I worked in an employed setting when I started out, with a pretty good built in referral base to the practice in general, a lot of which slopped over to me when I started, mostly because the comp plan didn't incentivize productivity (it did once I became the group director, but that's not the issue here). But it definitely took 3 or so years before I was in the 16-20 patients a day range. By the time I left there it was more like 22-25 which was above my comfort level (not that I couldn't do it, I just didn't want to work that hard), mostly because patients and referring docs really liked me.
A lot of this will depend on your local market, and how your group integrates into it. If there are a bunch of PP groups all hustling for the same referrals, you'd going to have to figure out a strategy to make people want to send their patients to you rather than the other groups. If you're up against an employed or "embedded" group in a hospital system, you'll need to seek out "your people" who will refer to you over the in-house group. This is a pretty common setup in community hospitals these days. There are docs (PCP, surgeons, specialists) who are employed by the hospital, but many others who have offices on the hospital campus and hospital privileges, who are independent. In this case, you need to out perform the in-house group in all ways (see patients faster, communicate better, make the patients happier).
