Health care in the United States is undergoing a significant transition. Numerous concerns and criticisms have been expressed regarding the quality, quantity, and cost of medical care. In the April 24, 1972, issue ofJAMA, we discussed the present status of patient education and pointed out the need for patients (consumers) to assume an active role in the management of chronic diseases or maintenance of normal health. Consumer participation, however, can be effective only if patients are properly prepared to assume their responsibilities and are accepted as members of the health care team. Currently, patient education and participation is not regarded as an integral part of quality medical care. In a recent national survey we conducted among physicians, nurses, and dietitians, the greatest difficulty in the treatment of a chronic disease was reported to be "a lack of patient knowledge and understanding about his disease and its management." Even federal