Although nearly 30% of group orthopaedic practices are now owned by hospitals, the 2013 JBJS Role of the Orthopaedic Surgeon study finds that orthopaedic surgeons still exercise powerful voices when it comes to which products and devices get purchased. The percentage of orthopaedic surgeons claiming influence over purchases has been remarkably stable at greater than 90% for the past two years, and surgeons’ influence continues to extend through most stages of procurement processes. Even surgeons in practices owned by hospitals remain actively involved in procurement, except for supplier price and contract negotiations.