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MODULE 22: PHYSICIAN RELATIONS AND NETWORKING
Section 5: Continuous Relationship Management and Feedback
Learn how to implement a proactive system for relationship maintenance, including regular check-ins, sharing outcomes data, and formally soliciting feedback to ensure your service continually evolves to meet the needs of your partners.
SECTION 22.5
Continuous Relationship Management and Feedback
From Stable Partnership to Dynamic Growth: The Art of Proactive Maintenance and Evolution.
22.5.1 The “Why”: The Partnership as a Living Organism
In the previous sections, we established a partnership and built the foundations of trust. It is tempting to view this as a stable, completed structure. This is a critical error in judgment. A clinical partnership is not a static edifice; it is a living, breathing organism. Like any organism, it requires continuous nourishment, monitoring, and adaptation to thrive. Without these inputs, it will inevitably stagnate, atrophy, and eventually fail. The forces of entropy—staff turnover, changing reimbursement models, new clinical guidelines, workflow friction—are constantly working to pull your carefully constructed collaboration apart.
Continuous relationship management is the active, systematic process of counteracting these forces. It is the professional equivalent of chronic care management for the partnership itself. It is the deliberate practice of monitoring the partnership’s “vital signs” (KPIs, provider satisfaction), providing “preventive care” (proactive communication, regular check-ins), and administering “therapeutic interventions” (process improvements, service line expansions) based on feedback and changing needs. This is not a passive, “let’s hope for the best” approach. It is an active, evidence-based strategy to ensure the long-term health, growth, and resilience of your most valuable professional asset.
The ultimate goal of this process is to achieve a state of dynamic stability. This means the partnership is not only strong and stable but also adaptable and capable of evolving. The needs of the practice today will not be the same as their needs two years from now. A successful CCPP does not just meet the needs of today; they anticipate and evolve to meet the needs of tomorrow. This final section of the module provides the master playbook for creating a self-sustaining, ever-improving partnership that becomes more valuable and more deeply integrated with each passing quarter.
Pharmacist Analogy: Managing the Post-Transplant Patient
Imagine you are a clinical transplant pharmacist managing a patient six months after a successful kidney transplant. The surgery (the “deal”) was a success. The initial, high-intensity post-op period (the “onboarding”) is over. The patient is stable. Is your job done? Absolutely not. The most critical, long-term work is just beginning.
Your entire focus now shifts to continuous, proactive management to ensure the long-term survival of that precious graft (the partnership).
- Routine Monitoring (The QBR): The patient has regularly scheduled clinic visits and lab draws. You meticulously track their creatinine, their immunosuppressant trough levels (tacrolimus, cyclosporine), and their vital signs. This is your Quarterly Business Review, where you systematically review the partnership’s key performance indicators.
- Soliciting Feedback (The Patient Interview): During each clinic visit, you don’t just look at the labs. You ask the patient, “How are you feeling with the medications? Any side effects? Any new challenges?” This is you actively soliciting feedback from the practice about your services. You’re looking for the subtle signs of “adverse effects” like workflow friction or communication gaps.
- Proactive Intervention (Therapeutic Adjustments): The patient’s labs show their tacrolimus trough is trending down. You don’t wait for it to become critically low. You proactively call them. “Hi Mr. Smith, your latest tacrolimus level was a little lower than we’d like. Have you started any new medications, even over-the-counter supplements?” You discover he started taking St. John’s Wort. You intervene, educate, and adjust. This is you seeing a small problem in the practice (e.g., a new MA is not using the correct referral process) and proactively intervening with training before it becomes a major issue.
- Adapting to New Data (Evolving the Plan of Care): A new clinical trial is published showing that a lower tacrolimus trough target is just as effective and has fewer side effects. You re-evaluate your patient’s goals and create a plan to slowly titrate them to the new, evidence-based target. This is you learning about a new value-based care program and proactively developing a proposal for how your services can evolve to help the practice succeed under the new model.
Managing a successful clinical partnership requires the same vigilance, proactive spirit, and data-driven adaptability as managing a transplant patient. The goal is the same: to prevent rejection, optimize long-term function, and ensure the continued health and success of the entity you are charged with protecting.
22.5.2 The Cadence of Connection: A Proactive System for Relationship Maintenance
Effective relationship management is not about grand, infrequent gestures. It is about a consistent, predictable cadence of connection and communication. It’s the small, reliable touchpoints that build the strongest bonds. You must design and execute a system of engagement that feels natural to your partners but is, in fact, a deliberate and strategic protocol. This system ensures you are always visible, always demonstrating value, and always in sync with the practice’s evolving needs.
The Daily Rituals: Visibility and Availability
These are the foundational habits that make you part of the practice’s daily fabric.
- The Morning Huddle: If the practice has a 5-10 minute morning huddle to review the day’s schedule, you must be there, even if you are part-time. This is your single best opportunity for face-time and proactive problem-solving. Your contribution should be brief and clinically focused: “Just a heads-up, I’ll be seeing Mrs. Rodriguez at 10 AM for a follow-up. Her blood pressure has been high, so I’ll be assessing her adherence and may have a recommendation for an add-on therapy for Dr. Smith later today.”
- The “Walk-Around”: Do not spend your entire day in your office. Once in the morning and once in the afternoon, take a 5-minute walk through the clinical area. Be visible. Make eye contact with the MAs and nurses. Ask a simple, open-ended question: “How’s the day going? Anything I can help with?” This makes you approachable and positions you as a resource, not an outsider.
- The “End-of-Day” Check-in: Before you leave (or sign off, if remote), check in with your physician champion or the lead nurse. A simple “Anything else you need before I head out?” closes the day’s loops and reinforces your commitment.
The Weekly Rituals: Data and Alignment
These touchpoints are designed to provide concise summaries of your impact and ensure you are aligned on priorities.
Masterclass Playbook: The “5-Minute Friday” Email
Every Friday afternoon, send a concise, bulleted email to the Practice Manager and your Physician Champion. This is non-negotiable. It demonstrates accountability and keeps your value top-of-mind. It must be scannable in 60 seconds.
Subject: Weekly Pharmacy Partner Update: [Date]
Body:
Hi Team,
Here is a quick summary of this week’s activity and impact:
- Patient Encounters: Completed 8 CMM visits and 12 CCM follow-ups.
- Clinical Impact Highlight: Identified a critical drug interaction (simvastatin + amiodarone) for patient J.D., preventing potential rhabdomyolysis. Coordinated with Dr. Evans to switch to pravastatin.
- Operational Impact Highlight: Successfully overturned a prior authorization denial for Entresto for patient M.S., saving the nursing staff ~45 minutes of work.
- Heads-Up for Next Week: My focus will be on proactive outreach to our 5 recently hospitalized patients to schedule TOC calls.
Have a great weekend,
[Your Name]
The Quarterly Ritual: The Formal Value Proposition
As discussed in the previous section, the Quarterly Business Review (QBR) is the cornerstone of your formal relationship management. It is your dedicated forum for presenting data, celebrating wins, addressing challenges, and strategically planning for the future. It elevates the partnership from the day-to-day trenches to a high-level strategic discussion. Failure to implement a consistent QBR process is a leading cause of partnership stagnation.
22.5.3 The Art & Science of Feedback: Your Compass for Growth
Many professionals fear feedback. They view it as criticism. As a CCPP, you must learn to view feedback as the most valuable clinical data you can possibly receive. It is the real-time “lab value” that tells you the health of your partnership. Actively and skillfully soliciting feedback is not a sign of weakness; it is the ultimate sign of confidence, professionalism, and commitment to continuous improvement. A partner who is actively seeking to get better is a partner who will be kept for the long term.
How to Ask: Creating Psychological Safety
You cannot simply ask, “Do you have any feedback for me?” This is too broad and puts the other person on the spot. You must ask specific, well-timed, and low-pressure questions that make it easy and safe for them to be honest.
| Stakeholder | Poor Way to Ask | A Better Way to Ask (Specific & Safe) | Optimal Timing |
|---|---|---|---|
| Physician | “Am I doing a good job?” | “Dr. Smith, I’m always trying to improve. What is one thing I could start doing or stop doing that would make my EHR notes even more useful for you?” | At the end of a positive, collaborative patient case discussion. |
| Practice Manager | “Are you happy with my work?” | “Ms. Davis, as we plan for the next quarter, is there a particular metric or operational challenge you’d like me to focus more of my attention on?” | During your QBR, in the “Goal Setting” section. |
| Nurse / MA | “Any issues with my workflow?” | “Hey Maria, I want to make sure the referral process isn’t creating extra clicks for you. Can you show me how it looks on your end? I want to make it as easy as possible.” | During a quiet moment, one-on-one, not in a group setting. |
How to Receive: The A.C.T. Model
When you receive feedback, especially if it’s critical, your natural human response is to become defensive. You must train yourself to override this instinct and respond with professional grace. The Acknowledge, Clarify, Thank (A.C.T.) model is your guide.
Masterclass Playbook: Receiving Critical Feedback
Scenario: A physician says, “Your notes are too long. I don’t have time to read a novel.”
Defensive Response (Destroys Trust)
“Well, they have to be long to be comprehensive and meet billing requirements. I’m just trying to be thorough so I don’t miss anything. It’s all important information.”
Result: The physician feels unheard and dismissed. They will never give you honest feedback again. You have damaged the relationship.
The A.C.T. Response (Builds Trust)
1. Acknowledge: “Thank you for telling me that. I really appreciate the honest feedback. The last thing I want is for my notes to be a burden.”
2. Clarify: “To make sure I fix this correctly, could you tell me which parts are most helpful and which parts you find yourself skipping over? Would a ‘headline’ summary at the top with my key recommendations be a better format for you?”
3. Thank & Act: “This is incredibly helpful. Thank you. I’m going to reformat my note template based on this feedback, starting today. I’ll send you an example after my next patient visit to make sure it’s exactly what you need.”
Result: The physician feels heard, respected, and sees you as a collaborative partner committed to improvement. You have dramatically strengthened the relationship.
22.5.4 Evolving the Partnership: From Value Demonstration to Value Expansion
A stable partnership is good. A growing partnership is great. Once you have established a foundation of trust and a system for maintenance, the final stage is to proactively identify opportunities to expand your value. This is how you evolve from a single-service provider into a true strategic partner, continuously deepening your integration and impact on the practice.
Identifying Unmet Needs: Your Next Strategic Target
You must constantly have your “professional prospecting” radar on, even within your existing partner practice. Now that you are an insider, you have access to a wealth of new data and observations. Your next proposal for a service line expansion should come from an unmet need you identify internally.
| Source of Insight | Example Observation | The Resulting “Value Expansion” Proposal |
|---|---|---|
| EHR Data Mining | While managing your diabetes patients, you run a report and find that 30% of the practice’s CHF patients are not on guideline-directed medical therapy (GDMT). | You propose a 3-month, targeted initiative to the practice manager: “I’ve identified 50 CHF patients who could be optimized. Let me dedicate 4 hours a week to a ‘GDMT push’ to get them on the right ACE/ARB, beta-blocker, and MRA doses. This will directly impact our hospital readmission rates.” |
| Provider Conversations | You overhear two physicians complaining about the complexity and time-suck of initiating and monitoring DOACs for their VTE patients. | You develop a pharmacist-driven “Anticoagulation Management Service” protocol, including initiation, bridging, and follow-up monitoring. You present it at the next provider meeting as a way to offload this work and improve safety. |
| Industry Changes | CMS announces a new value-based care model focused on osteoporosis and fracture prevention for Medicare patients. | You research the model’s quality metrics, realize the practice has a large eligible population, and present a business case to the practice owner for a “Fracture Liaison Service” led by you to manage these patients. |
Turning Your Champion into an Army
Your final task is to leverage the deep trust you’ve built with your physician champion and practice manager to broadcast your value across the organization and even beyond. A true partner doesn’t just do the work; they help the practice celebrate and publicize the success of the work.
- Arm Your Champion: Make it easy for them to brag about you. When you have a great outcome, summarize it in a single slide or a concise paragraph. “Dr. Smith, that was a fantastic win with Mrs. Jones avoiding readmission. I’ve created a one-slide summary of the case. Would you be willing to share it at the next all-provider meeting as an example of our collaborative work?”
- Co-author a Poster or Publication: Find an interesting clinical outcome from your work. Propose to your champion that you co-author an abstract for a regional medical or pharmacy conference. This provides them with academic credit and showcases the innovative work being done at their practice.
- Seek Testimonials: At the one-year mark of a successful partnership, formally ask your champion and practice manager for a written testimonial. This can be used (with their permission) as powerful social proof when you approach your next prospective partner, starting the entire cycle anew from a position of even greater strength.
