Being the New-in-Practice Kid on the Hospital Block

In my small town, the arrival of a new student was an exciting event. Where was he from? Who would be her friends? Was he an athlete? Would she be popular? While I'm sure being the "new kid" is never easy, as a preteen who had never moved, I was intrigued by the opportunity to reinvent oneself in a new setting.

Establishing your practice in a new hospital can carry the same sense of excitement. As the new pathologist in town, you have no history (for better or for worse). I believe you can work this angle to your advantage. While your diagnostic skills and willingness to be a resource will certainly help pave the way, here are some tips for getting your name out in the hospital.

1. Increase your visibility:

• Eat lunch in the physician dining room or main cafeteria. Don’t be afraid to sit with someone you haven't met; food can unite almost anyone!
• Visit the physician's lounge or the hospital cafe during popular coffee break times. Even stopping in to grab a drink or snack gives you a chance to meet clinicians one on one.
• Attend fundraising galas, award ceremonies, or holiday parties. Attending these events (even when they're not your idea of a fun time) gives you a chance to meet people outside of the hospital setting, when people have their guard down. Bring your spouse and mingle!

2. Provide needed (non-patient care) services:

• Volunteer to serve on a hospital committee or multi-disciplinary process improvement team (they always need physician champions). In my hospital, our nursing staff was lacking good blood component administration education, so I put on a 20 minute educational session for key units. Not only did this improve our transfusion safety, but it also allowed me to meet many nurses and our nurse leadership. For a small investment of time, I built several relationships at once.
• Since you're new, you may be able to change the way certain processes have worked in the past, just by offering alternatives. While you don't want to be the person always saying, "At my previous institution, we did this…". There are times when having outside experience is extremely valuable. Just use this approach sparingly, and realize that everyone may not appreciate suggested changes.

3. If you're in any sort of leadership role, be open about the good (and bad):

• Schedule a meeting with key players: other department chairs, section directors, CEO, CMO, etc. in your first few months—let them know your plans for improvement and/or growth, and the areas you've identified as strengths
• If you're lab director, act as the "goalie" for lab problems or complaints and work on solving visible issues. When I started, a couple of clinicians were quite vocal about incorrect contact information on their pathology reports. I "intercepted" the email sent to the CEO, took care of this easy issue, and closed the communication loop by informing the clinicians and CEO of the resolution. I also invited the clinician to personally contact me directly about concerns or problems. These steps established me as a leader, but also as an "ally" of my CEO.
• Keeping open lines of communication (even if there is a problem in the lab) has also been invaluable for developing my relationships with the hospital leadership. After a particular blood bank issue, I was able to debrief with the head of operative services and chair of the surgery service to hear their concerns and share my plan to prevent the issue in the future. Even though opening up about an issue is scary, the leaders respected that I was forthright and had a plan to address it.

Not every day will be easy when you're the new kid. People may still try and deal with issues using previous pathways, they may forget to invite you to meetings, and may ask you to get second opinions on cases you feel quite confident about. Hold your head up, and know that this does get better! With a positive attitude and assertive self-confidence, keep gently pushing, and one day you'll realize you’ve become an integral player in the hospital structure.