AUSA Katherine Pfeifle went for it on cross.

When Pfeifle brought up his $4 million Dallas house, Rimlawi did not dodge the subject.

“If you want me to say I’ve moved up in the world, yes,” he said. “Yes, I have a nice house.”

A surgeon owns a nice house? Not exactly shocking. But what might be shocking is that the government, despite the cries that they never prosecute white collar crime, are trying to use their clout, the fear they wreak on their targets, to bring down what they claim is a nefarious scheme of bribery and kickbacks between Forest Park Hospital and the surgeons whose patients they sought to fill its operating rooms.

Assistant U.S. Attorney Andrew Wirmani told jurors that the doctors acted out of pure greed, making medical decisions to “line their own pockets.” The bribes and kickbacks, he said, were not bags of cash exchanged in dark alleys. Rather, the hospital gave the doctors financial perks in the form of paid business expenses — expensive advertising to promote their practices, he said.

If operating rooms sit empty, they are a drain on hospital revenues. If they’re filled, they contribute. As for physicians, if they are promoted as great docs and innovators in their field, their waiting rooms fill up. If not, they can’t pay the lease on the Porsche. Hard as it is to imagine, the economics of medicine isn’t a whole lot different than any other enterprise.

Joint marketing is as much marketing for hospitals and surgeons as it is for car manufacturers and comic book heroes. Unless it influences the surgeons in the exercise of their professional judgment, whether by advising a patient that surgery is needed or taking the surgery to a hospital that is ill-equipped to handle it.

Dr. Rimlawi wasn’t exactly a slacker, who would have starved but for the paid promotion by Forest Park.

Rimlawi said he and a co-defendant, Douglas Won, helped pioneer minimally invasive spine surgery and were the only ones at Forest Park at the time who could perform the specialty procedure.

The technique employs thin tubes that pass through muscle fibers to get to the spine without having to cut open the patient’s back. It reduces the risk of infection and speeds up recovery.

Even so, skilled and innovative surgeons need to get their qualifications out to the public to bring in patients and, yes, make money. This is not a crime in America, making money, at least until President Ocasio-Cortez puts her pen and phone to use. But making money is not the antithesis of being a great doc and putting the patient’s interests first.

If the physician’s exercise of professional judgment is entirely proper for the patient first, then anything that happens between hospital and doc are just good business. If there are two hamburger stands that offer similar burgers, but one gives you free fries with your burger, did it bribe you? Did you get a kickback for picking the stand with free fries?

Sure, Forest Park hoped he would bring his surgeries to them, he said, just like every other hospital. And yes, hospitals competed for his surgeries. But in the end he did what was right for his patients, Rimlawi told jurors.

If he already had a corrupt deal with Forest Park executives to sell them surgeries, Mesereau asked, then why did the hospital’s marketers routinely pester and pressure him for more?

“It doesn’t make any sense,” Rimlawi said.

Rimlawi took his surgeries to Forest Park at some times, and other hospitals at other times, as his medical judgment dictated. Forest Park didn’t own him, but wanted Dr. Rimlawi to bring more and more surgeries, if not all his surgeries, to its ORs. How can one blame Forest Park Hospital for wanting its rooms filled, day and night, so the sound of the cash register would constantly ring? This is how a hospital makes money. Without money, a hospital cannot survive, cannot thrive.

Hospitals court docs for their patients, knowing that patients tend far more to pick a doc than a hospital. Even now, with hospitals regularly advertising directly to patients on the television, the thrust is directed toward physicians with expertise in dealing with a particular disease or form of surgery, because nobody says, “Hey, let’s go out hospital shopping today” unless they are in need of treatment.

At trial, however, the government manufactured a case by getting the hospital’s marketing people to flip on the docs.

Pfeifle read the names of several other witnesses who testified that Rimlawi took marketing money to bring surgeries to Forest Park. Rimlawi said he barely knew them.

So marketers are framing him in a large health care fraud case?

“I think you guys scare witnesses,” Rimlawi told her.

“She’s petrified,” he said about one employee who testified. “She doesn’t know what you guys can do to her.”

Prosecutors “made” the witnesses say what they did, he said, because his accusers would have done anything for lesser sentences.

And, indeed, there is nothing remotely unusual about a witness, even one disinclined to lie exactly, from “framing” their testimony in such a way as to convert an entirely lawful, ethical and financially beneficial business practice into something dark and nefarious. If the Department of Justice had a superpower, it would be scaring people into doing its bidding in exchange for not having a sentence of life plus cancer imposed.

Come to think of it, it’s almost as if the government bribes witnesses by offering the possibility of substantially reduced sentences if the witnesses give kickbacks of framing their testimony in a way that makes the government’s case not look ridiculous.

While it might seem to people outside the medical profession as if making money by joint marketing is unseemly, given the god-like attributes docs enjoy, surgery is still subject to the same economic rules as any other enterprise that produces not only a good and decent “product,” but a good living for its practitioners. That Dr. Rimlawi did well isn’t a crime. As long as his patients came first, he’s entitled to have as nice a house as he wants.