RingMD, the telehealth company founded by Justin Fulcher, eventually operated across more than fifty countries, a footprint few digital health platforms achieve. Fulcher is quick to note that the hardest part of that expansion was never the obvious one. Compliance requirements mattered, but he describes them as table stakes rather than the real obstacle standing between a company and a new market.

Trust Does Not Transfer

“The deeper requirement is institutional trust, and that doesn’t transfer between jurisdictions,” Fulcher said. A track record built in one country carries almost no weight in another. “A government contract in India doesn’t tell a hospital system in the United States anything about you. A FedRAMP authorization doesn’t open the same doors in Southeast Asia,” he said. Each new market required RingMD to rebuild credibility from the ground up, with regulators and institutions that had no reason to take earlier wins on faith.

Fulcher said companies that try to scale on momentum alone, rather than earning trust market by market, tend to run into a wall they can’t pitch or fundraise their way past. He described watching competitors move quickly into new countries without doing that groundwork, only to stall once local regulators and hospital systems asked for the kind of track record that can’t be manufactured overnight.

RingMD took a different approach from the beginning. “We made compliance and data governance foundational from the start,” Fulcher said, adding that this was not a response to any single client’s demands. It was a bet that operating across many regulated environments at once would eventually require that foundation, a bet he says paid off years later as the company’s footprint grew into new regions.

A Framework Built for the Long Run

That framework, built market by market rather than assumed to travel automatically, became one of the defining features of how Justin Fulcher approached expansion. It is also a pattern he later carried into public sector work, where institutional trust proved just as resistant to shortcuts as it had been for RingMD entering new health systems abroad. Refer to this article for related information.

Find more about Justin Fulcher on https://www.facebook.com/JustinLFulcher/