
    making medication recommendations to physicians for all types of diseases and
    medical conditions, commonly referred to as “disease states.”
    In 2010, Dr. Trask obtained a certificate in Medication Management
    Therapy, which indicates expertise in several areas, including disease state
    management and selecting, initiating, and modifying medication therapy. In 2011,
    Dr. Trask obtained board certification as a geriatric pharmacist, which
    demonstrated competence in over 100 disease states in the senior population.
    Dr. Trask has also taught classes in pharmacology.
    Dr. Anita Truitt, a female born in 1955, is also a licensed clinical
    pharmacist. At the time of the events material to this appeal, Dr. Truitt was
    approximately 55 years old. Dr. Truitt obtained a Bachelor of Science Degree in
    Pharmacy in 1978, and a Doctor of Pharmacy Degree in 2003. Throughout her
    decades-long career as a pharmacist, her job duties have required her to counsel
    and educate patients in several disease states.
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    In 2002, the plaintiffs began working as clinical “float” pharmacists for Bay
    Pines VA Healthcare System (“Bay Pines”). In 2003, they received assignments as
    “module” pharmacists. Bay Pines is split into 4 “modules,” all of which provide
    primary care. Dr. Trask worked in Module D and Dr. Truitt worked in Module B.
    The plaintiffs had all the same supervisors. Their first-line supervisor was
    Dr. Robert Stewart, a male in his 40s. Their second-line supervisors, each an
    Associate Chief of Pharmacy, were Dr. Keri Justice, a female in her 30s, and
    Dr. Camaro West-Lee, a female in her 40s. Their third-line supervisor was the Bay
    Pines Chief of Pharmacy, Dr. Gary Wilson, a male in his 50s.
    B.    The Plaintiffs’ Duties and Performance as Module Pharmacists
    Dr. Trask testified that her duties as a module pharmacist involved
    monitoring labs, calculating dosages, conducting extensive patient interviews,
    evaluating non-formulary drug requests, training personnel and new pharmacists,
    and making informed medication recommendations to physicians. When
    providing treatment, Dr. Trask would typically interview the patient, evaluate his
    medical history, look for changes in the patient, consider modifications to
    medication, screen for contraindications, and educate the patient. Dr. Trask
    believed she performed all the duties of a mid-level provider.
    Apart from providing primary care, Dr. Trask collaborated with several
    patient-centered care teams in Module D including the Spinal Cord Injury Team,
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    the Traumatic Brain Injury Team, and the Post-deployment team for veterans
    returning from Iraq and Afghanistan. Dr. Trask received specialized training and
    testified that she was the Bay Pines pharmacy service’s “expert in spinal cord
    injury.” Dr. Trask received an “exceptional” rating on all her performance reviews
    and never had a complaint filed against her.
    Dr. Truitt testified that her duties as a module pharmacist involved managing
    patients’ medications and recommending certain drug therapies to physicians. She
    testified that more than 50% of her module practice at Bay Pines involved disease
    state management. Dr. Truitt also trained newly hired doctors and pharmacists and
    served as a preceptor for pharmacy students at a nearby college. Dr. Truitt
    received exceptional performance reviews for her work as a module pharmacist.
    While the plaintiffs contended that they were doing most of the duties of a
    mid-level provider, the admitted that they never signed prescriptions in their own
    names. In fact, module pharmacists at Bay Pines never prescribed, managed, or
    monitored medications independent from a physician.
    C.    Advanced Scope of Practice
    Bay Pines pharmacists have the ability to hold either a general scope of
    practice or an advanced scope of practice (“advanced scope”). A general scope of
    practice, held by all clinical pharmacists, entails general pharmaceutical duties,
    such as processing prescriptions and using clinical judgment to follow lab work.
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    An advanced scope allows a pharmacist to prescribe medications for a specific
    disease state within their practice, such as diabetes, hypertension, and
    hyperlipidemia.
    While there are several types of advanced scopes, the defining feature of
    most is that they allow pharmacists to independently write prescriptions without a
    doctor’s approval. Thus, pharmacists with advanced scopes function “very much
    like a physician or an advanced provider, a nurse practitioner, or a . . . physician’s
    assistant.”
    To obtain an advanced scope, a clinical pharmacist must obtain approval
    from the Bay Pines Pharmacy Professional Standards Board (“Standards Board”).
    The Standards Board looks at two criteria: (1) whether the pharmacists’ job
    requires an advanced scope, and (2) whether the pharmacist is qualified and
    credentialed to hold an advanced scope. Obtaining and maintaining an advanced
    scope requires long-term peer review from multiple supervisory pharmacists. As
    such, the Standards Board does not grant advanced scopes “unless they are a
    requirement of the job area and job description in which someone practices.”
    A pharmacist could initiate the process for obtaining an advanced scope by
    speaking with his or her supervisor. The supervisor would then submit a request to
    the credentialing department, which would provide the necessary paperwork,
    including an “Advanced Scope of Practice and Prescriptive Authority
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    Application.” The application was a short document that required the applicant to
    check a few boxes, sign, and date. The application also contained a section for
    signatures from “collaborating” physicians, who would indicate their approval or
    disapproval of the applicant’s receipt of an advanced scope.
    The Standards Board reviewed all advanced scope applications. At the time
    material to this appeal, the Standards Board committee consisted of Dr. Stewart
    and seven other individuals. Dr. Justice was the Chairperson of the Standards
    Board. Once the Standards Board had reviewed the application and interviewed
    the relevant supervisory pharmacists, it would reach a final decision, subject to
    Dr. Wilson’s approval.
    The plaintiffs did not have advanced scopes. As module pharmacists, their
    jobs did not require one. Dr. Trask was unaware of any person receiving an
    advanced scope who did not have an assignment requiring one.
    Without an advanced scope, the plaintiffs lacked authority to independently
    prescribe medications to manage patients’ diseases. As Dr. Truitt recognized,
    “[T]echnically we could not make the change [in medications] without the doctor’s
    approval in making that change.” Dr. Trask similarly testified, “I made
    recommendations all day long. I couldn’t put it in my name because I didn’t have
    an advanced scope.”
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    D.    Patient Aligned Care Teams
    In the spring of 2010, the VA Central Office announced a nationwide
    initiative known as “Patient Aligned Care Teams,” or “PACT.” The goal of PACT
    was to develop a patient-centered, team-based approach to health care. PACT was
    intended to replace episodic care based on illness and patient complaints with
    coordinated care and long term healing relationships.
    Each PACT team consists of a provider, such as a physician, nurse
    practitioner, or physician assistant, a licensed practical nurse, a clerk, and other
    team members, such as clinical pharmacists, social workers, and dieticians. PACT
    required each team member to function at his or her “highest” licensed capacity in
    order to provide complete care to the patient. In PACT, the pharmacist would
    function as a mid-level provider who managed chronic disease sates, made critical
    decisions about the patient’s care, and prescribed medications. A PACT
    pharmacist needed to function under an advanced scope so that he or she could
    independently prescribe medication.
    E.    PACT Pilot Program at Lakeside Clinic
    In April 2010, Bay Pines initiated a series of pilot programs to test the
    implementation of the PACT initiative. One of the pilot programs was at the
    Lakeside Clinic (“Lakeside”)—a standalone primary care area not located within
    the central Bay Pines modules. Dr. Larry Atkinson, the acting Chief of Primary
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    Care, and members of the Bay Pines PACT executive council chose Lakeside as
    the pilot site.2 They chose Lakeside because it had available space, it was close to
    the primary care administrative offices, and the providers there had been involved
    with PACT from its inception.
    Dr. Brian Steele, a male in his 30s, was working as a module pharmacist at
    Lakeside when it was chosen as a pilot program site. Management selected
    Dr. Steele to participate in the pilot program because he was already working with
    the physicians selected to participate in the pilot program. Dr. Steele also had
    several nationally recognized certifications that were valuable for pharmacists
    wishing to participate in PACT.
    Dr. Steele’s participation in the pilot program required him to have an
    advanced scope so that he could perform the responsibilities of a PACT
    pharmacist. But at the time the pilot program commenced, Dr. Steele was not
    qualified to receive an advanced scope. Rather than move a clinical pharmacy
    specialist with an advanced scope to Lakeside, Bay Pines decided to “embrace the
    pilot” and train Dr. Steele.
    After several months of training in the disease management clinic, Dr. Steele
    applied for an advanced scope. Dr. Steele received an advanced scope in January
    2011 on the grounds that his participation in the Lakeside pilot program required it.
    2
    While Dr. Justice was on the PACT executive council, she did not have direct
    responsibility for choosing that pilot site.
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    F.    PACT Implementation Plan
    On February 10, 2011, pharmacy management held a meeting with the
    module pharmacists. Dr. Justice announced that the module pharmacists would
    remain in their positions and transition into becoming PACT pharmacists.
    Pharmacists who already had advanced scopes would mentor the module
    pharmacists, such as the plaintiffs, in disease state management to prepare them for
    their new roles as PACT pharmacists. This initial plan pleased the plaintiffs, as
    they would keep their jobs, receive training, presumably obtain advanced scopes,
    and eventually become PACT pharmacists.
    At the end of February 2011, Dr. Justice and Dr. Wilson attended a meeting
    between the chiefs of multiple VA medical centers within their region and their
    regional leaders. Roy Coakley, a regional leader who had recently met with
    Richard Stark, the so-called “father of PACT,” attended the meeting. At the
    meeting, Dr. Justice and Dr. Wilson sought guidance from Coakley and others
    regarding Bay Pine’s PACT implementation plan. After speaking with Coakley
    and other pharmacy chiefs, Dr. Wilson learned that training module pharmacists as
    PACT pharmacists was not best practice. Rather, pharmacists who already had
    experience providing mid-level care with advanced scopes should be considered
    for the PACT positions “in order to provide the best possible care to the patients.”
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    On March 3, 2011, based on the advice they received at the February 2011
    meeting, Dr. Wilson and Dr. Justice announced a revision to the PACT
    implementation plan. Rather than leaving the current module pharmacists in place
    and training them to become PACT pharmacists, management allowed all Bay
    Pines pharmacists to apply for a PACT pharmacist position.
    On May 19, 2011, Dr. Wilson sent an email to all Bay Pines pharmacists
    announcing that the time had come to “reorganize” and “implement PACT . . .
    throughout the Bay Pines Healthcare System.” Dr. Wilson stressed that “[m]ultiple
    national initiatives” were guiding their restructuring decision, which would require
    “reassigning pharmacists, relocating workload and maximizing efficiency.”
    Dr. Wilson noted that the PACT model required “strong clinicians,” and that
    “Central Office . . . established the qualification standards that each clinician
    should possess.”
    The email contained a reorganization table that announced the creation of
    seven PACT positions—two at Module B, two at Module D, two at Lakeside, and
    one at the Palm Harbor Community-Based Outpatient Clinic, another part of Bay
    Pines. In July 2011, Human Resources formally posted to the USA Jobs website
    the PACT positions opening at Module B, Module D, and Lakeside. At that time,
    the Palm Harbor position had not yet been approved, so the July 2011 USA Jobs
    postings included only the six main-campus positions.
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    G.    PACT Applicants and Selections
    Twelve Bay Pines pharmacists, including the plaintiffs and Dr. Steele,
    applied for the six PACT positions formally posted on USA Jobs in July 2011.
    Among the applicants was Dr. Linda Rolston, a female in her mid-50s.
    Dr. Rolston obtained an advanced scope in 1988. Dr. Rolston believed she had
    applied for the PACT position initially planned for Palm Harbor, but did not
    realize that the July 2011 USA Jobs posting included only the six positions at the
    main campus. Dr. Justice informed Dr. Rolston that the Palm Harbor position was
    not yet approved. Dr. Justice nevertheless offered Dr. Rolston one of the PACT
    positions at the main campus. Dr. Rolston declined the offer and told Dr. Justice
    she would like to be reconsidered when the Palm Harbor position became
    available.
    In September 2011, Bay Pines selected six applicants to fill the PACT
    pharmacist positions. Dr. West, Dr. Justice, and Dr. Stewart provided input, but
    Dr. Wilson was the ultimate selecting official. The six applicants chosen for the
    PACT positions were Hetal Bhatt-Chugani, Will Lavinghousez, Brian Steele,
    Rodrique Rodney, Germain Thomas, and Michael Kelley. Each of the selected
    pharmacists possessed an advanced scope in disease state management prior to
    applying for the positions.
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    The five applicants not selected were the two plaintiffs and three others,
    Peter Pasek, Natalia Schwartz, and Timothy Ebert. Pasek and Schwartz both
    already possessed an advanced scope in disease state management prior to
    applying for the positions. The plaintiffs and Ebert were the only applicants who
    did not have advanced scopes when they applied. Dr. Wilson did not select the
    plaintiffs primarily because they did not have advanced scopes, and they did not
    have experience prescribing medicine under an advanced scope.
    Bay Pines’ PACT pharmacist selections are summarized in the following
    table:
    Name/Approximate Age in              Application Outcome         Possession of
    2011/Gender                                             Advanced Scope?
    Hetal Bhatt-Chugani/33/F               Selected                  Yes
    Will Lavinghousez/30/M                 Selected                  Yes
    Linda Rolston/54/F                     Selected, but withdrew Yes
    Brian Steele/32/M                      Selected                  Yes
    Rodrique Rodney/28/M                   Selected                  Yes
    Germain Thomas/31/F                    Selected                  Yes
    Michael Kelley/29/M                    Selected                  Yes
    Peter Pasek/28/M                       Not Selected              Yes
    Natalia Schwartz/(young)/F             Not Selected              Yes
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    Timothy Ebert/26/M                    Not Selected             No
    Donna Trask/58/F                      Not Selected             No
    Anita Truitt/55/F                     Not Selected             No
    H.    Plaintiffs’ Attempts to Obtain Advanced Scopes and Receive Training
    The plaintiffs attempted to obtain advanced scopes and receive related
    training on several occasions. Soon after the VA Central Office announced the
    PACT initiative, Plaintiff Dr. Trask told Dr. Justice that she wanted whatever
    training and education would be necessary to perform a PACT position, including
    obtaining an advanced scope. Dr. Justice responded, “Oh, we’ll get that later.”
    Dr. Trask mentioned her desire to obtain an advanced scope to Dr. Justice several
    more times, but was repeatedly “put off.” According to Dr. Justice, at the time
    Dr. Trask initially requested an advanced scope, and the several times thereafter,
    her module was not operating under PACT and, therefore, she did not need an
    advanced scope.
    In April 2011, a few months before PACT selections were made, Dr. Ernest
    Baul, the primary care provider for spinal cord injury patients, asked Dr. Trask to
    obtain an advanced scope in order to help treat spinal cord injury patients. The
    advanced scope would allow Dr. Trask to write orders for soft prosthetics and
    assist with lipid management. Dr. Trask informed Dr. Stewart of Dr. Baul’s
    request, and asked him to initiate the process for obtaining an advanced scope with
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    the credentialing department. Dr. Stewart’s request got passed on to Dr. Justice,
    who said she was on administrative leave and would not be able to review the
    matter until mid-May. Dr. Justice ultimately denied Dr. Baul’s request for
    Dr. Trask to receive an advanced scope on the grounds that Dr. Baul already had
    access to pharmacists who had advanced scopes and were better suited to help him.
    In July 2011, the plaintiffs attempted to obtain advanced scope applications
    on their own, but management refused to provide the applications, or any guidance
    on how to obtain one. The plaintiffs ultimately obtained the application with the
    assistance of a union representative.
    On or about July 25, 2011, the plaintiffs completed their written advanced
    scope applications. The applications required written recommendations from
    collaborating physicians. All six of the Module D physicians recommended
    approval of Dr. Trask’s request for an advanced scope. Two of the six Module B
    physicians recommended approval of Dr. Truitt’s request for an advanced scope.
    Apart from signing the applications, several physicians testified that both plaintiffs
    were highly regarded and well-qualified to receive advanced scopes. In other
    words, several treating physicians believed that, based on their extensive
    experience, the plaintiffs were qualified to independently prescribe medications
    under supervision.
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    The Standards Board held the plaintiffs’ July 25, 2011 applications until
    after the PACT pharmacist positions were filled in early September 2011. On
    September 15, 2011, after PACT selections had been made, Dr. Justice informed
    the plaintiffs that the Standards Board had denied their advanced scope
    applications on two grounds: (1) their current positions did not require them to
    maintain an advanced scope or have prescriptive authority, and (2) there was
    insufficient data available to complete a Focused Professional Practice Evaluation
    of direct patient care activities. Dr. Justice clarified that the second reason for
    denying the plaintiffs’ advanced scope applications meant that the plaintiffs had
    not received sufficient training. This was the first time Bay Pines had ever denied
    an advanced scope application.
    I.    Discrimination Complaints and Reassignment
    On August 30, 2011, just before PACT selections were made, the plaintiffs
    made their initial contact with an Equal Employment Opportunity (“EEO”)
    counselor and asserted that they were the victims of gender and age discrimination.
    On September 26, 2011, following their non-selection for the PACT pharmacist
    positions, Bay Pines reassigned the plaintiffs to the outpatient float pool. While
    their reassignments did not affect their salary or their grades, the plaintiffs no
    longer spoke with physicians or consulted patients. Instead, as float pharmacists,
    the plaintiffs performed a “dispensing job” as if they were “on an assembly line.”
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    The plaintiffs believed their reassignments resulted in a loss of “prestige and
    responsibility.”
    On October 12, 2011, Dr. Truitt and Dr. Trask each filed a formal complaint
    of discrimination with the VA. Dr. Truitt subsequently received her 2011
    performance review, which rated her compliance performance as “fully successful”
    rather than “exceptional.” Dr. Trask also testified that in May and June of 2012,
    just after the parties had provided EEO investigation testimony that spring,
    management did not allow her to attend certain committee meetings as a union
    representative.
    II.    PROCEDURAL HISTORY
    On August 2, 2013, the plaintiffs filed a second amended complaint in
    federal district court against the VA alleging causes of action for gender
    discrimination under Title VII, age discrimination under the ADEA, retaliation,
    and hostile work environment. In a March 19, 2015 order, the district court
    granted summary judgment in favor of the VA on all of the plaintiffs’ claims. This
    appeal followed.
    III.   DISCUSSION
    A.    Gender and Age Discrimination
    Employment discrimination claims all require proof of discriminatory intent.
    See Vessels v. Atlanta Indep. Sch. Sys., 
    408 F.3d 763
    , 767 (11th Cir. 2005).
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    When, as here, a Title VII or ADEA plaintiff’s employment discrimination claim is
    based on circumstantial evidence, courts apply the burden-shifting framework set
    out in McDonnell Douglas Corp. v. Green, 
    411 U.S. 792
    , 
    93 S. Ct. 1817
     (1973).
    Kidd v. Mando Am. Corp., 
    731 F.3d 1196
    , 1202 (11th Cir. 2013) (Title VII);
    Kragor v. Takeda Pharms. Am., Inc., 
    702 F.3d 1304
    , 1308 (11th Cir. 2012)
    (ADEA).
    Under the McDonnell Douglas framework, a plaintiff must first create an
    inference of discrimination through her prima facie case. Vessels, 
    408 F.3d at 767
    .
    “Once the plaintiff has made a prima facie case, a rebuttable presumption arises
    that the employer has acted illegally.” Alvarez v. Royal Atl. Developers, Inc., 
    610 F.3d 1253
    , 1264 (11th Cir. 2010). “The employer can rebut that presumption by
    articulating one or more legitimate non-discriminatory reasons for its action.” 
    Id.
    “If it does so, the burden shifts back to the plaintiff to produce evidence that the
    employer’s proffered reasons are a pretext for discrimination.” 
    Id.
    On appeal, the plaintiffs argue that they established a prima facie case for
    gender and age discrimination with respect to two discrete adverse employment
    actions: (1) their non-selection for the PACT pharmacist positions, and (2) the
    denial of their requests for an advanced scope and associated training. We address
    each argument in turn.
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    1.     Non-Selection for PACT Pharmacist Positions
    In a typical failure-to-hire scenario, the plaintiff establishes a prima facie
    case of unlawful discrimination by demonstrating that: “(1) she was a member of a
    protected class; (2) she applied and was qualified for a position for which the
    employer was accepting applications; (3) despite her qualifications, she was not
    hired; and (4) the position remained open or was filled by another person outside
    of her protected class.” EEOC v. Joe’s Stone Crabs, Inc., 
    296 F.3d 1265
    , 1273
    (11th Cir. 2002).
    To demonstrate that she was qualified for the position at the prima facie
    stage, a plaintiff must show that she satisfied an employer’s objective
    qualifications. Vessels, 
    408 F.3d at 769
    . “[S]ubjective evaluations play no part in
    the plaintiff's prima facie case.” 
    Id.
     “Rather, they are properly articulated as part
    of the employer’s burden to produce a legitimate race-neutral basis for its decision,
    then subsequently evaluated as part of the court’s pretext inquiry.” 
    Id.
    Here, the plaintiffs failed to demonstrate that they were objectively qualified
    to fill the PACT pharmacist positions, which is fatal to their prima facie case. It is
    undisputed that one of the objective hiring criteria for the PACT pharmacist
    positions was the possession of an advanced scope. Because the PACT initiative
    required the PACT team pharmacist to function as a mid-level provider who
    managed chronic disease sates, made critical decisions about the patient’s care, and
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    prescribed medications, a PACT pharmacist needed to function under an advanced
    scope so that he or she could independently prescribe medication. This objective
    requirement was made abundantly clear by Bay Pines’ PACT pharmacist
    selections, all of whom had previous experience independently prescribing
    medication under an advanced scope.
    The plaintiffs presented copious amounts of evidence establishing that they
    were very experienced clinical pharmacists who consistently received outstanding
    performance reviews. We have no doubt that the plaintiffs were proficient module
    pharmacists at Bay Pines. That said, the plaintiffs did not have advanced scopes
    and had no experience providing mid-level care with independent prescription
    authority. Despite the subjective factors supporting their qualifications to function
    as PACT pharmacists, the plaintiffs did not possess the objective qualifications
    necessary to fill the position. Because the plaintiffs were not objectively qualified
    to perform the duties of a PACT pharmacist, they failed to establish an element of
    their prima facie failure-to-hire case. See Vessels, 
    408 F.3d at 769
    ; Joe’s Stone
    Crabs, Inc., 
    296 F.3d at 1273
    .
    2.     Denial of Requests for Advanced Scopes and Related Training
    To establish a prima facie case for disparate treatment in an employment
    discrimination case, the plaintiff must show that: “(1) she is a member of a
    protected class; (2) she was subjected to an adverse employment action; (3) her
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    employer treated similarly situated employees outside of her protected class more
    favorably than she was treated; and (4) she was qualified to do the job.” Burke-
    Fowler v. Orange Cty., 
    447 F.3d 1319
    , 1323 (11th Cir. 2006).
    With respect to the third prong of the prima facie case, the plaintiffs and the
    employee they identify as a comparator must be similarly situated in all relevant
    respects. Wilson v. B/E Aerospace, Inc., 
    376 F.3d 1079
    , 1091 (11th Cir. 2004).
    The comparator must be “nearly identical” to the plaintiffs to prevent courts from
    second-guessing a reasonable decision by the employer. 
    Id.
     Thus, in order for the
    plaintiffs in this case to establish a prima facie case for unlawful disparate
    treatment, they must show that a similarly-situated individual outside of their
    protected class applied for an advanced scope and received it. See Maynard v. Bd.
    of Regents, 
    342 F.3d 1281
    , 1289 (11th Cir. 2003).
    The plaintiffs’ sole proffered comparator is Dr. Steele, a young male who
    received an advanced scope and the associated training due to his participation in
    the Lakeside PACT pilot program. But, compared to the plaintiffs, Dr. Steele was
    not a “similarly-situated individual.” While Dr. Steele was also a module
    pharmacist, he did not even work in the same building as the plaintiffs. The acting
    Chief of Primary Care and members of the Bay Pines PACT executive council
    chose Lakeside as the site for the PACT pilot program. Dr. Steele received an
    advanced scope and the associated training because he happened to work at
    22
    Case: 15-11709    Date Filed: 04/05/2016    Page: 23 of 31
    Lakeside, the chosen pilot program site. The plaintiffs did not work at that
    location.
    Dr. Steele was already a module pharmacist at Lakeside and worked with
    many of the providers selected to participate in the pilot program. Thus, Dr. Steele
    was a natural choice for serving as a pharmacist in the Lakeside PACT pilot
    program. Once selected to participate in the pilot program, Dr. Steele’s job duties
    required that he train for and obtain an advanced scope. Conversely, prior to the
    implementation of PACT, the plaintiffs’ jobs never required that they train for or
    obtain an advanced scope. As such, Dr. Steele and the plaintiffs were dissimilar in
    several critical respects, and were a far cry from being “nearly identical.” Wilson,
    
    376 F.3d at 1091
    .
    Simply put, the plaintiffs were module pharmacists in Bay Pines’ pre-PACT
    main campus whose jobs did not require possession of an advanced scope, while
    Dr. Steele was a pilot-program-participant whose job did require the possession of
    an advanced scope. Thus, Dr. Steele was not a valid comparator.
    The plaintiffs proffered no comparator other than Dr. Steele. In fact, the
    plaintiffs presented no evidence that any other Bay Pines module pharmacist ever
    applied for an advanced scope so that he or she would qualify for a PACT position.
    Because the plaintiffs did not demonstrate that a similarly situated comparator
    outside of their protected class was given an advanced scope, they failed to
    23
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    establish a prima facie case for unlawful disparate treatment. 3 See Maynard, 
    342 F.3d at 1289
    .
    Not only did the plaintiffs fail to identify a valid comparator, which is fatal
    to their prima facie case, but the VA came forward with undisputed evidence that
    Bay Pines had actually selected Dr. Rolston, a female in her mid-50s, to fill one of
    the PACT pharmacist positions. For this reason and others, we find no
    “convincing mosaic of circumstantial evidence” giving rise to an inference of age
    or gender discrimination. See Smith v. Lockheed-Martin Corp., 
    644 F.3d 1321
    ,
    1328 (11th Cir. 2011).
    B.     Retaliation
    Title VII makes it illegal for “an employer to discriminate against any of his
    employees . . . because he has opposed any practice made an unlawful employment
    practice by this subchapter, or because he has made a charge, testified, assisted, or
    participated in any manner in an investigation, proceeding, or hearing under this
    subchapter.” 42 U.S.C. § 2000e–3(a). The ADEA contains a similar anti-
    3
    Even if the plaintiffs had established a prima facie case of age and gender
    discrimination, which they did not, they certainly failed to demonstrate that Bay Pines’ reasons
    for not selecting them for the PACT positions and denying their advanced scope applications
    were pretexts for unlawful discrimination. This too is fatal to the plaintiffs’ claims.
    No pharmacist had ever applied for an advanced scope under the circumstances that the
    plaintiffs did. The plaintiffs concede that they were module pharmacists whose jobs did not
    require an advanced scope. They only applied for advanced scopes in order to qualify for the
    PACT pharmacist position, not because Bay Pines had some particular need for more
    pharmacists with advanced scopes. Given that Bay Pines had no need for additional pharmacists
    with advanced scopes at the time of the plaintiffs’ applications, its denial of their applications
    was hardly suspect.
    24
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    retaliation provision. See 
    29 U.S.C. § 623
    (d). To establish a prima facie case of
    retaliation, plaintiffs must prove that: (1) they engaged in statutorily protected
    conduct; (2) they suffered an adverse employment action; and (3) the adverse
    action was causally related to the protected expression. Butler v. Ala. Dep’t of
    Transp., 
    536 F.3d 1209
    , 1212-13 (11th Cir. 2008).
    “Once a plaintiff has established a prima facie case, the employer then has
    an opportunity to articulate a legitimate, non-retaliatory reason for the challenged
    employment action.” Pennington v. City of Huntsville, 
    261 F.3d 1262
    , 1266 (11th
    Cir. 2001). “The ultimate burden of proving by a preponderance of the evidence
    that the reason provided by the employer is a pretext for prohibited, retaliatory
    conduct remains on the plaintiff.” 
    Id.
    On appeal, the plaintiffs argue that the district court erred by granting
    summary judgment in favor of the VA with respect to their retaliation claims. The
    plaintiffs contend they suffered four discrete instances of retaliation following their
    initial August 30, 2011 EEO contact: (1) on September 26, 2011, they were
    reassigned to the outpatient float pool, (2) at the end of 2011, Dr. Truitt received
    her annual performance review, which rated her compliance performance as “fully
    successful” rather than “exceptional,” (3) in April 2012, Dr. Truitt had to seek
    approval from three supervisors to attend a planning committee meeting as a union
    representative, and (4) in May and June of 2012, pharmacy management did not
    25
    Case: 15-11709     Date Filed: 04/05/2016     Page: 26 of 31
    permit Dr. Trask to attend committee meetings as a union representative. As
    explained below, none of these events constitute an actionable retaliation claim.
    1.     Reassignment to Float Pool
    We have considerable doubt about whether the plaintiffs’ reassignment to
    the float pool can satisfy the elements of a prima facie retaliation case. A work
    reassignment may constitute an adverse employment action when the change is “so
    substantial and material that it . . . alter[s] the terms, conditions, and privileges of
    employment.” See Davis v. Town of Lake Park, Fla., 
    245 F.3d 1232
    , 1245 (11th
    Cir. 2001) (quotation marks omitted).
    Here, the plaintiffs’ reassignment resulted in no decrease in pay or grade.
    And while the plaintiffs offered some subjective evidence that the float pharmacist
    position involved decreased responsibility and prestige and required the
    performance of more menial tasks, it is not clear that these changes were so
    substantial that they amounted to an actionable adverse employment action. See
    
    id.
     (“In the vast majority of instances, . . . an employee alleging a loss of prestige
    on account of a change in work assignments, without any tangible harm, will be
    outside the protection afforded by Congress in Title VII's anti-discrimination
    clause.”).
    Additionally, Title VII retaliation claims require proof that “[the] protected
    activity was a but-for cause of the alleged adverse action by the employer.” Univ.
    26
    Case: 15-11709      Date Filed: 04/05/2016    Page: 27 of 31
    of Tex. Sw. Med. Ctr. v. Nassar, 570 U.S. ___, 
    133 S. Ct. 2517
    , 2534 (2013). As
    early as February 2011, almost eight months before the plaintiffs engaged in their
    protected activity, pharmacy management stated that pharmacists who were not
    selected for PACT positions might become floating pharmacists. Because
    pharmacy management had already decided to reassign module pharmacists who
    were not selected for PACT positions to the float pool following the
    implementation of PACT, the plaintiffs’ protected activity could not have been a
    but-for cause of their reassignment. See 
    id.
    In any event, even assuming arguendo that the plaintiffs’ reassignment to the
    float pool constitutes a prima facie retaliation case, the plaintiffs presented no
    evidence that the Bay Pines’ legitimate non-discriminatory reason for the
    reassignment was pretextual. The record evidence demonstrates that the plaintiffs’
    reassignment to the float pool was a natural consequence of their non-selection for
    the PACT positions and the elimination of module pharmacist assignments.
    Because Bay Pines proffered legitimate non-discriminatory reasons for the
    plaintiffs’ reassignment to the float pool, the plaintiffs had the burden of
    demonstrating that Bay Pines’ reasons were pretextual. The plaintiffs offer no
    argument as to how or why this might be the case, let alone point to record
    evidence demonstrating pretext. Accordingly, the plaintiffs failed to meet their
    27
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    burden to show that Bay Pines had retaliatory intent when it reassigned them to the
    float pool, and the district court properly granted summary judgment on this claim.
    2.     Remaining Retaliation Claims
    “[T]o prove adverse employment action in a case under Title VII’s anti-
    discrimination clause, an employee must show a serious and material change in the
    terms, conditions, or privileges of employment.” Davis, 
    245 F.3d at 1239
    .
    “Moreover, the employee’s subjective view of the significance and adversity of the
    employer’s action is not controlling; the employment action must be materially
    adverse as viewed by a reasonable person in the circumstances.” 
    Id.
    Viewed objectively, neither Dr. Truitt’s performance review nor the
    restrictions on Dr. Trask’s attendance at committee meetings constitutes an adverse
    employment action. Dr. Truitt did not suffer an adverse material consequence after
    receiving a “fully successful” performance review, and Dr. Trask appears to have
    suffered nothing more than frustration regarding her inability to attend certain
    meetings. As such, neither of these events constituted a serious and material
    change in the terms, conditions, or privileges of the plaintiffs’ employment. 
    Id.
    C.    Hostile Work Environment
    To establish a hostile work environment claim under Title VII, a plaintiff
    must show that “the workplace is permeated with discriminatory intimidation,
    ridicule, and insult, that is sufficiently severe or pervasive to alter the conditions of
    28
    Case: 15-11709     Date Filed: 04/05/2016    Page: 29 of 31
    . . . employment and create an abusive working environment.” Gowski v. Peake,
    
    682 F.3d 1299
    , 1311 (11th Cir. 2012). To prove a prima facie case of hostile work
    environment, a plaintiff must establish that: (1) he or she belonged to a protected
    group, (2) he or she was subjected to unwelcome harassment, (3) the harassment
    was based on a protected characteristic, (4) the harassment was sufficiently severe
    or pervasive to alter the terms and conditions of his or her employment and create
    an abusive working environment, and (5) a basis exists for holding the employer
    liable. Gupta v. Fla. Board of Regents, 
    212 F.3d 571
    , 582 (11th Cir. 2000).
    “It is a bedrock principle that not all objectionable conduct or language
    amounts to discrimination under Title VII.” Jones v. UPS Ground Freight, 
    683 F.3d 1283
    , 1297 (11th Cir. 2012) (quotation marks omitted). “Therefore, only
    conduct that is based on a protected category . . . may be considered in a hostile
    work environment analysis.” 
    Id.
     (emphasis added) (quotation marks omitted); see
    also Reeves v. C.H. Robinson Worldwide, Inc., 
    594 F.3d 798
    , 809 n.3 (11th Cir.
    2010) (“[T]he Courts of Appeals have uniformly observed that Title VII is not a
    civility code, and that harassment must discriminate on the basis of a protected
    characteristic in order to be actionable.”). “Innocuous statements or conduct, or
    boorish ones that do not relate to the [age or gender] of the actor or of the offended
    party (the plaintiff), are not counted.” Jones, 683 F.3d at 1297.
    29
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    The plaintiffs argue on appeal that the district court erred by granting
    summary judgment in favor of the VA with respect to their hostile work
    environment claim. The plaintiffs broadly cite to several instances in which
    pharmacy management behaved rudely and made comments that plaintiffs
    considered offensive, belittling, and humiliating, most of which involved PACT
    implementation and union representation. The plaintiffs also cite testimony of
    other witnesses who believed that the plaintiffs were treated poorly.
    The plaintiffs’ evidence does not amount to an actionable hostile work
    environment claim. The plaintiffs’ naked assertion that they have been subjected
    to discriminatory hostile treatment is not sufficient to constitute a hostile work
    environment. Rather, the plaintiffs must show the hostile treatment was based on
    their protected status. Jones, 683 F.3d at 1297. Despite the voluminous incidents
    of pharmacy management’s alleged hostility, pharmacy management’s comments
    were never related to the plaintiffs’ protected characteristics, and there is no
    evidence that their alleged hostility was in any way motivated by a discriminatory
    animus regarding the plaintiffs’ age or gender. This alone is fatal to the plaintiffs’
    claim. See id; Reeves, 
    594 F.3d at
    809 n.3.
    Additionally, pharmacy management’s comments, though frequently
    unprofessional, were not “filled with intimidation and ridicule that was sufficiently
    severe or pervasive to alter [the plaintiffs’] working conditions.” Gowski, 682
    30
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    F.3d at 1313. Rather, the plaintiffs’ struggles exemplify “the ordinary tribulations
    of the workplace, which . . . do[es] not constitute actionable . . . harassment.”
    Gupta, 
    212 F.3d at 586
     (quotation marks omitted). Accordingly, the district court
    properly granted summary judgment in favor of the VA with respect to the
    plaintiffs’ hostile work environment claim.
    IV.    CONCLUSION
    In light of the foregoing, we affirm the district court’s order granting
    summary judgment in favor of the VA on all of the plaintiffs’ claims.
    AFFIRMED.
    31