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Wrong Mary Barthel?

Dr. Mary Frances Barthel

Chief Quality and Safety Officer

Blessing Hospital

HQ Phone: (217) 223-1200

Email: m***@***.com

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Blessing Hospital

11th St. Suite 200

Quincy, Illinois 62301

United States

Company Description

Since 1875, Blessing Hospital has provided high-quality, accessible healthcare to residents in a 15-county area of northeast Missouri, western Illinois and southeast Iowa. A not-for-profit, not-tax-supported, independent hospital, Blessing is home to cent ... more

Find other employees at this company (684)

Background Information

Employment History

Hospitalist Independent Contractor

Sound Physicians

Program Medical Director for CogentHMG Hospitalist Program, Medical Director


Hospitalist Program Medical Director

Cogent Healthcare , Inc.

Hospitalist, Chief of Medicine, and Hospitalist Program Medical Director

Gundersen Lutheran Medical Center



Web References (19 Total References)

Alpha Medical Group | Physician Recruiters [cached]

The big jump in pay in the Midwest comes as no surprise to Mary Frances Barthel, MD, chief quality and safety officer for Blessing Health System in Quincy, Ill. Dr. Barthel is the former hospitalist program director for the hospital's Cogent Healthcare group, which merged with Sound Physicians last year.

"It's totally supply and demand," she explains.

by Mary Frances Barthel, ... [cached]

by Mary Frances Barthel, MD

Dr. Barthel explains how her hospitalist group has asked for revision of bylaws to prevent such practices.
Mary Frances Barthel, MD, is director of the Cogent Healthcare hospitalist program at Blessing Hospital in Quincy, Ill. Dr. Barthel has been a hospitalist since 2002.

WHEN MEDICARE LAUNCHED its two-midnight ... [cached]

WHEN MEDICARE LAUNCHED its two-midnight rule last fall, Mary Frances Barthel, MD, thought she had it all figured out.

As director of the Cogent Healthcare hospitalist program at Blessing Hospital in Quincy, Ill., Dr. Barthel spent a great deal of time hammering the point home that under the new rule, doctors' expectations of how much time patients would need in the hospital would determine whether they would be admitted or placed in observation.
No longer, as Dr. Barthel understood it, would she and her colleagues have to parse out admission criteria in commercial
"We did a big blitz around the Oct. 1 kickoff," says Dr. Barthel. "We had a medical staff meeting, mailings and one-on-one education with physicians who admit a lot of patients. We came up with a really good synopsis of the final rule and advice on what to do."
But six months later, Dr. Barthel has had to circle back to those same doctors with a different approach.
"The more we heard from the advisory company, the less confident we were saying that time was the most important factor," says Dr. Barthel. "Lately, we've gone back to using InterQual to answer whether the patient's presenting problems meet medical necessity for inpatient admission, and then we also ask the physician to predict how long he or she expects the patient to be in the hospital."
Her group now bills many more ICU patients as observation than they did before Oct. 1. As for the rest of the one-midnight inpatient stays, "I get the impression that the advisory company believes such stays should basically never happen," says Dr. Barthel.
Or should they-like Dr. Barthel and her colleagues- still rely on admission criteria that may (may!) provide some protection once recovery audit contractors (RACs) start tackling claims?
"It used to be that outpatient physicians who admit their own patients could just fax an order to the admitting office, but we no longer allow that," says Mary Frances Barthel, MD, director of the Cogent Healthcare hospitalist program at the hospital. Instead, a representative from the physician's clinic has to call one of the hospital's utilization nurses to discuss the patient's status and expected length of stay.
For outpatient physicians covered in the hospital by hospitalists, that's now a two-step process: The outpatient physician has to call the hospitalist, who then calls a utilization nurse.
"That order used to be a fax before," says Dr. Barthel. "Now, it has to be a phone call."
Then there's this innovation: Dr. Barthel, who's also the hospital's utilization management physician advisor, has designed two versions of the letter sent to the attending physician when an admission is downgraded to observation status before discharge.
"One version says, 'Your patient did not meet medical necessity requirements so was changed to observation,' " she notes.

Today's Hospitalist :: For hospital medicine, burnout is a continuing threat [cached]

"I don't know anybody personally who can just do shifts month after month after month and never feel burnout," says another veteran hospitalist Mary Frances Barthel, MD, who is medical director with the Cogent Healthcare hospitalist program at Blessing Hospital in Quincy, Ill.

In the wake of new duty-hour rules protecting residents' time during training, Dr. Barthel says she expected to see newly-trained doctors burning out fast once they started to practice. But that hasn't been the case.
"The new people have tons of energy and no issues at all seeing a high volume of patients," says Dr. Barthel. "But I can't say the same for people I know who have been doing this for several years."
Here's a look at the lessons that both Drs. Kendall and Barthel have learned on how to mitigate burnout.
For Dr. Barthel, the seven-on/seven-off block of 12-hour shifts she and her colleagues currently work is the biggest burnout factor they face. She sees it as a major reason why veteran hospitalists face a greater risk of burning out than doctors just out of residency.
"The 12-hour shifts get to be really draining," she notes. As the parent of school-age children, she's leading the charge in her program to renegotiate her group's contract to go to an hourly wage. That will allow some group members each day to choose to work an eight-hour shift while another hospitalist holds down a traditional 12-hour one. (A nurse practitioner will provide coverage for the other four hours each day when a hospitalist won't be on.)
"Instead of 15 shifts per month, those of us working eight-hour shifts would have to do 22," Dr. Barthel explains.
Dr. Barthel agrees that being able to draw on reserve physicians helps protect group members already on board. She points to the advantage of working for a national management group, with Cogent sending what it calls a "traveling physician" to her group at Blessing, starting next month.
"We're losing one physician, partly because he wants to teach but also because he's tired of working seven-on/seven-off," Dr. Barthel says. "The traveling physician could be here six months until we fill that slot."
A line in the sand Dr. Barthel says that the one downside to working as a traveling physician or a locum is that "little bit of skepticism when physicians first arrive. There's some hesitancy to really accept them. Overall, however, Dr. Barthel says that she and her colleagues are very well received within the medical staff.
That's important, Dr. Kendall notes, because he sees not being treated well on the job as a major factor in hospitalist burnout. That's why, as another condition for heading up the program, he negotiated having the freedom to choose whom the group admits for.
Dr. Barthel says that her passion is quality improvement, and she looks forward to negotiating more time to pursue it.
Right now, her job is about one-quarter administrative vs. 75% clinical, but she'd like a 50-50 split. "I enjoy patient care," she says, "but there's rarely a day when I can come in, see patients, get my administrative issues taken care of, and be able to go home and be in a good mood with my family."
The problem, Dr. Barthel adds, "is these hectic, busy days when you're on for 12 hours and you're running the whole time.

-Mary Frances Barthel, ... [cached]

-Mary Frances Barthel, MD Blessing Hospital

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