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Chief Medical Officer Wants Docs to Sign with a Sine Wave


An older doctor with a beard and glasses writing on a piece of paper with a sine wave at the bottom.

Wellington Bowl, M.D., Chief Medical Officer at Winning Big Hospital in Boston, MA., has a great way to figure if clinical progress notes are completed.


Clinical teams need to document, so there is a record of the patient’s medical treatments and testing. In the medical profession, it has been said that if you did not document, you did not do it.


Dr. Bowl explains his philosophy on clinical progress notes. “It is important to make sure that we have complete documentation, and it’s done in a timely manner. The documentation needs to be accurate, and it should be signed. Sometimes physicians work with nurse practitioners or physician assistants. These notes may need a cosign from the physician. I love math. Yes, MATH! To make things easier, I am requiring that a cosine wave be placed after the signature on notes that are cosigned. A sine wave should be placed when the note does not need a cosign. The sine wave and the cosine wave have the same shape. But the cosine wave has a phase shift. That’s important!”


Dr. Bowl hopes that when there is a sine wave or a cosine wave at the end of clinical documentation, physicians, nurses, and anyone else on the medical team will know when the clinical documentation is completed.


Abby Fraction, M.D., general surgeon at Winning Big is willing to work with Dr. Bowl on his initiative. “You may think with the name Fraction, that I have a natural interest in math. As a child I ran in the opposite direction. But Dr. Bowl is onto something. There is no question that as a hospital, we will know if a doctor cosigned or signed a note, when we see a sine or a cosine wave as a visual cue,” says Dr. Fraction.

Robert Y-Axis, Chief Financial Officer, chimes in: “I am concerned about the amplitude and frequency of the waves. This can have a huge impact on our revenue cycle.”


Hopefully the visual cues from the sine and cosine waves bring more clarity than confusion.


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