Peter Eisler and Barbara Hansen, USA TODAY -- Jonathan Stelly was 22, a semi-pro baseball player aiming for the big leagues, when a fainting spell sent him to his cardiologist for tests.
The doctor's office called afterward with shocking news: If Stelly wanted to live to age 30, he was told, he'd need a pacemaker.
Stelly knew it would be the end of his baseball dream, but he made a quick decision. "I did what the doctor said," he recalls. "I trusted him."
Months after the surgery, local news outlets reported that the Louisiana cardiologist, Mehmood Patel, was being investigated for performing unnecessary surgeries.
Stelly had another doctor review his case. Then another. And another. They all agreed: He needed blood pressure medication, but he never needed the pacemaker.
Today, Patel is in prison, convicted of billing Medicare for dozens of unnecessary heart procedures. Stelly, now 34, still has the pacemaker - but the doctors shut it off years ago.
"Baseball was my life, and he took that away," Stelly says. "For nothing."
Tens of thousands of times each year, patients are wheeled into the nation's operating rooms for surgery that isn't necessary, a USA TODAY review of government records and medical databases finds.
Some, such as Stelly, fall victim to predators who enrich themselves by bilking insurers for operations that are not medically justified.
Even more turn to doctors who simply lack the competence or training to recognize when a surgical procedure can be avoided, either because the medical facts don't warrant it or because there are non-surgical treatments that would better serve the patient.
The scope and toll of the problem are enormous, yet it remains largely hidden. Public attention has been limited to a few sensational cases, typically involving doctors who put cardiac stents in patients who didn't need them.
In fact, unnecessary surgeries might account for 10% to 20% of all operations in some specialties, including a wide range of cardiac procedures - not only stents, but also angioplasty and pacemaker implants - as well as many spinal surgeries. Knee replacements, hysterectomies, and cesarean sections are among the other surgical procedures performed more often than needed, according to a review of in-depth studies and data generated by both government and academic sources.
Since 2005, more than 1,000 doctors have made payments to settle or close malpractice claims in surgical cases that involved allegations of unnecessary or inappropriate procedures, according to a USA TODAY analysis of the U.S. government's National Practitioner Data Bank public use file, which tracks the suits.
About half the doctors' payments involved allegations of serious permanent injury or death, and many of the cases involved multiple plaintiffs, suggesting many hundreds, if not thousands, of victims.
Those malpractice cases, which can be settled with no admission of wrongdoing, account for no more than a fraction of cases in which people got surgery that wasn't needed, and there's no way to know the total number.
In an era when many hospitals are required to report every infection and surgical error, neither the federal government nor the states track unnecessary surgeries or their consequences, which can include surgery-related infections or other complications - a nicked nerve or artery, for example - that can cause severe disability, even death.
"It's a very serious issue, (and) there really hasn't been a movement to address it," says Lucian Leape, a former surgeon and professor at the Harvard School of Public Health. Leape, a renowned patient safety expert who began studying unnecessary surgery after a 1974 congressional report estimated that there were 2.4 million cases a year, killing nearly 12,000 patients.
Leape's take today? "Things haven't changed very much."
Read the entire story and an intereactive map on USA Today.
The key to protecting yourself is to do your research.
Look into the procedure before saying yes to surgery. Also, get a second, even a third opinion and ask a lot of questions - are there alternatives to the surgery?
You can also check on doctors and their qualifications on the North Carolina Medical Board's website where you can see any disciplinary action, malpractice lawsuits or complaints about a specific doctor or physician's assistant.
You cannot completely eliminate the risk of becoming a victim but you can be your own best advocate.