In this study, the researchers conducted the second phase of a two-part project which examined the costs of defensive medicine. In the first phase of the project (Grant #58347), the researchers constructed a database of tort signals and health claims data from CIGNA HealthCare. The tort signals – medical malpractice premiums and the number of malpractice suits filed in a physician’s geographic area – are factors which may be viewed by physicians as indicators of litigation risk. In phase two of the study, the researchers conducted analyses of the tort signals and claims data and: 1) quantified costs associated with positive defensive medicine in the United States for the complete spectrum of medical care; 2) identified specific clinical conditions for which positive defensive medicine exists, and quantified defensive medicine costs for each of these conditions; and 3) identified the specific types of services and resources (e.g. medications) associated with defensive medicine in each identified condition. The objective of the project was to measure the degree to which fears of medical malpractice litigation motivates physicians to practice positive defensive medicine, which includes ordering tests, procedures, and/or medications that offer little or no clinical benefit to patients.