Financial reimbursement and ownership of medical testing equipment leads to over-prescribing of these tests. These types of conflict of interest extend to ownership of MRI and CT facilities, surgicenters, cardiac imaging equipment, laboratory services and much more. A recent article in JAMA documented that MDs over prescribe two types of cardiac stress imaging tests: nuclear scans and cardiac echograms. We need to be certain the tests we reimburse for are appropriate and not influenced by reimbursement structures if we want to practice the best medicine and affordably.