Doctor Update: Should tax cheating affect a doctor’s medical license?

Buck Owens, the country music icon from Bakersfield, knew how to sing about getting away with bad behavior. He made it all sound so unavoidable, excusable, endearing even, and, as he explained in one of his best songs, “My one excuse to offer you? The devil made me do that.”

Maybe Dr. Tomas Ballesteros Rios, also of Bakersfield, sang as sweetly into the ears of the California Medical Board, which has allowed him to continue to practice with few restrictions despite the doctor’s trouble with the Internal Revenue Service, two felony convictions, fines, and probations.

Over two posts, I’ll track Rios’ trail of run-ins with various authorities. The story starts with a tax dodge, not uncommon in medical board records across the country. Cheating on one’s taxes can lead to penalties as high as $500,000 and even jail time if the IRS decides to go after you. But if doctors cheat on their taxes, the cheating can be met by medical boards with a shrug, a fine, or a few days of being prevented from practicing. But rarely does it lead to any serious penalties. Perhaps that is as it should be. Or perhaps, as some have argued, when a state confers upon a person a professional license it is also requiring that person to uphold himself or herself to a higher standard than any old person filing a Form 1040EZ.

For 2002, Rios filed a false tax return with the IRS, according to Medical Board of California records. This wasn’t just a rounding error, either. The IRS settled the dispute with Rios and tallied up $72,000 in taxes that Rios should have paid. That was significantly more than the median household income in the U.S. that year. So you could have taken the amount of money Rios kept from the government that year and paid for at least one if not two American workers to have a job.

As is often the case, the tax cheating wasn’t noticed initially; it actually took until November 2009 for the IRS to file its case against Rios and reach a plea agreement, in which he was convicted of “making and subscribing a false income tax return, a felony.” He was sentenced to two years of probation and ordered to pay fines and restitution totaling $52,371.

In August 2010, based on the felony tax conviction, Rios was accused by the Medical Board of California of “conviction of a substantially related offense” and a “dishonest act.” In June 2011, the Board suspended his license for 60 days. It also put him on probation for three years, which allowed him to continue practicing without any real restrictions on his license.

The Medical Board of California had the authority to take his license away permanently were it able to establish that the tax evasion was connected to his medical practice. Assuming the income came from his medical practice, that seems like an easy link to make.

Rios was also licensed to practice medicine in Hawaii in 2005. Only five years later, he was accused by the medical board in Hawaii of a “conviction related to profession.” He settled the case in October 2010, was ordered to pay a $2,500 fine and was put on 90 days of probation.

In all likelihood, this was also related to Rios’ tax problems, but Hawaii makes Rios’ history painfully opaque. Reporters, patients and everyone else are hampered by Hawaii’s aggressively anti-consumer stance. While so many states have moved toward providing deep background information on physicians that is easy to find and easy to navigate, Hawaii remains one of the worst states in the country in terms of how easily people can find and use physician histories.

In summary, taking $72,000 from the federal government resulted in Rios not being able to work for 60 days. If he had walked into a convenience store and grabbed $72,000 out of a cash register, he likely would have been thrown into jail, but the different judicial standards set for white collar crime are well researched and remarked upon. A rare exception happened in 2014 when Dr. Ali Vaziri of Napa, California, was sent to prison for a year for tax fraud.

How much did he cheat? About $45,000 more than Rios.

And Aziri is still practicing medicine.

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