The primary role of the clinical medical librarian (CML)--locating and providing quality-filtered, patient-specific information to physicians--has been questioned recently because of the dramatic rise in end-user searching. This study administered a questionnaire to evaluate the current impact of this service in a major hospital setting with a long established CML program. The study showed that the CML provided house officers with information that affected patient care (defined as diagnosis, diagnostic tests, or treatment) between 40% and 59% of the time. This was true even though most physicians reported they generally researched the question prior to consulting the CML. In addition, the house officers in this study indicated that they distributed the CML-provided information to other health care providers 56%-96% of the time. Based on these limited results, it appears that CMLs can continue to provide information that has a strong impact on patient care, despite the availability of an end-user local MEDLINE system.