Orthopedic practices are at the forefront of today’s changes in surgical delivery systems. Orthopedic services are increasingly being expanded through medical extenders. This, in combination with the shift toward performing increasingly invasive surgeries in outpatient settings, is changing the very fabric of the service. Whether provided in a central vertically integrated facility, or on a network basis, the best orthopedic services are crafted for an ever-changing delivery system. Our firm has been at the forefront of these changes and has guided our clients through these changes, while assuring that clinical excellence is maintained.