University Orthopedics (UOI) will partner with The Center for Orthopaedics (CFO), both based in Johnston, Rhode Island, allowing Drs. A. Robert Buonanno, Michel Arcand, Michael Belanger, John Czerwein, David Moss and Vincent Yakavonis will bring their talents to the team at University Orthopedics.
Rhode Island’s UOI and CFO Merge

Commenting jointly, Dr. Edward Akelman and Dr. Mark Palumbo from University Orthopedics told OTW, “Senior members of both practices have had a cooperative professional relationship for the past several decades. Historically, there has been mutual admiration between the groups with respect to the delivery of high-quality musculoskeletal care. Our pre-merger analysis indicated the practices had a similar corporate culture. Further, the partnership is expected to enhance overall operational efficiency allowing us to better serve the orthopedic patient population of Rhode Island and Southern New England.”
Asked how they will know that things are on the right track six months from now, they commented to OTW, “Joint meetings have been underway since September to ensure a seamless transition at the merger start date of January 1, 2019. Subsequent to the practice integration, the physicians of the Center for Orthopedics (CFO) will continue to serve their existing patient population from their office location in Johnston, Rhode Island.University Orthopedics will provide access for CFO patients to additional subspecialty expertise and for CFO physicians to additional management and facility resources. Our usual strict attention to financial performance measures along with the tracking of patient (and physician) satisfaction will keep us on the right path.”
Dr. Buonanno told OTW, “Over the past three years we have navigated the maze of the ever-changing medical environment. Between the hospital acquisitions, mergers and the consolidation of health care providers we felt this partnership positioned us to continue to provide quality care for our patients. Partnering with 40 colleagues in the same medical specialty provides us the opportunity to provide patients with the personal care they have come to know, rather than being employed by a larger hospital group or health care organization.”
“Our patients have already enthusiastically endorsed our partnership and will be the barometer of our success. The surgeons at University Orthopedics have been close friends and colleagues for many years, having done our orthopedic training with many of them at the Brown Medical program we felt this was the right fit for our physicians and patients.”
“We now have access to the largest orthopedic group in Rhode Island’s sub-specialty care such as orthopedic pediatrics and oncology, which will benefit our patients.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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