The orthopedic wellness franchisor is targeting Maryland, North Carolina and Virginia with a model that separates clinic ownership from patient care.
Structural Elements, the orthopedic wellness brand founded by acupuncturist Doug Bertram, is expanding its franchise system into Maryland, North Carolina and Virginia. The brand splits ownership from care delivery: a clinic franchisee runs the business side while a separate micro-franchise track licenses the practitioners who treat patients.
Clinic owners handle scheduling, billing, marketing and credentialing, while licensed providers complete a 71-hour training program and run a cash-pay practice inside the clinic, free of insurance reimbursement constraints. The split lets operators without a clinical background invest alongside providers who want to practice without running a business.
Health and wellness now ranks as the third-largest franchised industry in the International Franchise Association's 2026 outlook, and more than half of American adults report a musculoskeletal condition. Structural Elements is betting a hybrid clinic-and-provider model can capture that demand faster than a pure real estate play or a staffing model alone.
Chief Development Officer Patti Rother, who has built franchise systems for other brands, is running the expansion and says she is targeting operators who have already run businesses successfully. The 2026 Franchise Disclosure Document also opens the door to candidates in Florida, Texas, Colorado and Georgia beyond the three states named in this round.
Prospective clinic owners take on real estate, staffing and franchise fees without needing a clinical license themselves, while providers considering the micro-franchise track give up employee benefits for the upside of running their own patient panel inside an established brand. Both sides depend on the franchisor's ability to keep recruiting qualified practitioners as the system scales into new states.
Revscale Media (illustration)The Australian strength and conditioning brand enters the U.S. through Florida, betting low attrition can win in a crowded boutique fitness market.
Revscale Media (illustration)PuroSystems is franchising AccuGuard Environmental, a mobile asbestos and lead testing concept built by one of PuroClean's top ten operators.
Revscale Media (illustration)The Berkshire Hathaway affiliate is pulling a respected real estate strategy shop in-house as it rebuilds itself into an active parent company.
VIO Med SpaThe med spa franchise signed 19 owners in nine months as health and medical led every franchise sector in 2025 sales growth.
Revscale Media (illustration)The Freeman Spogli-owned retailer opened 13 stores across six states last quarter and is holding a pace of 60 to 70 signings a year.
Franchise TimesAfter a delisting, a $10.5 million settlement and a 30-unit franchisee bankruptcy, F45 is selling fewer territories and vetting owners harder.
