Final year students in Chicago. Building a dental tourism concierge service for uninsured Americans facing $30K+ dental implant quotes.

The model in one sentence: End to end concierge for full mouth dental implants in India patient pays $9K-12K all in (procedure + travel + 14-day recovery stay) instead of $30K 60K in the US. I handle everything from US side qualification to in country coordination to post trip follow up.

Why this niche specifically:

1. Dental is never meaningfully covered by US insurance $1,500/year cap on most plans, Medicare doesn't cover dental at all. Removes the "is this covered" objection entirely. Patient self pays regardless.
2. India is globally famous for dental implants — JCI/ISO clinics in Delhi, Mumbai, Bangalore, Chennai use Korean/German/Swiss implant systems (Straumann, Nobel Biocare, Osstem).
3. Recovery is clean 14 days, no physiotherapy required, patient flies home comfortably.
4. Decision maker is the patient themselves (not a spouse or adult child making the call for an aging parent) — faster sales cycle.

Customer is NOT Indian-Americans (I pivoted on this): Indian Americans have direct contacts back home, no visa issues, no cultural friction. They don't need a facilitator. The real underserved customer is the uninsured American (45-70, self pay, often self employed or retired) who is paralyzed by US dental quotes but has zero cultural connection to India.

What I'm building:

• Not a referral business (introductions are free and disintermediated easily)
• A concierge service flat fee per patient for 60 day end to end management
• Moat is in the wrap around: family confidence layer (daily WhatsApp updates), recovery experience, US side aftercare network

Current state — radical transparency:

• Day zero. No customers yet. No entity yet. Co-founder and I are both F-1 visa holders.
• 5 partnership pitches sent to established Indian operators this week. 2 confirmed call slots so far.
• Plan: partner with one operator for first 5 cases (no hospital relationships day one), then evaluate direct partnerships.

Where I need help — 4 questions:

1. For anyone in healthcare/medical tourism: What's the biggest mistake first time facilitators make in their first 12 months that kills the business?
2. On regulatory exposure: I know I need a healthcare attorney before taking money but anyone navigated the US regulatory landscape on cross-border medical facilitation? (FTC health ad rules, state corporate practice of medicine laws, anti-kickback statute, HIPAA if I touch records). Looking for war stories.
3. F-1 visa structuring: Both founders are Indian students in the US. Likely structure is Indian Pvt Ltd with resident director + US side service contracts. Any founders here built a similar cross border setup? What worked, what didn't?
4. Honest pushback: I've been told "go work under someone first." I'm pushing back because every successful operator I've researched started by doing, not apprenticing. Is that the right read, or am I being naive?

Open to harsh feedback. Will reply to every comment.

Final year students in Chicago. Building a medical tourism facilitation service specifically for Indian American families needing elective surgery (knee/hip replacement to start) at JCI hospitals in India.

The thesis:

1. US knee replacement: $40-50K out of pocket. Same surgery at Apollo/Fortis/Artemis: $6-8K all-in. Patients save $30K+.
2. Indian American USA is an underserved corridor. Every operator I've researched (Vaidam, MediGence, SatyugHealthcare, MyMedOpinion, CureTheGlobe, Shafiya MediTrip, Al Masiha, LaMedTrip) is India based and focuses on Africa, Middle East, or ASEAN. Almost no one is purpose built for US based Indian diaspora.
3. Cultural fluency, US presence, and trust within Chicago/NJ/Bay Area Indian American community is a real moat that India based operators structurally can't replicate.

Current plan:

• Partner with established Indian operators for back end (so I don't need hospital relationships day one)
• Focus on one procedure (knee/hip replacement) and one community (Indian American parents 60-75) until 10 cases completed
• Build trust through founder led content + warm community network in Chicago
• Move to direct hospital partnerships in Year 2 once volume justifies it

What I'm trying to figure out:

1. For anyone in this industry what's the biggest mistake first time facilitators make in their first 12 months?
2. The real bottleneck I'm hearing is patient acquisition, not operations. Anyone validate or push back on that?
3. F-1 visa angle: my co-founder and I are both Indian students. Have any Indian student founders here structured a similar setup (likely Indian Pvt Ltd with US side contracts)? Looking for what worked and what didn't.
4. Anything that should genuinely stop me from pursuing this, given the competitive landscape?

Open to harsh feedback. Already getting "you don't have experience, go work under someone first" from some advisors pushing back on that because the operators making real money in this space all started by doing, not apprenticing. But would love to hear from anyone who actually built this.

Will reply to every comment. DMs open.

Final year students in Chicago. Building a medical tourism facilitation service specifically for Indian American families needing elective surgery (knee/hip replacement to start) at JCI hospitals in India.

The thesis:

1. US knee replacement: $40-50K out of pocket. Same surgery at Apollo/Fortis/Artemis: $6-8K all-in. Patients save $30K+.
2. Indian American USA is an underserved corridor. Every operator I've researched (Vaidam, MediGence, SatyugHealthcare, MyMedOpinion, CureTheGlobe, Shafiya MediTrip, Al Masiha, LaMedTrip) is India based and focuses on Africa, Middle East, or ASEAN. Almost no one is purpose built for US based Indian diaspora.
3. Cultural fluency, US presence, and trust within Chicago/NJ/Bay Area Indian American community is a real moat that India based operators structurally can't replicate.

Current plan:

• Partner with established Indian operators for back end (so I don't need hospital relationships day one)
• Focus on one procedure (knee/hip replacement) and one community (Indian American parents 60-75) until 10 cases completed
• Build trust through founder led content + warm community network in Chicago
• Move to direct hospital partnerships in Year 2 once volume justifies it

What I'm trying to figure out:

1. For anyone in this industry what's the biggest mistake first time facilitators make in their first 12 months?
2. The real bottleneck I'm hearing is patient acquisition, not operations. Anyone validate or push back on that?
3. F-1 visa angle: my co-founder and I are both Indian students. Have any Indian student founders here structured a similar setup (likely Indian Pvt Ltd with US side contracts)? Looking for what worked and what didn't.
4. Anything that should genuinely stop me from pursuing this, given the competitive landscape?

Open to harsh feedback. Already getting "you don't have experience, go work under someone first" from some advisors pushing back on that because the operators making real money in this space all started by doing, not apprenticing. But would love to hear from anyone who actually built this.

Will reply to every comment. DMs open.