On patients that I sign out AMA I always write up an addendum that says something to the effect of patient not intoxicated, not altered, everything explained in layman's terms and voiced back, pt directed to f/u PCP asap, return to ER if desires etc. However I recently had another doc tell me that he essentially writes the above and then makes the patient sign "I understand the above instructions." and sign their name. Anyone else going this far? I know we are never truly safe from a suit and used to think what I was doing was sufficient but this practice doesn't seem like such a bad idea.