Traditionally, health care quality has been provider defined and focused, even though consumers define and evaluate health care quality. And, there is no relationship between consumer and provider perceptions of quality. Importantly, consumers use their evaluations when they decide to sue, recommend or return for services, and comply with treatment regimens. This article examines the changing role of the consumer in health care quality, explicates the need for a change in the health care paradigm, and suggests strategies for increasing patient participation in health care planning and quality assessment.