AI Scribes in Medicine Are Short-Circuiting Thinking

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July 09, 2026

What if We Accidentally Outsource the Real Work to AI?

We must be mindful of the ways automation alters our habits of mind.

By

John Warner

As I have now argued in three books and countless columns and articles, I believe that we should view our work as writers through the lens of a practice: the skills, knowledge, attitudes and habits of mind of a practitioner.

Gathered together, and working in interrelated ways, it is these elements of a practice that allow us to complete the labor of writing, generating written artifacts that satisfy the requirements of a rhetorical situation involving an audience attached to a need for the writing.

One of the hardest aspects about teaching writing is that one of the key elements of a writer’s practice—habits of mind—is almost impossible to assess from the outside.

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Two students can turn in nearly identical artifacts, but it’s entirely possible that only one of them is developing the habits of mind that lead to continued growth. If one student is following prescribed templates and, essentially, filling in the blanks, while another is discovering the moves necessary to meet the occasion through close study and consideration of the rhetorical situation, it is only the latter who is developing a powerful and adaptable writing practice.

Habits of mind are how we do our thinking as we plan, research, draft, revise, edit and polish our writing. In order to assess progress in these areas, I asked students to reflect on their practices after each completed assignment, using two questions: 1. What do you know now that you didn’t know before? And 2. What can you do now that you couldn’t do before?

The goal is to make these habits of mind more visible to the students themselves, so they have a better meta-awareness of their own practices. One of the additional challenges regarding the building of a practice is that, over time, if one’s habits of mind are developing well, they become increasingly invisible to the practitioner even when being put to use, a.k.a. a habit.

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In faculty development workshops, I often ask these experts to reflect on and unpack the different elements of the practice and then explore when and how they learned these things and to consider whether or not what they were asking students to do and how students were doing these things was helping them develop their practices.

As I also often say in these books and articles, it’s not only writers who have a practice. Essentially any activity or profession that requires a combination of these elements can be viewed through the lens of a practice. In Why They Can’t Write: Killing the Five-Paragraph Essay and Other Necessities, I analogize writers to chefs and find significant overlaps in their practices. Doctors have practices, lawyers have practices, musicians, teachers, woodworkers, personal assistants, researchers, nurses, therapists, engineers, all have practices consisting of skills, knowledge, attitudes and habits of mind.

I believe it is this arena of habits of mind that is perhaps the separator between different levels of expertise within an area of practice—and not coincidentally the most important vehicle for developing one’s habits of mind is experience. The more you do, the more you know, and the more what you know can be deployed to shape your habits of mind.

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My journey as a writer is solid evidence of this, but even that journey pales in comparison to teaching, where I truly went from one of the world’s least competent composition instructors to someone who is now considered, by some, as an authority on these issues. Yes, I read and studied and thought, but mostly I did it, working the problem of teaching students how to write over many years, building my experience and, in turn, my expertise.

Introducing automation into a practice inevitably alters the practitioner’s habits of mind and changes the experience. Some believe that the potential for “cognitive offloading” that LLM automation may enable could be a benefit to humans, freeing them up to do the “important” work.

I am a skeptic on this front, or at least a skeptic that we will know what the “important” work is without a lot of trial and error and deep consideration of what we mean by this word “important.”

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One area where this is becoming increasingly clear is the practice of medicine, as illustrated by a long and thoughtful piece by Helen...