Substantial diversity exists in the estimates associated with the practice of defensive medicine. Physicians' efforts to limit legal liability have generally been grouped into risk reduction strategies (positive defensive medicine) and risk avoidance strategies (negative defensive medicine). This article examines the practice of these forms of defensive medicine in a ‘high-risk’ specialty -emergency medicine. A sample of North American emergency medicine. physicians provided data for the study at hand. The results, which failed to substantiate some popularly-held and previously untested suppositions associated with the practice of defensive medicine, point to the danger of making broad generalizations across physician specialities.