The end of the 20th century saw a sea of change in the view of individuals in relation to their health and health care. The term “consumer” began to be used to describe myriad new roles and responsibilities for lay people who receive health services and who are often the target of health promotion and disease prevention interventions. This article (1) describes how the term “consumer” is used by various stakeholders in the health care sector; (2) specifies the assumptions that underlie the notion that a “new” kind of health care consumer can (and should) have a significant effect on their own health and on the health care system; (3) challenges the evidence base of these assumptions, noting that many are either unsupported or clearly contradicted by what we know; (4) articulates a set of principles to inform an alternative, more productive, and feasible role for individuals with respect to their health and health care; and (5) identifies the implications of those principles for health promotion and health care professionals in the 21st century.
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