Not exactly... surgeons office. Everything is in-house for our business--we do not outsource any IT function (big perk--job security). There are two of us IT guys to cover 55 employees spanning 4 offices. We're heavily virtualized as well--two hosts running about 25 virtual servers, but we still have a couple of physical servers around.

We run a 3-year cycle for employee devices and a 5-year cycle for servers as far as replacements go. Most devices then become "IT Toys" when they're decommissioned. We use them as test beds for vetting changes and for creating experimental devices.