CCPP Module 22, Section 1: Identifying and Approaching Prospective Medical Partners
MODULE 22: PHYSICIAN RELATIONS AND NETWORKING

Section 1: Identifying and Approaching Prospective Medical Partners

From Dispensing Expert to Strategic Healthcare Ally: Mastering the Art of Professional Prospecting.

SECTION 22.1

Identifying and Approaching Prospective Medical Partners

Learn the art of “professional prospecting” by analyzing your local healthcare landscape to identify the physicians and practices who will become your most enthusiastic early adopters.

22.1.1 The “Why”: The Great Mindset Shift

For your entire career, the dynamic has been clear and consistent: physicians diagnose and prescribe, and patients bring those prescriptions to you. The workflow has been largely passive; you are the final, critical checkpoint in a process initiated by others. This model has allowed you to become an unparalleled expert in product verification, drug interaction screening, and patient counseling at the point of dispensing. These are invaluable skills. However, to build a successful collaborative practice, you must fundamentally invert this dynamic.

You must transition from a passive recipient of clinical decisions to a proactive initiator of clinical partnerships. The word “prospecting” or “sales” might feel uncomfortable, evoking images of pharmaceutical reps with branded clipboards and catered lunches. It is imperative that you discard this association immediately. For the clinical pharmacist, prospecting is not a sales activity; it is a diagnostic activity on a systemic scale. You are not selling a product. You are identifying systemic weaknesses in patient care within your community and presenting a targeted, evidence-based therapeutic solution: your clinical expertise.

This section is dedicated to teaching you how to perform this diagnosis. We will reframe “prospecting” as a form of clinical investigation, leveraging your analytical skills to identify practices that are struggling with the very problems you are uniquely qualified to solve. You will learn to read the vital signs of a medical practice—its quality scores, its patient demographics, its operational pressures—just as you would read a patient’s lab results. This is not about convincing someone to buy something they don’t need. It’s about finding the partners who are already searching for a solution and demonstrating, with data and professionalism, that you are the answer.

Pharmacist Analogy: Diagnosing the “Underserved Practice”

Imagine a new patient, Mr. Jones, comes to your pharmacy. As you review his profile, you see a collection of clinical “symptoms”:

  • He’s on 14 medications from 4 different prescribers (polypharmacy, fragmented care).
  • His last A1c was 9.8%, yet he’s only on metformin and a sulfonylurea (clinical inertia).
  • He has prescriptions for both an ACE inhibitor from his PCP and an ARB from his cardiologist (therapeutic duplication).
  • He mentions he was in the hospital last month for a COPD exacerbation (high-risk event, readmission risk).

You don’t see Mr. Jones as just a collection of prescriptions to be filled. Your clinical mind instantly diagnoses a deeper problem: this is a patient with an profound, unmet need for Comprehensive Medication Management (CMM). You know, with professional certainty, that you could optimize his regimen, improve his A1c, resolve the duplication, and likely prevent his next hospitalization. You feel a professional obligation to intervene.

Now, elevate that thinking from a single patient to an entire medical practice. “Professional prospecting” is the exact same diagnostic process. Instead of looking at a patient profile, you will learn to look at a practice’s “profile” and see its symptoms:

  • The practice has a publicly reported A1c control rate of only 60% (clinical inertia on a population level).
  • It serves a geographic area with high rates of hospital readmissions for heart failure (population at high risk).
  • It’s part of an Accountable Care Organization (ACO), meaning it faces financial penalties for poor outcomes (a clear financial pain point).
  • Online patient reviews frequently mention “feeling rushed” and “not having time for questions” (workflow and capacity issues).

When you see these signs, you are not a salesperson; you are a clinician diagnosing an “Underserved Practice.” This is a practice with a systemic, unmet need for medication expertise. Your approach is not a sales pitch; it’s a consultation. You already possess the diagnostic skills. This module will teach you where to find the data and how to apply those skills to identify your future partners.

22.1.2 The Masterclass in Healthcare Landscape Analysis

Before you can approach a single physician, you must become a master of your local healthcare ecosystem. This is the most critical phase of building your practice. A well-executed analysis will yield a shortlist of highly qualified, receptive potential partners, making your outreach efforts targeted and effective. A superficial analysis will lead to wasted time and frustrating rejections. This is your intelligence-gathering phase. You are a clinical detective surveying the scene, looking for clues, and building a case file on every potential partner.

Our approach will be systematic, moving from a high-level view down to a granular analysis of individual practices. We will focus on leveraging publicly available data to build a sophisticated targeting model. This is where your meticulous, detail-oriented pharmacist mindset becomes a superpower.

Step 1: Defining Your Ideal Partner Profile (IPP)

You cannot find what you’re looking for if you don’t know what it is. The first step is to define, with extreme clarity, the characteristics of a practice that would be a perfect fit for your skills and service model. This requires introspection before you begin your external research. Your IPP will act as a filter for all the data you gather.

Action Item: Complete Your Ideal Partner Profile Worksheet

Use the following table as a guide to think through and document your ideal partner. Be honest and specific. This document will be the foundation of your entire prospecting strategy.

Characteristic Guiding Questions Your Ideal Profile (Example Filled In)
Your Clinical Niche Where does your passion and deepest expertise lie? What patient population do you most want to serve? (e.g., Diabetes/Endo, Cardiology, Geriatrics, Psychiatry, Pediatrics) Diabetes & Cardiometabolic Disease. I am most confident with GLP-1s, SGLT2s, insulin titration, and managing complex hypertension and dyslipidemia.
Practice Specialty Which specialty aligns best with your niche? Primary Care (Internal/Family Med) is the most common, but don’t overlook specialists. Primary Care (Internal/Family Medicine) is my top target. Endocrinology is a close second.
Practice Size & Structure Solo practitioner? Small group (2-5 providers)? Large multi-specialty group? Hospital-owned clinic? FQHC? Small, independent group (2-5 physicians). I believe they will be more agile and easier to approach than a large, bureaucratic system.
Payment Model Orientation Are they primarily Fee-for-Service (FFS) or are they involved in Value-Based Care (VBC) like an ACO, CPC+, or Medicare Advantage? Heavy involvement in Value-Based Care. They must have a clear financial incentive to improve quality metrics.
Geographic Location What is your desired service area? How far are you willing to travel (for in-person services)? Is telehealth an option? Within a 20-mile radius of my home for a hybrid model (1-2 days onsite, rest remote).
Key “Pain Points” What problems are they likely facing that you can solve? (e.g., poor quality scores, high readmission rates, physician burnout, patient access issues) Primary pain points: Poor MIPS scores for A1c & BP control, physicians overwhelmed with medication questions and prior authorizations for newer agents.
EHR System Are you familiar with certain EHRs? (e.g., Epic, Cerner, eClinicalWorks, Athenahealth). This is a “nice to have,” not a “must have.” Familiar with Epic and Athenahealth, but willing to learn any system.

Step 2: Data Sources – The Pharmacist’s Intelligence Gathering Toolkit

With your IPP defined, you now have a lens through which to view the vast amount of available data. Your goal is to find practices that match your IPP. This is where your methodical, analytical skills shine. We will treat this like a drug information query, using multiple validated sources to build a complete picture.

A. Public Data Sources: The Unhidden Goldmine

A surprising amount of information about physician and practice performance is publicly available, primarily from the Centers for Medicare & Medicaid Services (CMS). This data is your most powerful tool for identifying practices with a clear, demonstrable need for your services.

Deep Dive: The CMS Care Compare Website

The CMS Care Compare website (formerly Physician Compare) is the single most important resource in your prospecting toolkit. It provides detailed performance information for clinicians participating in the Quality Payment Program (QPP), which includes most physicians who see Medicare patients. Mastering this tool is non-negotiable.

How to Use It Strategically:

  1. Go to the “Find and Compare Doctors” section. Search by location (your city/zip code) and specialty (e.g., “Internal Medicine”).
  2. Generate a List. This will give you a list of all participating clinicians in your area. You can see their practice locations and group affiliations.
  3. Drill Down to Performance Data. This is the key step. For each clinician or group, look for a section on “Quality of care.” Here, you can find their performance on specific Merit-based Incentive Payment System (MIPS) quality measures.
  4. Look for the “Symptoms.” You are looking for practices that are performing poorly on measures directly related to medication management. These are your prime targets.

The following table shows you exactly what to look for. Think of this as interpreting a practice’s “lab results.”

MIPS Quality Measure What It Measures “Symptom” of Need (Poor Performance) Your Pharmacist-Led “Therapeutic Intervention”
Controlling High Blood Pressure Percentage of patients aged 18-85 with a diagnosis of hypertension whose BP was adequately controlled (<140/90). Low percentage (e.g., < 75%). This practice is struggling to get its patients’ BP to goal. Implement pharmacist-led BP management service using evidence-based titration protocols, combination therapy, and adherence counseling.
Hemoglobin A1c Poor Control (>9.0%) Percentage of diabetic patients whose most recent A1c was >9.0%. High percentage (e.g., > 10%). This indicates a significant number of patients with dangerously uncontrolled diabetes. Provide intensive diabetes management, including medication titration (especially insulin, GLP-1s, SGLT2s), CGM interpretation, and patient education.
Statin Therapy for Patients with Cardiovascular Disease Percentage of patients with clinical ASCVD who were prescribed a statin. Low percentage. The practice is missing a fundamental, guideline-directed medical therapy. Conduct chart reviews to identify undertreated patients, manage statin intolerance, and ensure appropriate intensity dosing.
Medication Reconciliation Post-Discharge Percentage of patients who underwent medication reconciliation within 30 days of an inpatient stay. Low percentage. The practice has a workflow gap in a high-risk transition of care. Establish and manage a robust transitions of care service, performing med rec for all recently discharged patients to prevent readmissions.

Beyond individual physician performance, you must also investigate hospital-level data, as hospitals are under immense pressure to reduce readmissions. A hospital with high readmission rates is likely pressuring its affiliated outpatient clinics to improve their transitional care management.

  • Hospital Readmissions Reduction Program (HRRP): Use the main Care Compare tool to look up hospitals in your area. They have publicly reported 30-day readmission rates for conditions like Acute MI, Heart Failure (HF), Pneumonia, and COPD. A hospital with a “Worse than National Rate” is a flashing red light indicating a systemic problem you can help solve.
  • Federally Qualified Health Center (FQHC) and Rural Health Clinic (RHC) Locators: These clinics are often funded by grants and serve complex, underserved patient populations. They are frequently very open to innovative care models that improve quality, making them potentially excellent partners. Use the HRSA Data Warehouse to find FQHCs and RHCs in your service area.
B. Professional & Network Data Sources: Mapping the Connections

Public data tells you who needs help. Network data tells you how to reach them. Building a professional network is not just about finding a job; it’s about creating pathways to your future partners.

Deep Dive: Using LinkedIn as an Investigative Tool

LinkedIn is far more than a resume site. It is a map of the professional relationships in your community. Your goal is to use it to find the “who’s who” and, most importantly, identify warm introduction pathways.

  1. Optimize Your Own Profile: Before you begin, ensure your profile is impeccable. Your headline should not be “Pharmacist at XYZ Pharmacy.” It should be “Clinical Pharmacist | Specializing in Diabetes and Cardiovascular Risk Reduction | Passionate about Collaborative Practice.” Your summary should clearly state your value proposition.
  2. Map the Target Practice: Once you’ve identified a promising practice from your CMS data analysis (e.g., “Main Street Family Practice”), search for that practice on LinkedIn. See who works there. Pay close attention to two key roles:
    • The Practice Manager/CEO/COO: This is the business leader. They care about finances, workflow efficiency, and quality scores.
    • Physicians/Medical Director: These are the clinical leaders. They care about patient outcomes, reducing their workload, and practicing at the top of their license.
  3. Find the Connection: Look at the profiles of these key individuals. Who are you connected to that they are also connected to? This “2nd degree connection” is your warm lead. It could be a former colleague, a pharmaceutical rep, or someone from a state pharmacy association. This is your number one asset for getting a meeting.
  4. Follow and Engage: Follow the practice’s company page and the individual providers. See what they post about. Are they celebrating a new service line? Complaining about administrative burdens? This is valuable intel that helps you tailor your approach.
C. On-the-Ground Intelligence: Leveraging Your Current Role

Do not underestimate the value of the data and relationships you already have. Your current position in a community or health-system pharmacy is a powerful listening post for identifying partnership opportunities.

Deep Dive: (Ethically) Analyzing Your Pharmacy’s Dispensing Data

Your pharmacy’s dispensing system is a real-time feed of the clinical challenges in your community. While adhering strictly to HIPAA and all privacy regulations, you can analyze prescribing patterns to identify prescribers whose patients could most benefit from your help. You are not looking at individual patient details, but at the aggregate data associated with a prescriber.

Create a “Prescriber Opportunity” Report for your own analysis. Look for prescribers who exhibit these patterns:

Data Pattern / “Symptom” What It Indicates How to Find It
High Volume of Polypharmacy Patients A large panel of complex, high-risk patients. The prescriber is likely overwhelmed. Run reports to identify prescribers with the most patients on >10 or >15 unique medications.
High Utilization of “Old” Diabetes Agents Prescriber may not be up-to-date on current guidelines or is facing significant barriers to prescribing newer agents (e.g., prior auths). Look for prescribers with a high ratio of sulfonylureas/TZDs compared to GLP-1s/SGLT2s.
Frequent “Stair-Stepping” of Analgesics Prescriptions for NSAIDs, then tramadol, then low-dose opioids for the same patients over time. Indicates a struggle with chronic pain management, a prime area for pharmacist intervention.
High Volume of “Problematic” Drug Combinations Frequent co-prescribing of opioids and benzodiazepines, or multiple anticholinergic agents in the elderly. This is a direct signal of patient safety risks that the prescriber may not have the time to address.
High Rate of Prior Authorization Rejections The prescriber’s office staff is likely overwhelmed and failing to complete PAs, leading to gaps in therapy. Track PAs by prescriber. A high volume or high rejection rate is a huge pain point you can solve.

This internal analysis allows you to cross-reference the public data. If “Dr. Smith” has poor MIPS scores for BP control and your dispensing data shows she rarely uses combination therapy, you have identified a highly specific, data-driven opportunity.

22.1.3 Tiering and Targeting: From a Long List to a Shortlist

Your analysis phase will generate a large list of potential partners. The next step is to prioritize this list with ruthless efficiency. Not all opportunities are created equal. Your goal is to identify the “low-hanging fruit”—the practices that are most likely to say “yes” and become successful early adopters. A strong first partnership will create the momentum and case study you need to secure future collaborations.

The Partnership Potential Scoring System

Use a simple scoring system to rank your prospects. This moves your targeting from a gut feeling to an objective, data-driven process. Create a spreadsheet and score each potential practice based on the criteria you’ve researched. The higher the score, the higher they should be on your priority list.

Action Item: Build Your Prospect Scorecard
Scoring Category Criteria Points
Financial Incentive (Max 5 pts) Confirmed participation in an ACO or other advanced VBC model. 5
Participates in MIPS but not a formal ACO. 3
Appears to be primarily Fee-for-Service. 1
Demonstrable Need (Max 5 pts) Publicly reported poor performance (<75th percentile) on 2+ medication-related MIPS measures. 5
Poor performance on 1 medication-related MIPS measure. 3
No poor performance data available or scores are high. 1
Practice Structure (Max 3 pts) Small, independent practice (1-5 providers). 3
Mid-sized group or FQHC (6-15 providers). 2
Large health system or hospital-owned clinic. 1
Ease of Approach (Max 3 pts) I have a warm introduction pathway via a mutual connection. 3
I have a strong “clinical in” via a complex mutual patient. 2
This will be a completely cold approach. 0
TOTAL SCORE / 16

After scoring all your prospects, sort them from highest to lowest score. Your initial outreach efforts should be laser-focused on your Tier 1 targets (e.g., scores of 12-16).

The Pre-Call Investigation: Building the Case File

Once you have your top 3-5 Tier 1 targets, it’s time to perform a final, deep-dive investigation on each one before you make any contact. You should know more about their practice’s potential needs than they do. Your goal is to walk into the conversation (or email) with such a clear understanding of their situation that your credibility is instantly established.

Your Pre-Call Investigation Checklist:

  • Review their website with a critical eye. What language do they use? Do they talk about “patient-centered care,” “quality,” or “team-based approaches”? This is language you can mirror. Do they list their Practice Manager? This is your key contact. Do they mention any special programs like Chronic Care Management (CCM)? This is a service you can supercharge.
  • Read every physician’s bio. Where did they go to medical school? Where did they do their residency? Finding a commonality (e.g., you both trained in the same city, or your pharmacy school is affiliated with their medical school) can be a valuable icebreaker.
  • Scour their online reviews (Google, Healthgrades, Vitals). Ignore the one-off angry comments. Look for themes. Are multiple patients saying, “The doctor is great, but the office staff is disorganized”? Or “I felt rushed and didn’t get to ask my questions”? These are real, tangible pain points that a pharmacist partner can help alleviate by offloading medication-related tasks.
  • Confirm their affiliations. Double-check which hospital system they are aligned with and which ACO they belong to. Knowing this allows you to speak their language. “I know that as part of the ‘Mission Health ACO,’ you’re focused on reducing HF readmissions…”
  • Final LinkedIn Check. Do a final search for any news, recent hires, or connections you may have missed.

22.1.4 Crafting the Initial Approach: Engineering a “Yes” to a Meeting

All the research and analysis you have done culminates in this moment: the first contact. The objective of your initial approach is not to sell your entire service model. It is a common and fatal mistake to overwhelm a busy clinician with a 10-page proposal in the first email. The single, solitary goal of your initial outreach is to secure a brief meeting (15-20 minutes). That’s it. Every word you write or say should be engineered to achieve that one objective.

Your approach must be concise, respectful of their time, data-driven, and centered on their problems, not your solutions.

Who to Approach: The Physician Champion vs. The Practice Manager

One of your first strategic decisions is who to contact first. There are two primary targets within an independent practice, each with different motivations.

Contact Target Their Primary Concerns When to Approach Them First Your Opening Pitch Angle
The Physician Champion Patient outcomes, clinical challenges, workload, burnout, staying current with evidence. When you have a strong “clinical in” (a complex mutual patient) or a warm introduction from a trusted colleague. Clinical Value: “I have an idea that could help you solve a clinical challenge with your complex diabetic patients.”
The Practice Manager / Administrator Financial performance, workflow efficiency, quality scores (MIPS/ACO), patient satisfaction, staff turnover. When you are making a cold approach and your primary value proposition is tied to improving their business metrics. Business Value: “I have an idea that could directly improve your practice’s MIPS scores for hypertension and diabetes.”

The Most Powerful Approach: The “Clinical In”

By far, the most effective way for a pharmacist to open a door is by demonstrating immediate, undeniable clinical value. The “Clinical In” strategy involves using a mutual patient to showcase your expertise and plant the seed for a broader collaboration. This approach pivots the conversation from “I want to offer you a service” to “I am already helping you care for your patient.”

Masterclass Playbook: Executing the Perfect “Clinical In”
  1. Identify the Right Patient: From your dispensing data or direct interaction, find a mutual patient who is complex, high-risk, and has a clear, solvable drug therapy problem (DTP). Mr. Jones from our analogy is a perfect example.
  2. Do the Workup: Perform a thorough CMM workup on the patient. Document the DTPs, your assessment, and your specific, evidence-based recommendations. Be prepared to defend every point.
  3. Craft the Communication: Your communication must be flawless. Use the SBAR (Situation-Background-Assessment-Recommendation) format. It is the language of medicine and demonstrates that you are a clinical peer. The communication should be delivered via the physician’s preferred method (secure email, fax, or even a formal letter).

    Example “Clinical In” Email/Fax:

    Subject: Regarding our mutual patient, John Doe (DOB: 01/15/1958)

    Dear Dr. Smith,

    I am the pharmacist at [Your Pharmacy] writing to you about our mutual patient, John Doe. I’ve noted a few opportunities to potentially optimize his complex cardiometabolic regimen.

    Situation: Mr. Doe’s most recent A1c was 9.2% and his BP is consistently 150s/90s, despite therapy with metformin, glipizide, and lisinopril.

    Background: He has a history of MI (2020) and a recent eGFR of 45 mL/min (Stage 3b CKD). He also reports significant concerns about hypoglycemia.

    Assessment: The use of glipizide in Stage 3b CKD carries a high risk of prolonged hypoglycemia and may not be providing adequate glycemic control. Furthermore, his current regimen lacks guideline-directed agents that provide secondary cardiovascular and renal protection.

    Recommendation:

    • Discontinue glipizide to reduce hypoglycemia risk.
    • Consider initiating an SGLT2 inhibitor (e.g., empagliflozin or dapagliflozin) for its proven cardiovascular and renal benefits in patients with ASCVD, CKD, and T2DM.
    • Consider adding a mineralocorticoid receptor antagonist (e.g., finerenone) for additional renal protection, if appropriate.

    I believe a more intensive, pharmacist-led approach to medication management could greatly benefit high-risk patients like Mr. Doe in your practice. I have several ideas on how a formal collaboration could help your practice meet its quality goals for diabetes and hypertension.

    Would you be open to a brief, 15-minute virtual call next week to discuss this further?

    Sincerely,
    [Your Name], PharmD

  4. The Follow-up: If you don’t hear back in 3-5 business days, a single, polite follow-up is appropriate. “Dr. Smith, just wanted to gently follow up on my note regarding John Doe. Please let me know if you have a few minutes to connect this week.”
The Cold Email (When You Must)

Sometimes, you have no warm lead or clinical in. A cold email, directed to the Practice Manager, is your next best option. The key is to keep it incredibly short and focused on their business problems.

Subject: An idea to improve MIPS scores at Main Street Family Practice

Dear [Practice Manager Name],

My name is [Your Name], and I am a clinical pharmacist specializing in chronic disease management.

I was reviewing the most recent publicly available quality data and noted an opportunity to potentially improve performance on key measures like A1c and BP control for your Medicare population.

I have developed a service model where an embedded clinical pharmacist can help providers achieve these goals, reduce administrative burden, and improve patient outcomes. Practices I work with have seen significant improvements in these exact metrics.

Would you be open to a 15-minute introductory call next week to explore if this might be a fit for your practice?

Thank you for your time,
[Your Name], PharmD

22.1.5 Conclusion: From Investigation to Invitation

This section has laid the groundwork for the most crucial non-clinical skill you will develop: the ability to systematically identify and engage potential physician partners. We have dismantled the uncomfortable idea of “sales” and rebuilt it as a professional, data-driven diagnostic process that is perfectly aligned with your core identity as a clinician. You are not an outside vendor; you are a prospective clinical partner, a problem-solver, and a healthcare ally.

Remember the key principles of this process:

  • Start with Why: Your motivation is to find the patients and practices that are being underserved and to bridge that gap with your expertise.
  • Diagnose Before You Prescribe: Your intensive research and analysis of the healthcare landscape is the diagnostic phase. Never approach a potential partner without having a clear, data-supported hypothesis about their specific needs and pain points.
  • Translate Your Value: Always frame your skills in the context of their problems. You don’t just “do medication reviews”; you “help physicians improve their MIPS scores for BP control.” You don’t just “counsel patients”; you “reduce hospital readmission rates for heart failure patients.”
  • Engineer the First Step: The entire goal of this exhaustive process is to earn a single, short meeting. By using warm introductions and powerful clinical insights, you move from being an interruption in their day to a welcome and valuable colleague.

You now have the complete playbook for identifying your ideal partners. You have learned how to sift through the noise of the healthcare market and pinpoint the exact practices that are primed for collaboration. You have the tools to score, tier, and target them with precision. In the next section, we will build on this foundation. Now that you have identified who to talk to, we will construct the compelling service proposal and value proposition you will present when you get that all-important first meeting.