“If the defendant abused a position of public or private trust, or used a special skill, in a manner that significantly facilitated the commission or concealment of the offense, increase [the sentence] by 2 levels.” [United States Sentencing Guidelines § 3B1.3 (1998).]

“For this adjustment to apply, the position of public or private trust must have contributed in some significant way to facilitating the commission or concealment of the offense (e.g., by making the detection of the offense or the defendant’s responsibility for the offense more difficult). This adjustment, for example, applies in the case of … the criminal sexual abuse of a patient by a physician under the guise of an examination.”[ Official Commentary and Application Notes to United States Sentencing Guidelines § 3B1.3 (1998).]

Although the example is that of a violent crime, this provision would also increase the sentence of a medical care practitioner who is convicted of a financial crime that was related to the practitioner– patient relationship, such as billing fraud.