The medical profession is facing significant changes in the way the rest of society relates to it. Mass education, mass media and mass consumerism have boomed in the 20th century, putting an increasing amount of pressure on professionals to meet rising public expectations. If doctors are to continue to provide a service that meets the demands of citizens and taxpayers, they need to develop a new relationship with patients, acting not as instructors but as guides, to help people make decisions about their own health. They will have to be more accountable for the quality of care they provide and work with a wider range of health and non-health professionals to meet patients' needs. Doctors need not only to accept the consumer society but also, I will argue, to encourage it. They can work to ensure that the benefits of the information revolution are felt by people excluded from consumerism because of poverty and social isolation, working to create an empowered, informed public whose members are given the best opportunity to look after their own health.