This study builds on the theory of planned behavior, institutional and diffusion theories to investigate physicians? attitudes and usage behaviors of electronic medical records (EMR). Interviews with seventeen physician-residents enrolled in a Family Practice residency program and eight attending physicians in the same clinic showed that most physicians held rather negative attitudes regarding the EMR system. EMR was often times seen as an intrusion in the patient-physician interaction. Other findings relate to the impacts EMR had on physicians? time, expertise, physicians? learning, the length (and sometimes the accuracy) of the clinical notes. Challenges associated with behavioral control issues such as availability of computers and the physical positioning of computers are shown to be very important in the context of this case. Physician-residents have to use EMR because of its mandatory nature, however, if they had a choice or the power, the majority of physicians would use the paper chart.