Being a new physician in a hospital or a group practice is a lot like being the new kid on the block: It's never easy, no matter how talented and self-assured you are. You need to acclimate yourself to another place and different ways of doing things, learn the rules, and build trust.

Chances are your ideas about how things might be improved won't be welcome—at least, not at first. So keep them to yourself for a while. This is a time for listening, gathering information, developing a patient base, and, perhaps, settling into a new community. In this fifth installment of our six-part series on finding a job, we'll tell you how to increase your prospects of succeeding in a new job—and what to do if things aren't working out.

You'll need to fit in "As a new associate, it's up to you to adapt to a practice's culture, not the other way around," says Jack Valancy, a practice management consultant in Cleveland Heights, OH. Find out how the physicians and staff communicate with each other. What are the practice's daily routines? Weekly ones? If you're fortunate, a manager or other veteran will help you settle in. Even if that doesn't happen, you can learn the drill on your own.

Your contract will probably address practice building and call schedules in a general way. Once you're on the job, you'll need to learn the specifics.

Practice building. "It's common for the new physician to be assigned patients who call for an appointment and don't request a specific physician," says Valancy. "Dr. New is also first in line to handle patient overflow—that is, treat patients who want to be seen immediately but whose regular physician is unavailable."

"Ask the patient's regular physician if he wants you to treat the patient only for that particular episode, or if you should also see the patient for follow-up," says Judy Bee, a practice management consultant in La Jolla, CA. Tread carefully; you don't want to be accused of stealing patients. If another physician's patient asks you to take over his care, Bee recommends the following response: "I'll be happy to be your doctor, but you're Dr. Smith's patient. Anything you work out with him is fine with me." If the patient is uncomfortable doing that, you can discuss the matter with Dr. Smith directly.

Regardless of whether the other physicians will cede patients to you, you'll probably be expected to draw new patients to the practice. When internist Geralyn M. Ponzio joined her father's practice in Bloomfield, NJ, several established patients gravitated to her, especially those who wanted a female physician to do their Pap tests and pelvic exams. To attract other patients, Ponzio made house calls, distributed business cards at assisted living facilities, gave talks at schools and senior centers, and handed out cards to friends, family, and specialists.