Orthopedic wellness franchise Structural Elements has announced a major expansion of its franchise network, targeting Maryland, North Carolina and Virginia over the coming year as it scales its unique dual-franchise model that supports both clinic owners and healthcare providers.
Founded by licensed acupuncturist Doug Bertram, Structural Elements said its franchise system addresses growing demand for integrated musculoskeletal care by separating clinic ownership from patient care. The company currently operates clinics in Hagerstown and Frederick, Maryland, and Shorewood, Wisconsin, and is now seeking qualified operators and licensed practitioners to expand its footprint across the United States.
The expansion follows the release of the company’s 2026 Franchise Disclosure Document (FDD), which invites conversations with single-unit and multi-unit franchise operators, as well as licensed healthcare providers, in growth markets including Florida, Texas, Colorado, Georgia, North Carolina and Virginia.
Structural Elements has franchised both clinics and practitioners since 2016, creating what it describes as the industry’s first model to franchise both the business and the care-delivery side of orthopedic wellness.
According to the U.S. Bone and Joint Initiative, more than one in two American adults lives with a musculoskeletal condition. The company noted that health and wellness has also emerged as the third-largest franchised industry in the International Franchise Association’s 2026 Franchising Economic Outlook, highlighting strong demand for specialized wellness concepts.
Unlike traditional healthcare practices, Structural Elements operates a cash-pay clinic model that combines hands-on therapy, movement education and recovery services to address the underlying causes of pain rather than simply treating symptoms.
Bertram developed the Structural Elements treatment methodology in 1995 before opening the first clinic in Hagerstown, Maryland, in 2013. Today, the concept has evolved into a national franchise opportunity designed to support both entrepreneurs and healthcare professionals.
Under the company’s dual-franchise structure, clinic franchisees oversee business operations, including scheduling, billing, collections, marketing and administrative support, while provider franchisees focus exclusively on patient care. Every provider completes the company’s 71-hour Practitioner Training Program, led in part by Bertram, before joining a clinic.
The franchisor also recruits trains and places practitioners across six healthcare disciplines, including physical therapy, acupuncture, athletic training, massage therapy, and other complementary orthopedic wellness services, creating multidisciplinary care teams under one roof.
“We separated the business of owning a clinic from the business of providing care,” said Doug Bertram, Founder and CEO of Structural Elements. “The operator we want has already run businesses and knows how to run them well. The providers we want are exceptional at care and tired of managing everything around it. We built a franchise for each of them, and the clinic is where they meet.”
The company’s franchise growth strategy is being led by Chief Development Officer Patti Rother, a franchise executive with extensive experience helping established brands transition into scalable franchise systems.
“I have spent my career helping established brands become franchise systems, and I am deliberate about the ones I take on,” said Patti Rother, Chief Development Officer of Structural Elements. “We look hard for three things: a founder who has actually done the work, a model that holds up when you take it apart, and care that changes how people feel. Structural Elements has all three. I have deep respect for Doug and the team he has built, and I believe in this approach to wellness enough to stake my name on it. That belief is why I am in this seat.”
Structural Elements believes its model offers an alternative to fragmented healthcare delivery by pairing experienced business operators with franchisor-trained practitioners. By removing administrative burdens from clinicians and allowing them to operate cash-based practices within professionally managed clinics, the company aims to improve patient outcomes while creating scalable franchise opportunities.
As it expands across priority markets, the brand is positioning itself to capitalize on rising consumer demand for integrated, non-surgical orthopedic wellness services and multidisciplinary care models that emphasize long-term mobility, recovery and performance.
