Bob Wachter of UCSF Medical Center expresses concern about how emerging EMR systems negatively impact clinical synthesis and reasoning skills. "When I was on clinical service in July and read the notes written by our interns and residents, I often had no idea whether the patient was getting better or worse [...] In other words, I couldn’t figure out what was going on with the patient." Says Wachter, "the time is now – before our trainees build habits that will be awfully hard to break – to recognize that electronic medical records do more than chronicle our patients’ histories, exams, and labs. They are also cognitive forcing functions, ever-so-subtly modifying our approach and language into something that can either improve our clinical care and teaching, or not. Let’s show these computers who’s boss, and put the “A” back in SOAP."