Opinion ID: 72320
Heading Depth: 2
Heading Rank: 3

Heading: loss of privilege to practice medicine

Text: The district court's second basis for departing from the sentencing guidelines was that Hoffer lost the privilege to practice medicine. Hoffer characterizes his loss of medical license as a “voluntary” act on his part, but that is a questionable characterization for two reasons. First, to the extent the matter was subject to his control, Hoffer used it to bargain for something in return from the government. Hoffer no more voluntarily gave up his medical license than the government voluntarily dismissed Counts III through VII of the indictment. Both actions were part of the overall trade reflected in the plea agreement. Second, if Hoffer had not relinquished his license, it likely would have been revoked by the Florida Board of Medicine, anyway. See Fla. Stat. Ann. § 458.331(1)(c) and (q). Whether characterized as “voluntary” or not, we do not think that Hoffer's loss of medical license is a valid basis for departure. In Koon, the Ninth Circuit held that the district court had erred by granting the defendants a downward departure from the sentencing guidelines on the ground that the defendants' convictions resulted in negative collateral employment consequences. See United States v. Koon, 34 F.3d 1416, 1454 (9th 17 Cir. 1994). The Ninth Circuit expressed concern that collateral employment consequences could be used as a proxy for socio-economic status, a factor the Commission has stated is never a permissible basis for departure. See id. (citing U.S.S.G. § 5H1.10). The Supreme Court rejected that reasoning stating, “[while] a defendant's career may relate to his or her socio-economic status, [] the link is not so close as to justify categorical exclusion of the effect of conviction on a career.” ___ U.S. at ___, 116 S. Ct. at 2052. The clear implication of the Supreme Court's statement is that collateral employment consequences could, under some set of circumstances, serve as a basis for a departure from the sentencing guidelines. The Court did not specify what those circumstances were. We will not speculate about all of the possibilities, either. It is enough for present purposes that the Koon Court did not indicate that the loss of an employment or career position could be a basis for departure where that loss was the direct result of the defendant abusing the trust inherent in that very position, an abuse of trust for which the guidelines require an enhancement. Hoffer received a two-level sentence enhancement under U.S.S.G. § 3B1.3 for using his special skills as a physician to facilitate the commission of his crimes and for abusing the position of trust he held as a physician. Hoffer betrayed society's trust by using his prescription writing privileges to distribute controlled substances outside the legitimate practice of medicine. It was because Hoffer was a physician, and was entrusted 18 as a physician with prescription writing authority, that he was able to commit the crimes for which he was convicted. The Commission, in § 3B1.3, stated that circumstances such as these warrant a sentence enhancement. In the background notes to § 3B1.3, the Commission explained that persons who abuse their positions of trust or use their special skills to facilitate or conceal the commission of a crime “generally are viewed as more culpable.” Yet, the district court's treatment of the position of trust Hoffer enjoyed, his medical license and physician status, netted out to a lesser sentence for him. The court gave Hoffer a four-level downward departure for losing his position of trust, which more than wiped out the two-level enhancement mandated by § 3B1.3 for Hoffer's abuse of that position of trust. Society, employers, and licensing authorities usually view abuse of a position of trust to commit or facilitate crimes as misconduct warranting loss of that position of trust. As a result, in virtually every case in which a § 3B1.3 enhancement is warranted, there will also be a loss of a position of trust. The two sanctions or results are inextricably intertwined. Allowing downward departures for loss of professional or employment position in cases in which that loss flows from an abuse of trust that warrants a § 3B1.3 enhancement would nullify the mandate of § 3B1.3. The Commission cannot have intended such a result. During the sentencing hearing, the district court suggested that United States v. Aguilar, 994 F.2d 609 (9th Cir.), opinion withdrawn, 11 F.3d 124 (9th Cir. 1993), supports its decision to 19 depart downward on the basis of Hoffer's loss of the privilege to practice medicine. In Aguilar, the district court granted the defendant, a federal judge, a downward departure from the sentencing guidelines because the defendant would suffer “additional punishment” through the course of potential impeachment and disbarment proceedings. A panel majority affirmed the district court's departure on these grounds, distinguishing the “additional punishment” the defendant suffered from the ordinary collateral consequences resulting from a criminal conviction. Emphasizing that the district court had not departed on the basis of the defendant's “loss of position,” id at 645, the majority held that the burden and humiliation the defendant would suffer in the public, quasi-judicial adversarial proceedings that would follow was a permissible basis for the district court to depart from the sentencing guidelines. See id. at 643-45.