WASHINGTON (AP) -- Dr. Thomas W. Michaelis spent two months in an Ohio prison in 1991 for trying to molest four teen-age girls.
He then worked for eight years as an obstetrician-gynecologist in an Indian Health Service hospital in Arizona, paid $101,000 a year by the government despite a law barring the hiring of sex offenders in agencies serving American Indians.
IHS officials fired Michaelis last year. By then, he had examined hundreds of women at the Phoenix Indian Medical Center after registering with local authorities as a sex offender.
Michaelis said he told IHS officials about his convictions for attempted molestation, but the agency hired him in 1993 anyway.
''They knew about it up front,'' Michaelis said. ''I guess they needed a doctor eight years ago.''
At least 21 doctors who worked for the IHS between 1996 and 2001, including one in Alaska, have been punished or denied licenses by state medical boards for offenses ranging from abusing drugs to neglecting patients who later died, an Associated Press review of disciplinary records found.
Officials at IHS, the federal agency charged with providing care to 1.5 million American Indians, acknowledge that background checks on their doctors are often inadequate. It's just one of many problems they blame on a lack of money.
''In general, there is no secretarial staff to support the medical staff activities,'' said Dr. Craig Vanderwagen, the agency's chief medical officer.
''Many of our people are seeing 40 patients a day or so. Then, your attention to take care of that (background check) paperwork goes right out the window,'' he said.
Several sanctioned doctors told AP that IHS officials knew about their backgrounds before they were hired. Documents from the State Medical Board of Ohio show IHS requested, and Ohio sent, records detailing Michaelis' crimes.
IHS officials rejected a Freedom of Information Act request from AP for records detailing what they knew before Michaelis was hired. Likewise, IHS officials declined to discuss any specific disciplined doctors, citing privacy concerns.
IHS managers have the power to hire doctors despite past troubles as they try to fill vacancies that include more than 10 percent of their physician jobs.
Vanderwagen said recruiting IHS doctors is often difficult, especially for relatively low-paying jobs on the most remote, poverty-ravaged Indian reservations.
Records show about 2.6 percent of IHS doctors have been punished by state boards -- a rate more than four times the average for all government doctors and the highest of any federal agency.
In contrast, just 0.5 percent of doctors who provide care to military veterans at Department of Veterans Affairs hospitals have ever been disciplined.
The IHS discipline rate is about the same as the national average for all doctors. But critics say the federal agency has an obligation to do better -- especially because Indians have suffered from substandard health care for more than a century and are vulnerable.
''There are perpetrators out there who tend to look for the state or county or federal systems that have loopholes,'' said Yvette Joseph-Fox, executive director of the National Indian Health Board, which represents tribal health officials.
''We've been haunted by these problems for more than a hundred years ... and for some strange reason, the perpetrators know that,'' she said.
AP identified 21 disciplined IHS doctors through state medical board files and a database of punished doctors compiled by the consumer watchdog group Public Citizen.
IHS doctors need only be licensed to practice medicine in one state, not the one where they work.
For instance, Michaelis relied on his Ohio medical license even though Arizona rejected his application. That means the only place Michaelis could practice in Arizona was a federal facility like an IHS hospital.
Dr. Michael D. Cerny's medical licenses have been revoked, denied or suspended in Pennsylvania, Ohio, Iowa and Illinois for drug problems and for tearing a woman's bladder during a hysterectomy, according to records from the states' medical boards.
Cerny now practices at the IHS hospital in Pine Ridge, S.D., earning more than $103,000 a year. He holds a valid medical license in Georgia.
Cerny did not return repeated calls to his office and home seeking comment. Neither did Pine Ridge hospital administrator Vern Donnell.
Dr. Paula J. Colescott surrendered her Colorado medical license in 1995 after she admitted having sex with a 19-year-old patient, according to Colorado State Board of Medical Examiners records. She also was reprimanded in 1991 for a similar sexual relationship with another patient, medical board records show.
Colescott, who now makes $98,310 a year at the Alaska Native Medical Center in Anchorage, said she was upset by news coverage of the 1995 case.
''So you're going to publish again, and publicly humiliate me again?'' Colescott said when interviewed. ''You never let it die, do you guys? No, I am not willing to comment.''
In a written statement, Paul Sherry, chief executive of the tribal consortium that runs the Alaska hospital, said Colescott ''meets all of the requirements of the medical bylaws and rules and regulations to practice as a licensed physician.''
Dr. Richard Chilian, a surgeon, had his North Dakota license suspended in 1997 and then reinstated with restrictions after he took 20 tablets of the anti-depressant Wellbutrin and became so disoriented he couldn't complete a surgery, according to North Dakota medical board records.
Chilian now makes $90,549 at the Phoenix Indian Medical Center. He said the North Dakota incident resulted from depression and IHS officials knew that.
''They knew all about it, 100 percent,'' Chilian said. ''There was never any attempt to cover things up.''
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