United States v. Hoffer ( 1997 )


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  •                                  United States Court of Appeals,
    Eleventh Circuit.
    No. 96-4354.
    UNITED STATES of America, Plaintiff-Appellant,
    v.
    Lee W. HOFFER, M.D., Defendant-Appellee.
    Nov. 21, 1997.
    Appeal from the United States District Court for the Southern District of Florida. (No. 94-6113-CR-
    FERGUSON), Wilkie D. Ferguson, Jr., Judge.
    Before ANDERSON, DUBINA and CARNES, Circuit Judges.
    CARNES, Circuit Judge:
    The defendant, Lee Hoffer, pleaded guilty to violating 
    21 U.S.C. § 846
     by conspiring to
    dispense controlled substances in violation of 
    21 U.S.C. § 841
    (a)(1), and to tampering with a witness
    in violation of 
    18 U.S.C. § 1512
    . After a sentencing hearing, the district court determined that
    Hoffer had an adjusted offense level of thirty-one and a criminal history category of I, which under
    the United States Sentencing Guidelines resulted in a sentencing range of 108 to 135 months.
    However, the district court departed downward four levels to an offense level of twenty-seven,
    which resulted in a guidelines range of 70 to 87 months. The court imposed a sentence of seventy
    months imprisonment, a $10,000 fine, and three years of supervised release.
    The district court justified its downward departure on two grounds. The first was that, as part
    of his plea agreement, Hoffer "los[t][the] privilege to practice medicine." The second basis for the
    departure was that, also as part of his plea agreement, Hoffer "voluntar[ily] disgorged" $50,000 in
    proceeds from his illegal activities. The government has appealed the district court's decision to
    depart downward. Because we conclude that the district court abused its discretion in departing
    downward for the two stated reasons, we vacate and remand for resentencing.
    I. FACTS AND PROCEDURAL HISTORY
    Lee Hoffer is a physician who, until recently, was licensed to practice medicine in Florida.
    In 1987, he opened a medical office in Coral Springs, Florida. In 1992, after a routine pharmacy
    inspection revealed that Hoffer had written an excessive number of prescriptions for controlled
    substances, agents from the DEA and the Broward County Sheriff's Office began investigating him.
    The investigation revealed evidence that Hoffer regularly provided an accomplice with controlled
    substance prescriptions. The accomplice would fill the prescriptions, sell them on the street, and
    return half the proceeds to Hoffer. Hoffer provided his accomplice with a pager to maintain their
    "business" relationship, and he met with him an average of twice a week, collecting around $1,000
    at each meeting. Hoffer's controlled substance distribution "business" lasted at least a year.
    In 1994, the United States Attorney presented Hoffer's case to a federal grand jury in the
    Southern District of Florida. The grand jury subpoenaed a number of witnesses including the wife
    of Hoffer's accomplice. Before his accomplice's wife testified, Hoffer attempted to persuade her to
    lie to the grand jury. The government tape recorded that attempt.
    The grand jury returned a seven-count indictment. Count I charged Hoffer with a violation
    of 
    21 U.S.C. § 841
    (a)(1), conspiracy to distribute and dispense controlled substances. Count II
    charged him with a violation of 
    18 U.S.C. § 1512
    , corruptly persuading another person with the
    intent to influence the testimony of that person in an official proceeding. Counts III—VII charged
    Hoffer with additional drug distribution crimes.
    Hoffer entered into a plea agreement with the government. Pursuant to the agreement,
    Hoffer entered a plea of guilty to Counts I and II and stipulated that he would: (1) voluntarily
    relinquish his license to practice as a physician in Florida and in all other states, territories and
    districts of the United States; (2) never again apply to be licensed as a physician; (3) execute
    agreements of voluntary withdrawal from practice as a physician in Florida and in all other states,
    territories and districts of the United States; and (4) not contest the civil forfeiture of $50,000.00
    he had acquired as proceeds from the sale of drugs. In exchange, the government dismissed Counts
    III—VII of the indictment and stipulated to the amount of drugs Hoffer had dispensed and
    distributed.
    Prior to his sentencing hearing, Hoffer filed a motion, pursuant to 
    18 U.S.C. § 3553
    (b) and
    U.S.S.G. § 5K2.0, for downward departure from the applicable sentencing guideline. In his motion,
    Hoffer contended that he was entitled to a downward departure on the following grounds: (1)
    exceptional acceptance of responsibility; (2) high prospects of rehabilitation; (3) aberrant behavior;
    (4) voluntary disgorgement of proceeds of criminal activity; (5) the "safety valve" provision,
    U.S.S.G. § 5K1.1; (6) loss of occupational licensure; and (7) the totality of these factors.
    At Hoffer's sentencing hearing, the district court determined that under U.S.S.G. § 2D1.1 (the
    guideline section applicable to drug manufacturing and trafficking offenses), Hoffer had a base
    offense level of thirty.1 To that base offense level, the district court added, pursuant to § 3B1.3, two
    levels for abusing a position of trust. The district court also added, pursuant to § 3C1.1, two levels
    for obstructing the administration of justice. Finally, the court subtracted, pursuant to § 3E1.1, three
    levels for acceptance of responsibility. The net result was an adjusted offense level of thirty-one.
    After the court determined Hoffer's adjusted offense level, Hoffer argued, in accordance with
    his earlier motion, that he should receive a downward departure from the sentencing guidelines. The
    1
    In making that determination, the district court relied on the parties' stipulation in the plea
    agreement that Hoffer had dispensed and/or distributed an amount of Schedule II controlled
    substances which, under the guidelines, was equivalent to more than 700 kilograms, but less than
    1000 kilograms, of marijuana.
    government responded that Hoffer was not entitled to a downward departure for exceptional
    acceptance of responsibility, that he did not qualify for the "safety valve" provision, that voluntary
    disgorgement of proceeds from criminal activity was not an appropriate basis for departure, and that
    a downward departure for loss of occupation or license was not warranted.
    After hearing testimony from Hoffer, his witnesses, and the government's witnesses, the
    district court noted that case law did not support a downward departure on the basis of exceptional
    acceptance of responsibility. However, the court went on to find that Hoffer's loss of privilege to
    practice medicine and voluntary disgorgement of proceeds made his case "atypical," warranting a
    downward departure of four levels. After adjusting his offense level to twenty-seven, the court
    sentenced Hoffer to imprisonment for a term of seventy months on both Count I and Count II, to be
    served concurrently. Additionally, the court imposed a fine of $10,000 and ordered three years of
    supervised release at the conclusion of Hoffer's term of imprisonment.
    Following the pronouncement of sentence, the district court asked, "did the defendant or
    counsel object to any finding made or the manner in which the sentence has been pronounced?" The
    court did not ask the government whether it had any objections to the sentence. At that point neither
    Hoffer nor the government stated any objections to the sentence, although the government had
    previously stated its position opposing the downward departure. The government has appealed the
    sentence imposed by the district court.
    II. STANDARD OF REVIEW
    In Koon v. United States, --- U.S. ----, ----, 
    116 S.Ct. 2035
    , 2043, 
    135 L.Ed.2d 392
     (1996),
    the Supreme Court held that an appellate court reviewing a district court's departure from the
    sentencing guidelines should ask "whether the sentencing court abused its discretion." The Court
    explained that while an abuse of discretion review standard preserves the sentencing court's
    "traditional discretion," it does not render appellate review an empty exercise. 
    Id.
     at ----, 
    116 S.Ct. at 2046
    . A sentencing court's factual findings continue to be afforded substantial deference, but a
    mistake of law is, by definition, an abuse of discretion. 
    Id.
     at ----, 
    116 S.Ct. at 2047
    .
    Whether to depart from the sentencing guidelines is a decision which requires a district court
    to make both factual and legal findings. Under 
    18 U.S.C. § 3553
    (b), a district court may depart from
    the applicable guideline range if "the court finds that there exists an aggravating or mitigating
    circumstance of a kind, or to a degree, not adequately taken into consideration by the Sentencing
    Commission in formulating the guidelines that should result in a sentence different from that
    described." Thus, to depart from the sentencing guidelines, a district court must make two
    fundamental determinations: (1) what, if any, factor makes the case "atypical" (i.e., unlike the
    typical case found under the applicable sentencing guideline), and (2) should that factor result in a
    different sentence. The first of these determinations is factual in nature, see Koon, --- U.S. at ----,
    
    116 S.Ct. at 2046-47
    , while the second involves both legal and factual considerations, see 
    id.
     at ----,
    
    116 S.Ct. at 2047
    .
    Cases implicating a factor not adequately taken into consideration by the Sentencing
    Commission are said to fall outside the "heartland" of typical cases embodying the conduct
    described in the applicable guideline. See U.S.S.G. ch.1, pt. A, intro. comment. 4(b). A district
    court determines whether a case falls outside the heartland by making a refined assessment of the
    facts of the case, comparing those facts to the facts of other cases falling within the guideline's
    heartland. See Koon, --- U.S. at ---- - ----, 
    116 S.Ct. at 2046-47
    .
    To determine whether a factor which takes a case outside the heartland should result in a
    different sentence, a district court must first decide whether the factor is forbidden, encouraged,
    discouraged, or unaddressed by the guidelines as a potential basis for departure. See 
    id.
     at ----, 
    116 S.Ct. at 2045
    . If a factor is forbidden, see, e.g., U.S.S.G. § 5H1.10 (race, sex, national origin, creed,
    religion and socio-economic status), a district court cannot use it to depart from the applicable
    guideline; to do so would be a per se abuse of discretion. See Koon, --- U.S. at ----, ----, 
    116 S.Ct. at 2045, 2047
    . If a factor is encouraged, see, e.g., § 5K2.1 (causing death), a court is authorized to
    depart from the applicable guideline if the guideline does not already take that factor into account.
    See Koon, --- U.S. at ----, 
    116 S.Ct. at 2045
    . If a factor is discouraged, see, e.g., § 5H1.2 (education
    and vocational skills), or is an encouraged factor already taken into account by the applicable
    guideline, a district court may depart only if the factor is present to an exceptional degree or in some
    other way makes the case distinguishable from an ordinary case where the factor is present.2 See
    Koon, --- U.S. at ----, 
    116 S.Ct. at 2045
    .
    Finally, a district court may depart on the basis of a factor not addressed by the Sentencing
    Commission if it finds, "after considering the "structure and theory of both the relevant individual
    guidelines and the Guidelines taken as a whole,' " that the factor takes the case out of the applicable
    guideline's heartland. 
    Id.
     at ----, 
    116 S.Ct. at 2045
     (quoting United States v. Rivera, 
    994 F.2d 942
    ,
    2
    The guidelines provide the following examples to illustrate the use of encouraged and
    discouraged factors in the departure decision:
    [D]isruption of a governmental function, § 5K2.7, [an encouraged factor], would
    have to be quite serious to warrant departure from the guidelines when the
    applicable offense guideline is bribery or obstruction of justice. When the theft
    offense guideline is applicable, however, and the theft caused disruption of a
    governmental function, departure from the applicable guideline range more
    readily would be appropriate. Similarly, physical injury would not warrant
    departure from the guidelines when the robbery offense guideline is applicable
    because the robbery guideline includes a specific adjustment based on the extent
    of any injury. However, because the robbery guideline does not deal with injury
    to more than one victim, departure would be warranted if several persons were
    injured.
    U.S.S.G. § 5K2.0.
    949 (1st Cir.1993)). However, a district court departing on the basis of an unenumerated factor
    should bear in mind the Commission's expectation that such departures will be "highly infrequent."
    Id. at ----, --- U.S. at ----, 
    116 S.Ct. at
    2045 (citing U.S.S.G. ch. 1, pt. A, intro. comment. 4(b)).
    We note that a district court is required to perform the foregoing analysis only when its
    decision to depart is not based on specific guidance contained within the guidelines. If the district
    court's departure is based upon a suggestion within the applicable guideline(s), this analysis is
    unnecessary. See U.S.S.G. ch. 1, pt. A., intro. comment. 4(b).
    On appeal, our review of a district court's decision to depart from the sentencing guidelines
    is a three-step process. First, we deferentially review the district court's determination of whether
    the facts of a case take it outside the heartland of the applicable guideline. See Koon, --- U.S. at ----,
    
    116 S.Ct. at 2047
     ("District Courts have an institutional advantage over appellate courts in making
    these sorts of determinations, especially as they see so many more Guidelines cases than appellate
    courts do."). Second, we independently determine whether the departure factor relied upon by the
    district court has been categorically proscribed, is encouraged, encouraged but taken into
    consideration within the applicable guideline, discouraged, or not addressed by the Commission.
    See 
    id.
     at ----, 
    116 S.Ct. at 2047
     (stating that an appellate court need not defer to the district court
    on questions of law). If the district court has relied upon a forbidden factor, it necessarily has
    abused its discretion. If the factor relied upon is not forbidden, we reach the third step of our review
    process. We review with deference the remaining factually sensitive findings of the district court,
    e.g., whether a discouraged factor is present to such an extraordinary degree that departure is
    warranted. See 
    id.
     at ----, ----, 
    116 S.Ct. at 2047, 2050
    .3
    3
    In United States v. Taylor, 
    88 F.3d 938
     (11th Cir.1996), our first post-Koon review of a
    district court's decision to depart from the sentencing guidelines, we recognized that Koon had
    changed the standard of review and the analysis that applies when reviewing departure decisions.
    See 
    id. at 945-46
    . We consistently applied the Koon standard of review and analysis in the next
    three guideline departure cases that followed. See United States v. Bernal, 
    90 F.3d 465
    , 467-68
    (11th Cir.1996); United States v. Santos, 
    93 F.3d 761
    , 763 (11th Cir.1996), cert. denied, --- U.S.
    ----, 
    117 S.Ct. 1437
    , 
    137 L.Ed.2d 544
     (1997); United States v. Bristow, 
    110 F.3d 754
    , 757-59
    (11th Cir.1997).
    However, in United States v. Gunby, 
    112 F.3d 1493
     (11th Cir.1997), we stated
    that when reviewing a district court's decision to depart upward from the sentencing
    guidelines we should ask the following three questions:
    (1) Was the aggravating circumstance cited by the district court adequately taken
    into consideration by the Sentencing Commission in formulating the guidelines?
    (2) If adequate consideration was not given to the circumstance, was
    consideration of the circumstance consistent with the goals of the sentencing
    guidelines?
    (3) If the circumstance was properly taken into account, was the extent of the
    departure from the guideline range reasonable?
    
    112 F.3d at
    1499 (citing United States v. Shuman, 
    902 F.2d 873
    , 875-76 (11th Cir.1990)).
    We stated that this three-part inquiry from pre-Koon case law was consistent with Koon.
    
    Id.
     at 1499 n. 8.
    A close examination of the second Gunby question reveals that it may well be
    inconsistent with the Supreme Court's decision in Koon and with our pre-Gunby
    decisions utilizing the Koon analysis to review departure decisions. In none of our
    pre-Gunby, post-Koon decisions did we inquire whether the factor relied upon by the
    district court as a basis for departure was consistent with the goals of the Guidelines. See
    Taylor, 
    88 F.3d at 945-46
    ; Bernal, 
    90 F.3d at 467-68
    ; Santos, 
    93 F.3d at 763
    ; Bristow,
    
    110 F.3d at 757-59
    . Nor have we done so in any of our post-Gunby guideline departure
    decisions. See United States v. Lewis, 
    115 F.3d 1531
    , 1538-39 (11th Cir.1997); United
    States v. White, 
    118 F.3d 739
    , 741-42 (11th Cir.1997); United States v. Phillips, 
    120 F.3d 227
    , 230-32 (11th Cir.1997). Moreover, in Koon itself, the Supreme Court
    expressly rejected the government's suggestion that courts should test potential departure
    factors against broad sentencing goals and reject those factors that are inconsistent with
    these goals. --- U.S. at ----, 
    116 S.Ct. at 2051
    . The Court stated: "We conclude, then,
    that a federal court's examination of whether a factor can ever be an appropriate basis for
    departure is limited to determining whether the Commission has proscribed, as a
    categorical matter, consideration of the factor." 
    Id.
     at ----, 
    116 S.Ct. at 2051
    .
    Because the second Gunby question appears to be inconsistent with Koon and our
    pre-Gunby decisions applying the Koon analysis, we do not utilize the Gunby analysis.
    Instead, we adhere to the analysis set forth in Koon, which was adopted by this Court in
    Having set forth the standard by which we review a sentencing court's decision to depart
    from the guidelines, we turn now to the merits in this case.
    III. DISCUSSION
    The district court granted Hoffer a four-level downward departure on the grounds that
    Hoffer's loss of privilege to practice medicine and his voluntary disgorgement of proceeds from his
    criminal activity made his case atypical and warranted a departure. On appeal, the government
    contends that it was improper for the district court to depart from the sentencing guidelines on these
    grounds.
    A. THE "WAIVER" ISSUE
    As a preliminary matter, we address Hoffer's contention that the government waived its
    objections to the sentence imposed by the district court because it did not state its objections at the
    conclusion of Hoffer's sentencing hearing. In United States v. Jones, 
    899 F.2d 1097
    , 1103 (11th
    Cir.1990), overruled on other grounds, United States v. Morrill, 
    984 F.2d 1136
     (11th Cir.1993) (en
    banc), we held that a party who, at the conclusion of the imposition of sentence, fails to articulate
    the grounds for objection or remains silent, waives any objection to the sentence unless such waiver
    would result in manifest injustice. However, in United States v. Weir, 
    51 F.3d 1031
    , 1033 (11th
    Cir.1995), we clarified Jones by explaining that so long as a party states its objection to the sentence
    at some point during the sentencing hearing, its failure to repeat the objection at the conclusion of
    the imposition of sentence will not result in a waiver of that objection. That clarification of the
    Taylor, and which we have expounded upon in the text previously. In United States v.
    Hogan, 
    986 F.2d 1364
    , 1369 (11th Cir.1993), we held that "it is the firmly established
    rule of this Circuit that each succeeding panel is bound by the holding of the first panel to
    address an issue of law, unless and until that holding is overruled en banc, or by the
    Supreme Court." The first panel to interpret and apply the Koon standards was the
    Taylor panel, not the Gunby panel.
    Jones rule is particularly applicable where, as in this case, the district court after imposing sentence
    did not ask the appellant if it had any objections to the sentence.
    Prior to the imposition of sentence, Hoffer had argued that the court should grant him a
    downward departure from the applicable sentencing guideline because, among other things, he had
    voluntarily disgorged $50,000 in proceeds from his illegal activities and he had voluntarily given
    up his medical license. Hoffer maintained that those factors removed his case from the heartland
    of cases pertinent to the applicable guideline and, therefore, justified a downward departure from
    that guideline.
    In response to Hoffer's loss of medicine license contention, the government countered that
    the legal authority cited by Hoffer did not support a downward departure, and that such a departure
    would be inappropriate under the circumstances of this case. The government concluded that
    objection by stating: "There is absolutely nothing, nothing about the facts of this case or about the
    personality of this man that would warrant a departure in any manner or form, your Honor." The
    government then went on to object that voluntary disgorgement was not an appropriate basis for the
    court to grant Hoffer a downward departure, either.
    To preserve an issue for appeal, an objection must be sufficiently detailed to allow the trial
    court an opportunity to correct any arguable errors before an appeal is taken. See Christopher v.
    Cutter Lab., 
    53 F.3d 1184
    , 1192 (11th Cir.1995). The government's objections were sufficient to
    allow the district court to correct any errors. See Wilson v. Attaway, 
    757 F.2d 1227
    , 1242 (11th
    Cir.1985) (appellate court may consider whether grounds of objection are apparent from the
    context). Accordingly, we hold that the government did not waive its objections to the district
    court's departure decision and the resulting sentence by failing to reiterate these objections after the
    sentence was imposed.
    B. THE "VOLUNTARY DISGORGEMENT" ISSUE
    As part of his plea agreement, Hoffer agreed not to contest the government's subsequent
    civil forfeiture action seeking $50,000 from Hoffer as the proceeds of his illegal activities. The
    "voluntary disgorgement" the district court relied upon was, in fact, a civil forfeiture. The district
    court, at the government's request and with Hoffer's consent, specifically termed the disgorgement
    a forfeiture. Moreover, the voluntariness of the forfeiture must be considered in the context of the
    plea agreement: Hoffer traded his right to contest the forfeiture for what the government gave him
    in the bargain, which included dismissing five counts of the indictment.
    We turn now to the issue of whether civil forfeiture, contested or uncontested, is a prohibited,
    encouraged, discouraged or unmentioned factor for departing from the sentencing guidelines. While
    this issue is a question of first impression in our circuit, a number of other circuits have concluded
    that civil forfeiture cannot be used by a district court as a basis for departure from the sentencing
    guidelines. See United States v. Weinberger, 
    91 F.3d 642
    , 644-45 (4th Cir.1996); United States v.
    Hendrickson, 
    22 F.3d 170
    , 175-76 (7th Cir.1994); United States v. Crook, 
    9 F.3d 1422
    , 1425-26
    (9th Cir.1993); United States v. Shirk, 
    981 F.2d 1382
    , 1397 (3d Cir.1992), vacated on other
    grounds, 
    510 U.S. 1068
    , 
    114 S.Ct. 873
    , 
    127 L.Ed.2d 70
     (1994). No circuit has held otherwise.
    Section 5E1.4 of the sentencing guidelines provides: "Forfeiture is to be imposed upon a
    convicted defendant as provided by statute." We agree with the Third, Fourth, Seventh and Ninth
    Circuits that § 5E1.4 indicates that the Commission viewed forfeiture as a wholly separate sanction,
    which, if imposed, was intended to be in addition to, not in lieu of, imprisonment. See Weinberger,
    
    91 F.3d at 644
    ; Hendrickson, 
    22 F.3d at 175
    ; Crook, 
    9 F.3d at 1426
    ; Shirk, 
    981 F.2d at 1397
    . This
    view is supported by the Commission's decision to include forfeiture as a relevant factor when
    setting fines, see U.S.S.G. § 5E1.4(d)(5), while leaving it out as a factor which may support a
    reduction in sentence. See Crook, 
    9 F.3d at 1426
    . The Commission's decision indicates that civil
    forfeiture is relevant only to the possible monetary sanctions which may flow from a criminal
    conviction, but it has no bearing on a convicted defendant's term of incarceration.
    Moreover, it would make little sense for forfeiture to serve as a basis for departure from the
    guidelines. Forfeited assets or property are frequently the proceeds of criminal activities. See, e.g.,
    
    21 U.S.C. § 853
    (a)(1) (mandating forfeiture of property which constitutes proceeds of certain
    criminal activities). The more successful a criminal is, the more likely he or she is to accumulate
    significant assets or property from the criminal activity. Allowing a departure from the sentencing
    guidelines based on forfeiture would, in essence, reward criminals for their proficiency or success
    in committing crimes. Surely, the Commission never intended such a result.
    Whether a forfeiture is contested or uncontested makes no difference to our holding. In
    either case, forfeiture lacks the quality of voluntariness which some courts have held may arguably
    make restitution a potential basis for departure. See, e.g., United States v. Hairston, 
    96 F.3d 102
    ,
    107-08 (4th Cir.1996), cert. denied, --- U.S. ----, 
    117 S.Ct. 956
    , 
    136 L.Ed.2d 843
     (1997) (holding
    that payment of restitution can, in exceptional circumstances, be basis for departure from sentencing
    guidelines); Hendrickson, 
    22 F.3d at 176
     (comparing forfeiture to voluntary payment of restitution
    and concluding that, unlike the payment of restitution, under no circumstances can forfeiture be the
    basis of a departure from the sentencing guidelines).4
    For the reasons set forth above, we hold that civil forfeiture can never be the basis for a
    downward departure from the sentencing guidelines; it is a prohibited factor. Therefore, the district
    court abused its discretion by relying on Hoffer's "voluntary disgorgement" as a basis to depart from
    4
    This case does not raise the question of whether voluntary payment of restitution can
    constitute "extraordinary acceptance of responsibility," supporting a departure from the
    sentencing guidelines, see Hairston, 
    96 F.3d at 107-08
    , and we intimate no view on the subject.
    the guidelines. See Koon, --- U.S. at ----, 
    116 S.Ct. at 2047
     ("A district court by definition abuses
    its discretion when it makes an error of law.").
    C. LOSS OF PRIVILEGE TO PRACTICE MEDICINE
    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 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 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 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
    .
    There was, however, a "vigorous dissent" by Judge Hall from the holding on this issue. She
    believed that the district court had erred in departing because, "[t]he kind of humiliation and
    suffering [the defendant] will suffer, while not common, is not "atypical.' " 
    Id. at 623
    . Additionally,
    Judge Hall found the departure contrary to the intent of the Commission:
    The Guidelines' policy is that "persons who abuse their position of trust ... generally are
    viewed as more culpable." U.S.S.G. § 3B1.3 comment. (backg'd). We must assume that the
    Sentencing Commission has adequately considered the special circumstances of defendants
    who hold high office, and rejected any notion that such persons should receive more lenient
    treatment. The district court's departure on the basis of consequences flowing from [the
    defendant's] breach of the public trust flies in the face of the Guidelines' policy.
    Id. Consequently, she concluded that the collateral consequences of the defendant's conviction are
    not a permissible basis for departure. Id.
    Hoffer, while recognizing that the original opinion in Aguilar has been withdrawn,
    nevertheless urges us to adopt the majority's reasoning. Even if the original opinion in Aguilar had
    not been withdrawn, we do not believe it supports Hoffer's position. In Aguilar, the district court
    had based its departure on the long, humiliating, and burdensome adversarial proceedings the
    defendant would face as the result of impeachment and disbarment. It was that "additional
    punishment" which led the panel majority to affirm the district court. In affirming the district court,
    it emphasized that the district court had not departed from the guidelines on the basis of the
    defendant's loss of employment or the foreclosure of career opportunities. See id. at 645.
    By contrast, in this case, the district court based its departure on the very grounds the Aguilar
    Court emphasized were not involved in that case: Hoffer's loss of employment and the foreclosure
    of career opportunities, i.e., his loss of the privilege to practice medicine. In contrast to the
    defendant in Aguilar, the process through which Hoffer lost his privilege to practice medicine was
    not long, burdensome or humiliating. The license forfeiture process Hoffer went through involved
    nothing more than the signing of a few documents. His experience simply does not compare to the
    "additional punishment" of protracted adversarial proceedings facing the defendant in Aguilar.
    Therefore, the reasoning of the Aguilar majority does not support the district court's downward
    departure.
    Moreover, we agree with Judge Hall's dissenting opinion in Aguilar. Because the guidelines
    contain a section specifically addressing those defendants who abuse the public trust to facilitate the
    commission of their crimes, the Commission certainly considered the potentially substantial
    collateral employment consequences this class of defendants face.               With those potential
    consequences in mind, the Commission nonetheless chose to make abuse of a position of trust the
    basis of a sentence enhancement. Having done so, we believe the Commission indicated that a
    defendant who receives a § 3B1.3 enhancement for abusing a position of trust cannot then receive
    a downward departure from the sentencing guidelines for losing that same position of trust. Stated
    generally, we hold that a factor which is inextricably intertwined with a basis for enhancement under
    the guidelines will ordinarily be a prohibited basis for downward departure from the guidelines.
    Accordingly, we hold that, under the circumstances of this case, the district court abused its
    discretion by granting Hoffer a downward departure based upon loss of his privilege to practice
    medicine.
    IV. CONCLUSION
    For the reasons set forth above, Hoffer's sentence is VACATED and the case is
    REMANDED for resentencing in accordance with this opinion.