Obviously you understand that going into solo FP/primary care is not easy. It's hard. It's difficult to be a businessperson. I had ZERO training at running a business. But I made it work.
I surrounded myself with people that I trusted, and people that can get stuff done. I make a decision, someone helps me carry it out. That's how business works. Sometimes I have to do stuff myself, like empty a trashcan or answer a phone. No big deal.
My advice, stay small. Get big (tons of staff) and you need to see tons of patients. See fewer patients. Stay small, offer a NAME-BRAND practice. Call your practice "Mike Heim, D.O." and be very selective who you take for patients. (don't take anyone on narcotics or state medicaid). If a cash practice works in your area, do it. If not, then selectively take insurers that pay better. Opting out of Medicare is a great idea if you can sustain without it. I'm about 40% Medicare and most would leave if I opted out, so I stay in the rat-race.
For a more complete description of my office model, you may be interested in this article I submitted to "The D.O." earlier this year.
http://www.do-online.org/pdf/pub_do0109lauer.pdf
