Geographical isolation, unavailable healthcare professionals, and insufficient government investments in healthcare severely constrain health services access in rural Bottom of the Pyramid markets. Social franchising offers a solution to this issue. It combines commercial franchising principles with social marketing to offer a sustainable business model for expanding healthcare access. Clinical franchising within social franchising is crucial in providing medical services. In this article, we put forth an argument for considering franchisee selection as a key ingredient in clinical franchising success. An exploratory study in India on social franchising among social enterprises and its results are also presented. © The Author(s) 2011.