Srneph, thanks for sticking with your thread and elaborating your concerns. Bert, thanks for explaining what you meant; I think we can all agree that it is sad to have to worry so much about the medico-legal aspects of chart signing. It is also clear that there are some legitimate quality of care issues as well.
Srnephdoc, in my post above, I explained why I think the automated messages are the real concern here. Again, a message left in the wrong place for a vacationing doc is a recipe for disaster; that is true with a paper or electronic message. Did that make sense to you and fit with your experience? If so, then perhaps your interface(s) can be configured to be brought into one common message box. All the labs, etc. would come to one box which is opened by a staff person who sends them to the appropriate doctor, and if someone is away, they would know to route it to the covering doctor. That doc reviews it, files it, AND sends it to the box of the vacationing doc who sees it upon his return.