"You never get a second chance to make a first impression."

Although most of us remember the Head and Shoulders™ ad for its cautionary slogan of "you never get a second chance to make a first impression," no one knows who exactly coined this wisely used phrase. Be it Oscar Wilde or Will Rogers (thank you, Google), no advice is more appropriate when it comes to starting a new job. I recently had the pleasure of taking a new position and hope I can provide you with some unique insights to help guide you through the process.

Stage 1: Orientation

You made it through the interview process, the state licensing and the hospital credentialing board and are feeling pretty good about your new job. Then, you get to sit through orientation with its deluge of information carefully arranged in a series of PowerPoint presentations that makes you think you are back in medical school. You listen attentively to the ad infinitum hospital policies and wonder how can there be so many. No doubt, the head of human resources makes an appearance, often inducing a chill in the room, offering their perspective and advice on how to avoid seeing them in the "principal's office."

Orientations are often performed en masse and you are likely only one of a few physicians in the room, with the remaining people being other members of the health care delivery team. You then may be 'blessed' with computer training. In my transition, I had the pleasure of sitting through 16 hours of inpatient and outpatient EPIC training at two different locations covering modules that would never apply to my day-to-day work. Remember, even in these conspicuously anonymous environments, your appearance, behavior and interactions matter. Resist the urge to seek out only the other MDs. As you sit through 'death by PowerPoint' and computer modules, stay awake and alert, and try to connect with your co-workers, as you are all in it together. These faces may be the first people you recognize on the wards, in the cafeteria or in the hallway. Transitions are always better with company and support. So remain positive despite your fear that you may develop a sacral decubitus ulcer from sitting in a cold auditorium or computer lab for hours straight. Try to remember that these trainers are faced with the mirage of fatigued and disgruntled faces constantly; focus on how you could better learn the intricacies of your hospital's systems. Remain calm and forge ahead with a positive attitude.

Stage 2: Your New Environment

After this, you likely will be further oriented to your individual work environment. Here you will get to meet the people with whom you will be working on a day-to-day basis. This is where you must remain upbeat, engaged and immediately demonstrate a willingness to work and learn the system. The best approach is to first determine how things are done at your new institution; yes, it will be different from your prior experiences. You must learn to adapt, overcome and evolve. Your ideas for how to improve patient care will be more readily accepted once you have become an invaluable member of the team. In the beginning, you will interact with new nurses, techs and support staff. Each of them is immediately assessing how you are going to be to work with, so relax, smile and be as friendly as you can. I personally try to remember one thing about each new person I meet so you have something to go back to, a reminder of that person. This is a strategy that I use with my patients, often writing in the medical record something of interest about them specifically so I can recall them individually.

I often say "99 percent of all conflict is rooted in a lack of communication." As a newbie, try and avoid conflict by clearly communicating. If you are unfamiliar with a procedure, a process or even where the bathroom is, just ask! They say that to be successful in practice you have to be "affable, able and available." Take these words to heart no matter if your new job lands you in the midst of a high-powered academic urban institution or in a small office setting in the country. Take the time to personally communicate with all referring physicians and take every phone call. Even if you have residents and fellows, be certain to take the time to contact the attending from another service and have an attending-to-attending conversation. The extra time you take will make a large impact, in addition to avoiding any lost-in-translation errors fellows and residents may pass along.

The new job will unquestionably bring times of uncertainty. You will ask yourself, did I make the right decision coming here? You will doubt yourself and yes, you will be humbled by how some people at your new place make it look so easy. You will feel slow and at times even lonely. These are all natural feelings as you start a new job. They will pass in time. Remember to observe and gather information and try to understand how your new place does it. You may have ideas for improvement, but consider whether your former way is truly better or just different. Be open to new ways of doing things, learning new procedures and being on new teams. Resist the urge to jump on too many committees, and if you are fortunate enough to be assuming a new job wherein you are the director of an area, take the time to first gather data on who is who and what is what before making any changes.

Stage 3: Your New Boss

As you start, you certainly want to make a good impression with your new boss. Establishing your boss' expectations from the start makes the transition easier; take the time to understand exactly what the boss wants and what they expect. This may be exceptionally challenging, so do not be afraid to be direct and forthcoming when discussing what's expected of you. No matter what, do not complain when starting your new position! When I arrived at my new job, my boss asked me if I knew "the difference between a puppy and an interventional cardiologist: eventually a puppy stops whining". A boss appreciates a physician who tries to be part of the solution, rather than part of the problem.

In summary, work hard, be a team player and don't complain! Remember, you are new and each person you meet is important, so smile and pay attention to what they have to say. They have been there for some time and can provide you the background information you need or maybe, more importantly, where the good coffee is located! You never get a second chance to make a first impression. Always look to help not only your patients, but also everyone around you. You and your team are all there for the same reason – to give the best care you can to each patient, so focus on incorporating yourself into the team and being the best you can be each day. And, never forget how you feel as "the new doc" so that one day when someone new starts you can help them in their transition. Good luck!

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This article was authored by Andrew J. P. Klein, MD, FACC, an interventional cardiologist in vascular and endovascular medicine at Piedmont Heart Institute.