Dr. Geoffrey Barnes FastWave Fellows Themed Interview

Interview with Dr. Geoffrey Barnes

Leading anticoagulation expert Dr. Barnes shares his story – from 'deer in headlights' to becoming a domain expert – and urges every cardiologist not to forget to examine their patients’ feet.

Dr. Geoffrey Barnes FastWave Fellows Themed Interview

Interview with Dr. Geoffrey Barnes

Leading anticoagulation expert Dr. Barnes shares his story – from 'deer in headlights' to becoming a domain expert – and urges every cardiologist not to forget to examine their patients’ feet.

Dr. Geoffrey Barnes FastWave Fellows Themed Interview

Interview with Dr. Geoffrey Barnes

Leading anticoagulation expert Dr. Barnes shares his story – from 'deer in headlights' to becoming a domain expert – and urges every cardiologist not to forget to examine their patients’ feet.

Dr. Geoffrey Barnes FastWave Fellows Themed Interview
Dr. Geoffrey Barnes FastWave Fellows Themed Interview
Dr. Geoffrey Barnes FastWave Fellows Themed Interview

Dr. Geoffrey Barnes is an Associate Professor of Internal Medicine at the University of Michigan specializing in cardiovascular and vascular medicine. He completed his medical training at the University of Michigan, where he also served as chief medical resident and earned a Master's in Health and Healthcare Research. Dr. Barnes focuses on anticoagulant and antithrombotic therapy for atrial fibrillation and venous thromboembolism, co-directing the Michigan Anticoagulation Quality Improvement Initiative (MAQI2). He leads AHRQ- and NIH-funded studies to improve anticoagulation care and holds leadership positions with several major medical organizations.

After you completed your fellowship training, was there a therapy area or subject matter you wish you had been taught more about or had more experience in?

Yeah, after I finished my cardiovascular training, I realized I had a lot of great training in cardiac disease but not as much emphasis on vascular disease. That was an area that really interested me and I felt it was underdeveloped in my training. So, I spent an extra year doing vascular medicine training to get a better understanding of arterial disease—the anatomy, the diseases, and how we manage them. The same for venous disease. I really wanted to grow my expertise in the vascular space to complement all the time I had spent learning about the cardiac space.

Many residents and fellows leave training with a sense that they aren’t fully prepared for clinical practice. Do you remember a time when you felt like you weren’t ready for “prime time”? How did you overcome this?

Absolutely. My entire first year out of fellowship, practicing on my own, was a “deer in headlights” experience. I was constantly questioning myself: Is that really the right thing? Do I really know what I’m doing? I had to build confidence because I no longer had someone to lean on—an attending to bounce ideas off of. The most important thing I did was build a network of mentors I could go to with any clinical question without feeling judged. That first year, I spent a ton of time in my mentors' offices, running cases by them, making sure I was thinking about things the right way. Getting that reassurance—that yes, I was approaching things correctly, that they believed in me and I could do this—was immensely helpful.

And those relationships you built, were they primarily local or nationwide?

They were both. I still went to my local mentors from my training days for guidance. But I also started reaching out to people I had networked with through professional societies. I wanted to get an outside perspective on how they were treating certain conditions or using new therapies. This helped me make sure I was in line with people I really respected.

You’re well-published and have participated in a lot of medical research. What advice would you give someone interested in getting more involved with clinical trials?

If you are in training and interested in research, I recommend two things. First, make connections with faculty at your training center. Find out who’s leading projects that you can get involved in. Team up with someone who's doing something you're interested in or get them to support an idea you have.

Second, build your network both inside and outside your institution. Connect on social media, go to national society meetings, and get involved in committees. Those connections with other leaders, both peers and mentors, are critical for opening up opportunities to be part of a paper, get involved in a trial, or anything else. Make a real effort to build your network. 

Moving on to more professional-related questions. When thinking about the business of healthcare, what are 2-3 concepts that you wish you knew coming out of fellowship?

As physicians, we are heavily influenced by how healthcare is paid for, but most of us have no idea how that infrastructure or those rules actually work. I wish I had understood more about how healthcare is paid for—which things that I do at the hospital are paid by Medicare versus private insurance, the different aspects, are patients paying versus the hospital. If I had a better understanding, I could think more about the pressure points and how to innovate and improve care.

The same goes for the medication side. Who actually manages the pharmacy piece of your insurance? What is a pharmacy benefits manager? How do they decide what's on or off the drug formulary list? What's a prior authorization process like? I didn't understand any of that, but it influences so much of what I do day-to-day. Those are two areas I really wish I'd learned more about.

Dr. Geoffrey Barnes is an Associate Professor of Internal Medicine at the University of Michigan specializing in cardiovascular and vascular medicine. He completed his medical training at the University of Michigan, where he also served as chief medical resident and earned a Master's in Health and Healthcare Research. Dr. Barnes focuses on anticoagulant and antithrombotic therapy for atrial fibrillation and venous thromboembolism, co-directing the Michigan Anticoagulation Quality Improvement Initiative (MAQI2). He leads AHRQ- and NIH-funded studies to improve anticoagulation care and holds leadership positions with several major medical organizations.

After you completed your fellowship training, was there a therapy area or subject matter you wish you had been taught more about or had more experience in?

Yeah, after I finished my cardiovascular training, I realized I had a lot of great training in cardiac disease but not as much emphasis on vascular disease. That was an area that really interested me and I felt it was underdeveloped in my training. So, I spent an extra year doing vascular medicine training to get a better understanding of arterial disease—the anatomy, the diseases, and how we manage them. The same for venous disease. I really wanted to grow my expertise in the vascular space to complement all the time I had spent learning about the cardiac space.

Many residents and fellows leave training with a sense that they aren’t fully prepared for clinical practice. Do you remember a time when you felt like you weren’t ready for “prime time”? How did you overcome this?

Absolutely. My entire first year out of fellowship, practicing on my own, was a “deer in headlights” experience. I was constantly questioning myself: Is that really the right thing? Do I really know what I’m doing? I had to build confidence because I no longer had someone to lean on—an attending to bounce ideas off of. The most important thing I did was build a network of mentors I could go to with any clinical question without feeling judged. That first year, I spent a ton of time in my mentors' offices, running cases by them, making sure I was thinking about things the right way. Getting that reassurance—that yes, I was approaching things correctly, that they believed in me and I could do this—was immensely helpful.

And those relationships you built, were they primarily local or nationwide?

They were both. I still went to my local mentors from my training days for guidance. But I also started reaching out to people I had networked with through professional societies. I wanted to get an outside perspective on how they were treating certain conditions or using new therapies. This helped me make sure I was in line with people I really respected.

You’re well-published and have participated in a lot of medical research. What advice would you give someone interested in getting more involved with clinical trials?

If you are in training and interested in research, I recommend two things. First, make connections with faculty at your training center. Find out who’s leading projects that you can get involved in. Team up with someone who's doing something you're interested in or get them to support an idea you have.

Second, build your network both inside and outside your institution. Connect on social media, go to national society meetings, and get involved in committees. Those connections with other leaders, both peers and mentors, are critical for opening up opportunities to be part of a paper, get involved in a trial, or anything else. Make a real effort to build your network. 

Moving on to more professional-related questions. When thinking about the business of healthcare, what are 2-3 concepts that you wish you knew coming out of fellowship?

As physicians, we are heavily influenced by how healthcare is paid for, but most of us have no idea how that infrastructure or those rules actually work. I wish I had understood more about how healthcare is paid for—which things that I do at the hospital are paid by Medicare versus private insurance, the different aspects, are patients paying versus the hospital. If I had a better understanding, I could think more about the pressure points and how to innovate and improve care.

The same goes for the medication side. Who actually manages the pharmacy piece of your insurance? What is a pharmacy benefits manager? How do they decide what's on or off the drug formulary list? What's a prior authorization process like? I didn't understand any of that, but it influences so much of what I do day-to-day. Those are two areas I really wish I'd learned more about.

Dr. Geoffrey Barnes is an Associate Professor of Internal Medicine at the University of Michigan specializing in cardiovascular and vascular medicine. He completed his medical training at the University of Michigan, where he also served as chief medical resident and earned a Master's in Health and Healthcare Research. Dr. Barnes focuses on anticoagulant and antithrombotic therapy for atrial fibrillation and venous thromboembolism, co-directing the Michigan Anticoagulation Quality Improvement Initiative (MAQI2). He leads AHRQ- and NIH-funded studies to improve anticoagulation care and holds leadership positions with several major medical organizations.

After you completed your fellowship training, was there a therapy area or subject matter you wish you had been taught more about or had more experience in?

Yeah, after I finished my cardiovascular training, I realized I had a lot of great training in cardiac disease but not as much emphasis on vascular disease. That was an area that really interested me and I felt it was underdeveloped in my training. So, I spent an extra year doing vascular medicine training to get a better understanding of arterial disease—the anatomy, the diseases, and how we manage them. The same for venous disease. I really wanted to grow my expertise in the vascular space to complement all the time I had spent learning about the cardiac space.

Many residents and fellows leave training with a sense that they aren’t fully prepared for clinical practice. Do you remember a time when you felt like you weren’t ready for “prime time”? How did you overcome this?

Absolutely. My entire first year out of fellowship, practicing on my own, was a “deer in headlights” experience. I was constantly questioning myself: Is that really the right thing? Do I really know what I’m doing? I had to build confidence because I no longer had someone to lean on—an attending to bounce ideas off of. The most important thing I did was build a network of mentors I could go to with any clinical question without feeling judged. That first year, I spent a ton of time in my mentors' offices, running cases by them, making sure I was thinking about things the right way. Getting that reassurance—that yes, I was approaching things correctly, that they believed in me and I could do this—was immensely helpful.

And those relationships you built, were they primarily local or nationwide?

They were both. I still went to my local mentors from my training days for guidance. But I also started reaching out to people I had networked with through professional societies. I wanted to get an outside perspective on how they were treating certain conditions or using new therapies. This helped me make sure I was in line with people I really respected.

You’re well-published and have participated in a lot of medical research. What advice would you give someone interested in getting more involved with clinical trials?

If you are in training and interested in research, I recommend two things. First, make connections with faculty at your training center. Find out who’s leading projects that you can get involved in. Team up with someone who's doing something you're interested in or get them to support an idea you have.

Second, build your network both inside and outside your institution. Connect on social media, go to national society meetings, and get involved in committees. Those connections with other leaders, both peers and mentors, are critical for opening up opportunities to be part of a paper, get involved in a trial, or anything else. Make a real effort to build your network. 

Moving on to more professional-related questions. When thinking about the business of healthcare, what are 2-3 concepts that you wish you knew coming out of fellowship?

As physicians, we are heavily influenced by how healthcare is paid for, but most of us have no idea how that infrastructure or those rules actually work. I wish I had understood more about how healthcare is paid for—which things that I do at the hospital are paid by Medicare versus private insurance, the different aspects, are patients paying versus the hospital. If I had a better understanding, I could think more about the pressure points and how to innovate and improve care.

The same goes for the medication side. Who actually manages the pharmacy piece of your insurance? What is a pharmacy benefits manager? How do they decide what's on or off the drug formulary list? What's a prior authorization process like? I didn't understand any of that, but it influences so much of what I do day-to-day. Those are two areas I really wish I'd learned more about.

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World's Brightest Physicians

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You've built relationships with colleagues across multiple disciplines and specialties. For a young clinician, how important is networking? Are there 2-3 tips that you can pass along on how to network better or effectively?

Networking is one of the most important things we can do, especially early in our career. And you have to be intentional about it. What I always recommend is that you start locally in building your network, then rapidly expand it. There are a few ways to do this. Some people are great on social media. They create a presence and connect with others on various platforms. Others get involved in committees or social work, joining fellow and training committees or other activities. And some people who moved around during their training use that network to stay connected and find out who their colleagues are now training with and who they know.

It's probably a combination of all three, but it's about being intentional and continuing to nurture and grow your network. That's so important.

What are some red flags to consider when looking at a practice? How important is it to negotiate the tangibles like salary, vacation time, as well as intangibles like time off, access to labs, and clinical work?

When I talk to people coming out of training and looking for their first job, I always tell them that there is no perfect job. The question is, can you find a job that's a good fit for you and helps you grow? That's what you're really looking for. To figure that out, reflect on your priorities. There is no job that will give you everything you need. But if you reflect on your priorities, you can see what's most important to you.

Is location important due to family? Do you need a job with a specific clinical practice, or are you happy with a broad range? Is salary the priority, or is it time off or control over your support staff? There are so many factors. You won't get them all, so you have to prioritize. And that just takes some self-reflection.

Moving on to some rapid-fire questions. If you had to choose 3 songs to play on repeat, what would they be?

I'm not a proceduralist, so the good news is I'm not in control of any music in a cath lab. However, when I'm working, especially on academic work, I do need music in the background. But for me it has to be music without words. I listen to a lot of classical music and instrumental jazz. I'll usually just ask my streaming service to play a station and give me a random assortment. That way, I get background noise without being distracted by the lyrics.

How about movies – what are your top 3 favorites of all time?

Two movies I love are Shawshank Redemption and Field of Dreams. Good classics! More recently, it's pretty much anything Disney with my daughter. She's seven and a half, so she's loving all the Disney stuff right now, which is great. We love watching them together.

If you could go back to your late 20s, what would you tell your younger self from a professional standpoint?

I would tell myself to enjoy the journey and not worry so much about the outcome. One of the advantages of being a physician is that our work will always be needed. So instead of worrying about getting the perfect job or the perfect residency, enjoy the process, the people around you, and make the most of every situation. That's the advice I would have given myself.

Lastly, is there anything that you want to raise awareness for?

I often speak on a variety of topics, but circling back to something we discussed earlier, I believe cardiovascular physicians need to focus more on the vascular element of disease, particularly peripheral artery disease (PAD). It's vastly under-recognized and undertreated, yet it has a huge impact on morbidity and mortality, with significant disparities in care across the country.

As cardiologists, we owe it to our patients to not only listen to their hearts, but also examine their legs and ensure they don't have other forms of vascular disease. My biggest plea to any cardiologist is this: look at your patients' feet, palpate the pulses, and assess for PAD. It could make a real difference in someone's life.

You've built relationships with colleagues across multiple disciplines and specialties. For a young clinician, how important is networking? Are there 2-3 tips that you can pass along on how to network better or effectively?

Networking is one of the most important things we can do, especially early in our career. And you have to be intentional about it. What I always recommend is that you start locally in building your network, then rapidly expand it. There are a few ways to do this. Some people are great on social media. They create a presence and connect with others on various platforms. Others get involved in committees or social work, joining fellow and training committees or other activities. And some people who moved around during their training use that network to stay connected and find out who their colleagues are now training with and who they know.

It's probably a combination of all three, but it's about being intentional and continuing to nurture and grow your network. That's so important.

What are some red flags to consider when looking at a practice? How important is it to negotiate the tangibles like salary, vacation time, as well as intangibles like time off, access to labs, and clinical work?

When I talk to people coming out of training and looking for their first job, I always tell them that there is no perfect job. The question is, can you find a job that's a good fit for you and helps you grow? That's what you're really looking for. To figure that out, reflect on your priorities. There is no job that will give you everything you need. But if you reflect on your priorities, you can see what's most important to you.

Is location important due to family? Do you need a job with a specific clinical practice, or are you happy with a broad range? Is salary the priority, or is it time off or control over your support staff? There are so many factors. You won't get them all, so you have to prioritize. And that just takes some self-reflection.

Moving on to some rapid-fire questions. If you had to choose 3 songs to play on repeat, what would they be?

I'm not a proceduralist, so the good news is I'm not in control of any music in a cath lab. However, when I'm working, especially on academic work, I do need music in the background. But for me it has to be music without words. I listen to a lot of classical music and instrumental jazz. I'll usually just ask my streaming service to play a station and give me a random assortment. That way, I get background noise without being distracted by the lyrics.

How about movies – what are your top 3 favorites of all time?

Two movies I love are Shawshank Redemption and Field of Dreams. Good classics! More recently, it's pretty much anything Disney with my daughter. She's seven and a half, so she's loving all the Disney stuff right now, which is great. We love watching them together.

If you could go back to your late 20s, what would you tell your younger self from a professional standpoint?

I would tell myself to enjoy the journey and not worry so much about the outcome. One of the advantages of being a physician is that our work will always be needed. So instead of worrying about getting the perfect job or the perfect residency, enjoy the process, the people around you, and make the most of every situation. That's the advice I would have given myself.

Lastly, is there anything that you want to raise awareness for?

I often speak on a variety of topics, but circling back to something we discussed earlier, I believe cardiovascular physicians need to focus more on the vascular element of disease, particularly peripheral artery disease (PAD). It's vastly under-recognized and undertreated, yet it has a huge impact on morbidity and mortality, with significant disparities in care across the country.

As cardiologists, we owe it to our patients to not only listen to their hearts, but also examine their legs and ensure they don't have other forms of vascular disease. My biggest plea to any cardiologist is this: look at your patients' feet, palpate the pulses, and assess for PAD. It could make a real difference in someone's life.

You've built relationships with colleagues across multiple disciplines and specialties. For a young clinician, how important is networking? Are there 2-3 tips that you can pass along on how to network better or effectively?

Networking is one of the most important things we can do, especially early in our career. And you have to be intentional about it. What I always recommend is that you start locally in building your network, then rapidly expand it. There are a few ways to do this. Some people are great on social media. They create a presence and connect with others on various platforms. Others get involved in committees or social work, joining fellow and training committees or other activities. And some people who moved around during their training use that network to stay connected and find out who their colleagues are now training with and who they know.

It's probably a combination of all three, but it's about being intentional and continuing to nurture and grow your network. That's so important.

What are some red flags to consider when looking at a practice? How important is it to negotiate the tangibles like salary, vacation time, as well as intangibles like time off, access to labs, and clinical work?

When I talk to people coming out of training and looking for their first job, I always tell them that there is no perfect job. The question is, can you find a job that's a good fit for you and helps you grow? That's what you're really looking for. To figure that out, reflect on your priorities. There is no job that will give you everything you need. But if you reflect on your priorities, you can see what's most important to you.

Is location important due to family? Do you need a job with a specific clinical practice, or are you happy with a broad range? Is salary the priority, or is it time off or control over your support staff? There are so many factors. You won't get them all, so you have to prioritize. And that just takes some self-reflection.

Moving on to some rapid-fire questions. If you had to choose 3 songs to play on repeat, what would they be?

I'm not a proceduralist, so the good news is I'm not in control of any music in a cath lab. However, when I'm working, especially on academic work, I do need music in the background. But for me it has to be music without words. I listen to a lot of classical music and instrumental jazz. I'll usually just ask my streaming service to play a station and give me a random assortment. That way, I get background noise without being distracted by the lyrics.

How about movies – what are your top 3 favorites of all time?

Two movies I love are Shawshank Redemption and Field of Dreams. Good classics! More recently, it's pretty much anything Disney with my daughter. She's seven and a half, so she's loving all the Disney stuff right now, which is great. We love watching them together.

If you could go back to your late 20s, what would you tell your younger self from a professional standpoint?

I would tell myself to enjoy the journey and not worry so much about the outcome. One of the advantages of being a physician is that our work will always be needed. So instead of worrying about getting the perfect job or the perfect residency, enjoy the process, the people around you, and make the most of every situation. That's the advice I would have given myself.

Lastly, is there anything that you want to raise awareness for?

I often speak on a variety of topics, but circling back to something we discussed earlier, I believe cardiovascular physicians need to focus more on the vascular element of disease, particularly peripheral artery disease (PAD). It's vastly under-recognized and undertreated, yet it has a huge impact on morbidity and mortality, with significant disparities in care across the country.

As cardiologists, we owe it to our patients to not only listen to their hearts, but also examine their legs and ensure they don't have other forms of vascular disease. My biggest plea to any cardiologist is this: look at your patients' feet, palpate the pulses, and assess for PAD. It could make a real difference in someone's life.

See How You Can Invest in FastWave

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Dr. Puneet Khanna

Interventional Cardiologist & Medtech Investor

See How You Can Invest in FastWave

We oversubscribed our last round of financing in just a few weeks, so don’t miss out on the next opportunity to invest.

IVL is an impressive therapy with an attractive market and I’m very excited about FastWave’s prospects.

Dr. Puneet Khanna

Interventional Cardiologist & Medtech Investor

See How You Can Invest in FastWave

We oversubscribed our last round of financing in just a few weeks, so don’t miss out on the next opportunity to invest.

IVL is an impressive therapy with an attractive market and I’m very excited about FastWave’s prospects.

Dr. Puneet Khanna

Interventional Cardiologist & Medtech Investor

Mailing Address:

FastWave Medical
400 S 4th St, Ste 410
PMB 21892
Minneapolis, MN 55415

Phone:

(833) 888-9283

Email:

team@fastwavemedical.com

© 2024 FastWave Medical Inc.

Follow FastWave’s Journey

Mailing Address:

FastWave Medical
400 S 4th St, Ste 410
PMB 21892
Minneapolis, MN 55415

Phone:

(833) 888-9283

Email:

team@fastwavemedical.com

© 2024 FastWave Medical Inc.

Follow FastWave’s Journey

Mailing Address:

FastWave Medical
400 S 4th St, Ste 410
PMB 21892
Minneapolis, MN 55415

Phone:

(833) 888-9283

Email:

team@fastwavemedical.com

© 2024 FastWave Medical Inc.

Follow FastWave’s Journey