A recent publication suggested that only 24% of U.S. doctors use electronic medical records (EMRs), and that physicians in group practices, urban settings, and multispecialty groups are more likely than others to use EMRs. If the widespread adoption of EMRs is to be accomplished in keeping with the President's Health IT goal of universal use by 2014, the reasons for EMR under-utilization must be ascertained and addressed. In order to assess current patterns of EMR use and reasons for non-use, physician opinions were surveyed directly, using an online social network of physicians in the United States called Sermo. In February 2008, 893 physician members of Sermo responded to the author's posting about EMR use. Their responses were notable for two reasons. First, EMR adoption (not just electronic billing or prescribing) may actually be higher (67%) than previous reports. Second, the most important barriers to EMR use were high cost, loss of autonomy, and workflow disruption (from both installation and ongoing use). These responses are discussed in the context of recent proposals by both private and public entities that EMR systems be given away for free to any physician who will use them, as well as the potential for patients' online personal health records to permit integration of data across multiple EMR systems.