An administrator recently told me that when he started in this business he was hired by an accounting firm and given the responsibility for check-signing at the medical practice he was running. That tradition stayed with him until he joined a new practice. He seemed a little upset about it and I was wondering if he felt the physicians just didn’t’ trust anyone to sign the checks except themselves. So who should be signing the checks? I have always practiced and recommended that only physicians should be signing the checks. Remember, this is “their” medical practice and as such they need to see where every dollar is going – one of the best ways to do this is by signing the checks. It is also a good “checks and balances” over the person who is preparing the checks. I believe physician oversight over the disbursement system even applies to very large medical practices.