A dispute between the medical staff and administration at Springfield Hospital Center is causing the nationwide agency that accredited the hospital to return for another look next month.

The Joint Commission on the Accreditation of Health Care Organizations, an independent, non-profit group, evaluated the hospital last July and granted accreditation in October.

Michael Golden, a spokesman for the state Department of Health and Mental Hygiene, confirmed yesterday that the JCAH will return in March. The survey will focus on the hospital's bylaws, Golden said.

Springfield's physicians hope the JCAH prompts the hospital to restore a principle they think would better serve patients, said Judith Stainbrook, a Westminster lawyer representing the medical staff.

Thatprinciple is that the administration and the physicians must agree on the adoption of bylaws on medical care, Stainbrook said.

The current bylaws have not been agreed to by physicians, she said.

The American Medical Association and its state affiliate, the Medical Chirurgical Society of Maryland, have pressured the JCAH to review the bylaw dispute, Stainbrook said.

Although the JCAH was aware of the dispute when it visited in July, it didn't take it into consideration because of pending litigation on the matter, Stainbrook said. The medical societies, however, maintain that regardless of the litigation, the JCAH is supposed to support physician input into those bylaws.

In 1989, Stainbrook said, the hospital administration abolished bylaws the doctors had agreed to and instituted its own bylaws unilaterally. The move prompted Dr. Ellis McClelland, then president of the medical staff, to file a suit in Carroll County Circuit Court .

Underthe new bylaws, the administration gave itself the right to appoint a new president of the medical staff, Dr. David Waltos, to oust McClelland, who had been elected by the other physicians.

"It sort of made the medical staff a tool of the administration," Stainbrook said.

The new bylaws also took away the doctors' right to appoint an executive committee from among them to review the medical staff.

Stainbrook said the new bylaws discourage physician from seeking constructive criticism. Physicians feel more vulnerable to reprisals if theyare evaluated solely by the administration, she said. Such an attitude could affect patient care, she said.

Another lawsuit pending was filed by Dr. Angel Losada, and is pending in Baltimore County Circuit Court. The suit charges that the hospital superintendent, Dr. Bruce Hershfield, infringed on Losada's First Amendment rights by punishing him for criticizing the hospital. Losada's criticisms involved thedischarge of patients too early, violence between patients and issues of treatment, said Stainbrook, who also represents Losada.

Losada's suit charges that the hospital suspended his prescription privileges and reported him for review by the state in retaliation for his criticisms.

Losada's skills as a psychiatrist are highly regarded by the rest of the staff, Stainbrook said. He said the hospital's action against him intimidated the staff into thinking they would also be punished for speaking out.

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