The purpose of this study was to determine the adoption of electronic medical records (EMR) by rural and urban Alabama family medicine physicians. This cross-sectional study evaluated EMR use among Alabama family medicine physicians (N = 1197). Half (49.3%) of the physicians surveyed reported using EMR in their practices; however, only 16.3% reported using EMR to its fullest capacity. The majority (49.9%) were categorized as nonusers, whereas basic users comprised 12.4%, moderate users made up 19.7%, and comprehensive users were 16.7% of the total. A physician's age (P < 0.001) and years of professional practice (P = 0.002) correlate significantly with EMR use. EMR users (mean 48.48, standard deviation [SD] 9.93; mean 18.63, SD 10.58) were significantly younger and had been in practice for a shorter time than non-EMR users (mean 52.92, SD 12.01, and mean 22.44, SD 13.04, respectively). This study allowed for the exploration of the current level of EMR use, the identification of individual user characteristics, and the identification of organizational user characteristics.