Last week, I told you the cold outreach was coming.

I spent more time than I'd like to admit sitting with a drafted email in front of me — cursor blinking, index finger hovering over send — not moving.

In residency, there's a moment when you go from supervised to on your own. The pager fires, the attending isn't in the room, and the decision is yours. You know the medicine. You've rehearsed this a hundred times in your head. But knowing the protocol and trusting yourself to execute it alone are two very different things.

This week I crossed that gap. At least on paper. The first inquiry is drafted. It goes out Monday.

———

This week's work forced me to sit with a question I hadn't fully answered yet: What does good first contact actually look like?

My instinct, as a physician, is to lead with competence. Demonstrate I know the process. Show I've done the research. Prove I'm serious before anyone has a reason to doubt it. In medicine, credibility is earned over years — and you lead with it because it matters to the patient.

But I don't think that's the right move here. Not at the very first touch.

Here's what I've come to understand: the goal of a first message isn't to close a deal. It isn't even to impress anyone. It's to open a door. Genuine interest in their business — not your qualifications — is what gets a response. Sellers aren't looking for the most credentialed buyer. They're looking for someone who actually cares about what they've built.

There's a reason the best patient interactions I've had didn't start with me reciting my training. They started with me sitting down and asking the right question. The expertise matters — but it lands better after you've shown you're actually listening.

Two businesses cleared the filter this week — a pool route in Las Vegas and a drug and alcohol testing clinic in the same market. The pool route gets first contact. The inquiry I drafted is short. One paragraph. No credentials, no financing disclosures, no process walk-through. Here's the entire email:

That's it. Open the door. See who answers.

———

This was the most intensive week in the program so far — and I mean that in the best way.

Multiple joint sessions with Lacy — afternoons, evenings, one late-night dive that went longer than planned because we kept finding more worth digging into. Plus solo deep work blocks layered on top. Fellow acquirers further along in the community are already deep into conversations and closing in on offers. Watching how they operate is like watching senior residents work. Instructive and humbling in equal measure.

On the pipeline:

Our first inquiry goes out this week — a Las Vegas pool route. Recurring revenue, recession-resistant, route-based. Straightforward business model. That's exactly the point.

A drug and alcohol testing franchise in the same market is a close second. Strong institutional client base, motivated seller, a multiple that works for our deal box. It earned "Inquire" status this week. That outreach follows once the pool route conversation is open.

We also killed a deal cleanly. An AI-powered patient acquisition platform for medical practices — good recurring revenue, healthcare vertical. Checked boxes on paper until we found the one detail that changed everything: a prior buyer had already acquired this business and defaulted on the seller note. The owner reabsorbed it and relisted.

Not a red flag. A flare gun.

Hard pass. The filter worked exactly as it should — without emotion, without "but the numbers look okay." You don't re-enroll a patient in a treatment that already failed once and pretend the chart doesn't exist.

Here's what's made this week's volume possible: from the moment a listing alert hits my inbox, AI is doing the first pass. Scoring the deal against our criteria, flagging what fits and what doesn't, building the initial question list, drafting the outreach. By the time I'm reading a listing seriously, most of the legwork is already done. What used to take an evening takes twenty minutes. The machine handles the triage. I make the call.

———

The labs are running now.

Pool route inquiry goes out Monday. If there's a response worth pursuing, we'll be requesting financials and route documentation by end of week.

The drug testing franchise inquiry follows close behind — same process, more complexity around the franchise structure and transfer approval.

And there's an honest moment underneath all of this I want to name: what if neither one responds?

In the ER, you don't order labs and go sit in the break room. You order labs and you're already moving — next patient, next decision, next problem to solve. The results come when they come.

Same here. The inquiry is out. If there's no response, we follow up. If there's still nothing, we move to the next listing — there are more in the queue. The pipeline doesn't wait on any one door.

The labs are running. We keep working the floor.

———

Stay in the exam room.

— Joe & Lacy
Acquisition Rx | Where clinical precision meets business acquisition.