Focus local first or big idea?

My ultimate goal is to have a hormone health business that treats patients nationwide, mostly through Telehealth.

I just opened a brick and mortar medical spa about a week before the whole COVID mess. I am a PA so I  can only treat patients in my state where I’m licensed at the moment. These laws are changing quickly so part of me thinks just to wait. But I have a feeling there are loop holes to bring my business nation wide but it would be a lot of work to figure out.

I convinced myself that it’s better to just focus locally for now. I get at least one person per week that wants to work with me that I turn away. Am I just taking the easiest route instead of doing what I ultimately want to do?

I’m having a hard time deciding if I continue to stay focused on my local business and then next year look into expanding OR do I look into being able to offer something nation wide, even if it’s not the exact same as I can offer in state.

Thanks for any help