A new survey of emergency physicians finds those most concerned about lawsuits are more likely to admit patients with cardiac symptoms and to order more tests. The results were published by Annals of Emergency Medicine July 13. Of the 7 million people who seek emergency department care for chest pain or other symptoms of acute coronary syndrome, about 50 percent are hospitalized or admitted to chest pain observation units, and the majority of these patients are subsequently shown not to have acute coronary syndrome. To determine the extent the practice of defensive medicine plays in emergency physicians admitting low-risk cardiac patients, researchers surveyed 33 emergency physicians at two university hospitals to gauge their fear of malpractice lawsuits and their impact on triage and workup patterns for patients with symptoms suggestive of heart disease. To determine the relationship between emergency physicians' fear of lawsuits and their clinical decision making, researchers ranked emergency physicians based on whether they had low, medium or high fear of malpractice. The research was funded by the Agency for Healthcare Research and Quality and the Robert Wood Johnson Foundation Generalist Physician Faculty Scholars Program, with supplemental support from the University of Wisconsin Department of Medicine.