James Andrews, MD, the ubiquitous sports orthopedist, performed his billionth surgery last week, closing the gap between himself and MacDonald's and promising to maintain his annualized growth rate of at least 40%.

The present tally is: MacDonald's: 6 billion customers; Dr. Andrews: 1 billion, 17 operations.

Dr. Andrews' staggering output can give the impression he is the sole practicing orthopedic surgeon in the sports world; that somehow he, alone, performs every surgery on every major athlete in every city and state in the country. By all credible accounts, that is the case.

"James [Andrews] is a one-man show," said John Cardenza, MD, President of the American Medical Association. "He's been doing it, it seems like, forever. His production is mind-boggling."

It remains unclear just how Dr. Andrews, in the last 20 years, has managed to marginalize every other practicing sports orthopedic surgeon in the nation.

"[Sports] is a 'clubby' culture," said Ernie Grunfeld, GM of the Milwaukee Bucks. "Dr. Andrews has somehow carved within it a certain demi-godlike status."

"But I mean, he makes mistakes," Grunfeld asserted. "Mase [Bucks forward Anthony Mason] ended up with two right knees."

Still, Grunfeld conceded, "When there's an orthopedic concern, we go to him."

Andrews, sources say, is "obsessed" with performing as many surgeries per day-- "sometimes hundreds"-- as his team of "schedulers" can fit in.

"He makes these 'laser guys' look cautious and slow," said an associate who, nervously, asked to be identified only as "an associate".