As I have now argued in three books and countless columns and articles, I believe that we must view our work as writers through the lens of practice: the skills, knowledge, attitudes and mental habits of the person working in the profession.
Collected together, and working in related ways, it is these elements of the practice that allow us to complete the task of writing, to produce written works of art that meet the needs of the speaking situation involving the audience that corresponds to the need for writing.
One of the most difficult aspects about teaching writing is that one of the most important aspects of the writer’s habit – mental habits – is almost impossible to assess without.
Two students can transform almost identical artifacts, but it is possible that only one of them develops the mental habits that lead to continuous growth. If one student follows the prescribed templates and, in fact, fills in the blanks, while the other finds the necessary steps to meet the occasion through careful study and consideration of the speaking situation, he is the only one who develops a strong and flexible writing practice.
Mental habits are how we do our thinking as we plan, research, write, revise, edit and polish our writing. To assess progress in these areas, I asked students to reflect on their practice 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 mental habits more visible to the students themselves, so that they have a better meta-knowledge of their actions. One of the additional challenges regarding habit formation is that, over time, if a person’s mental habits develop well, they end up being invisible to the practitioner even when they are used, known as habit.
At faculty development conferences, I often ask these professionals to think and express various aspects of work and then evaluate. when again How read these things and see if what they asked the students to do or not and how the students did these things helped them to improve their habits.
As I often say in these books and articles, writers aren’t the only ones with a habit. In fact any job or profession that requires a combination of these factors can be viewed through the lens of practice. In Why They Can’t Write: Killing the Five-Paragraph Essay and Other RequirementsI match writers with chefs and find significant overlap in their careers. Doctors have habits, lawyers have habits, musicians, teachers, woodworkers, personal assistants, researchers, nurses, therapists, engineers, all have habits that include skills, knowledge, attitudes and mental habits.
I believe that it is this field of mental habits that perhaps separates the different levels of expertise in the field of practice—and not just coincidentally the most important way to develop human habits is experience. The more you do, the more you know, and the more your knowledge can be invested in shaping your habits of mind.
My journey as a writer is a solid proof of this, but even that journey is nothing compared to teaching, where I really went from one of the least creative teachers in the world to someone who is now considered by others to be an authority on these matters. Yes, I read and researched and thought, but mostly I did it, working on the problem of teaching students how to write for many years, building my knowledge and, later, my expertise.
Introducing automation into the process changes the work’s mental habits and changes the experience. Some believe that the power of “intelligent outsourcing” that LLM automation might enable can be beneficial to people, freeing them up to do “important” work.
I’m a skeptic on this one, or at least I doubt we’ll know what “important” work is without a lot of trial and error and some serious consideration of what we mean by the word “important.”
One area where this is becoming increasingly clear is medical practice, as shown in a long and thoughtful piece by Helen Ouyang, a professor and physician of emergency medicine, published in The New York Times Magazine.
Ouyang explores medical practice through the emergence of doctors’ clinical notes (or “charts”), the summaries they write showing conversations with patients and their performance in further diagnosis on the way to a treatment plan.
Ouyang traces the chart’s origins to the rise of hospitals in the 19th century when doctors’ notes became part of the medical record. In the 1960s, the note format was formalized by Lawrence Reed at Case Western Reserve University, who compiled the SOAP program. US is “down,” what the patient says. O “objective,” what the doctor sees or measures. UA and P are “assessment” and “planning,” a conclusion drawn from specific and objective data and then the next steps forward.
AI scribes that will record and summarize doctor-patient interactions are one of the first AI applications to realize widespread adoption. I wrote about them in my book More Than Words (first published in 2025), meaning they would have been used enough to receive public notice in 2024.
The desire for this type of automation is obvious and understandable: Charging is very time-consuming, it seems like a legitimate piece of business that could be outsourced, and any time spent on a phone call or typing a note is time that can be spent with patients. Automation, in theory, can free up time for more meaningful work.
Ouyang wasn’t worried about the potential shift in AI scribes, seeing them as “the next natural step in this long evolution of the medical record.” The doctor’s role “seemed simple: read i [AI] draft, correct what was wrong, sign. Fast, very easy.”
But he says the process “started to bother me” as he realized he had given up the opportunity to think about his patient’s situation, no longer sifting through the story to find meaning, but instead, exploring something “that was already made for me.”
What he found was music to my ears, as someone who has been beating this drum for a long time: Writing is thinking. Ouyang says, “Over time, however, I’ve come to realize how much of my thinking had to do with the writing process itself.”
He goes on to note how the presence of an AI scribe is changing other aspects of doctors’ work, including how they interact with patients. His performance by others was interrupted. The wider practice of medicine is being restructured, all but what seems to be a necessary consideration of what these changes might mean for doctors, patients and hospitals.
Efficiency has been privileged above all else, but efficiency alone is not a measure of quality, certainly not in education, or in health care.
Ben Gooch, a UK general practitioner, faced the same problem as the authors of AI, commenting on a follow-up visit with a patient he had seen, “I sat down to review a patient I had seen six weeks ago. I read the note. It was accurate. It was perfect. It had no factual errors that I could see. And I didn’t.” Gooch realized that in the name of speed he had lost touch with what was most important to his work—his knowledge of his patients, acquired through communication and the mindful practice of clinical note-taking.
The good news is that these are two thoughtful professionals who had the ability to recognize how their actions have been distorted in ways that threaten to undermine their expertise as part of the overall process.
What happens when student doctors (or lawyers, or teachers, whatever you are) have never learned the psychological practices that support the technology associated with these practices? Ouyang reports that third-year medical students at Johns Hopkins will no longer take notes during their shifts, instead relying on AI scribes.
It is possible that AI writers could be engaged in a practice that informs the reflective thinking that Ouyang and Gooch see as essential to their work, but this investigation does not seem possible.
Maybe AI is the future of work, but if that future is going to deliberately set aside the most important contributions of the human mind, what are we doing here?
