If you’ve ever felt strong-armed by your doctor into getting tests done or prescriptions filled that felt excessive (and expensive), you’re not imagining it, and you may not need them. Her insistence on additional procedures and exams aren’t just for assured good health–most of the time, it’s to protect her from malpractice suits. And it’s definitely one of the contributing factors to rising health care costs, the L.A. Times reports.

Medical malpractice suits account for less than 1% of America’s trillion-dollar health care bill each year. Yet, according to a study published today in the Archives of Internal Medicine,  76% of doctors admitted to treating patients “more aggressively” for fear of being sued. About half reported that another motivating factor was “clinic performance measures”–meaning their performance review from their bosses. And 40% reported that, because they couldn’t spend enough time with their patients, they ordered additional diagnostic tests to make up for that fact.

Also interesting in this study: 62% of physicians reported that if additional testing and procedures didn’t generate revenue for specialists and subspecialists, diagnostic testing would be reduced.

But probably the most telling statistic from this particular study is the percentage of doctors who admit that their patients are receiving too much health care. It’s 42%. 42% of doctors admit to administering additional, unnecessary, financially-burdensome care, because they want to look like they’re doing their job, or because they don’t want to get sued.

Government agents, civilians, watchdog groups, and activists are constantly wringing their hands over what can be done about America’s staggeringly high health care costs. Unfortunately, when individuals’ health is what’s at stake, few outsiders want to recommend cutting back on medical care for fear that something may get missed or misdiagnosed. But when medical care is run like a business, costs and inflation behave like those in a business.

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