Sfernandez,
I am solo FP, on my own for 3 years and in practice a total of 5 years. I started like you did, bare bones. but when you feel the growing pains it's time to losen the belt so to speak. I have built my practice up to around 2,000 patients and have been closed to new patients (except close family members of existing patients) for nearly 2 years.
Since you asked specifically about hours of operation, 8:30 to 5 is pretty good. To capture the working class folks, consider opening very early or staying later. I am open 7AM-4PM, and will stay as long as patients need to be seen, as late as 5:30 or 6PM seeing patients (acutes). I work only until noon Fridays. I ALWAYS fill the early morning slots with working folks, because they can see me before work and don't have to use sick time or lose money. Alternatively you could be open 10AM to 7PM, for the same purpose as what I achieve by opening early.
I do my inpatient hospital rounds either before office hours or after the day is done, depending on the situation. I see nursing home patients once weekly on Sundays, and therefore don't lose money taking clinic time out of the office for low reimbursing Medicare SNF patients.
For billing, I use Emedware by Sage Software. I have a fulltime biller. You could probably get by with a good billing software system and a all-in-one, biller/secretary type person. You don't need more clinical staff until your practice is bigger.
Some questions I have for you: if it took 11 months to build only 400 patients and you see 30-40/week, what is the market for solo FP's in your area? Are PCP's needed there, or is the market saturated with PCP's? Do you have a concierge type practice or cash only model that allows you to afford seeing so few? I only have perspective from my location in rural Maine where we are really hurting for FP's, and we turn away 4-10 people per day who call seeking to establish w/ me. I had to close to new patients within 9 months of opening. If the market is really poor, it might be worth considering changing to a different location where the need is higher.
I hope this helps generate some ideas for you. Good luck!
