Most startups don’t last. The majority of technology companies fail within their first few years, and the ones that survive rarely do so by moving faster than everyone else. Justin Fulcher, who kept RingMD operating for more than a decade across more than 22 countries and 12 million users, has a specific explanation and it starts with a lesson he learned early on.
Justin Fulcher is a technology entrepreneur and national security advisor whose career includes co-founding RingMD and work on defense acquisition modernization. Speed and scale, the twin metrics that dominate early-stage technology, are ones he spent years treating as measures of progress. When he moved to scale a new market before the operational and regulatory foundations were in place, the results forced a harder look at how he was building.
“Early on I made the mistake many founders make: I equated speed with progress,” Fulcher said. “In one case we moved quickly to scale a new market before the operational and regulatory foundations were fully in place. The technology worked, but the surrounding system wasn’t ready, and we had to step back and rebuild parts of it properly. It was painful, but a critical lesson to learn.”
The Foundations That Can’t Be Rushed
The lesson Fulcher draws is specific. Technology, however well-built, is embedded in systems it can’t function independently. Regulations determine what a platform can legally do. Infrastructure determines whether it can reliably do it. Partnerships determine whether the institutions around it will support or resist adoption.
Move before those elements are in place and technical quality becomes almost irrelevant. A product can work in the lab and fail in the field, not because the technology is broken, but because the surrounding system wasn’t prepared.
In healthcare, that gap carries concrete consequences. A telehealth platform entering a new country faces licensing requirements that vary by jurisdiction, insurance structures with no established category for what it offers, and clinical communities whose trust has to be earned. RingMD eventually operated in different environments like Singapore’s heavily regulated healthcare system and markets where patients were accessing formal care for the first time. The surrounding system had to be built in each case before the platform could function sustainably within it.
“That experience taught me that speed and durability have to be balanced,” Fulcher said. “You should experiment quickly and learn fast, but the core architecture of regulatory alignment, infrastructure, partnerships has to be solid before you scale. In complex sectors like healthcare, durable systems ultimately matter more than short-term growth.”
Why Longevity in Tech Is Rare
The broader insight runs counter to how the industry typically frames ambition. Speed in regulated sectors tends to produce weak systems. Cutting through regulatory detail, treating compliance as a later problem, scaling distribution before operations are ready, these approaches help a company move fast, but they’re also often the ones that collapse when exposed to real-world pressure.
RingMD’s durability over more than a decade was built on decision-making in the opposite direction. Compliance and data governance were embedded into the platform’s architecture from the start. Credibility with regulators and institutional partners was earned market by market, and the company scaled into new environments only after those foundations were in place.
“Most startups don’t survive very long and many disappear within a few years,” Fulcher said. “RingMD has been operating for more than a decade, which is relatively rare in the technology sector. That kind of longevity usually comes from building durable systems and focusing on real problems rather than chasing short-term trends.”
Patience as Competitive Advantage
For Justin Fulcher, the lesson isn’t limited to healthcare. He has applied the same framework to his work at the intersection of technology and national security, where institutional environments are even less forgiving of shortcuts. Procurement systems and acquisition processes require the same foundational work as entering a new healthcare market. Organizations that succeed tend to build the surrounding system before pushing for adoption.
His core thesis: patience around core foundations and fundamentals compounds. Companies that rebuild on weak ground lose more time than those that build correctly the first time. The discipline to slow down and reconstruct when something isn’t working is, in his account is what separates durable builders from those optimizing for the wrong metrics.
