When physicians were asked to rate the "defensiveness" of their orders for tests or procedures, researchers found that "defensive medicine," or the overuse of tests and procedures from fear of malpractice litigation, is often clouded by other factors. UTMB’s Dr. Howard Brody, who was not involved in the study, said that it correctly points out that there may be other reasons physicians overprescribe, among them feeling one patient is slightly sicker than another, feeling time is short to evaluate alternatives, or even wanting to please patients by performing more tests as satisfaction surveys become more important under the Affordable Care Act. However, he is skeptical that defensive medicine can be precisely quantified. "I've frankly come to the conclusion that you can't measure defensive medicine," because you just cannot sort clearly the reasons you did something, he said.