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Changes in the US healthcare system in the past 20 years have meant increasing pressure on consumers to find their own healthcare information. Their search, amid an ever‐widening array of information resources, has profound implications for library reference services. A recent study of 350 public librarians in Michigan is, to date, the only investigation of librarian practices in health information provision in a large region of the USA. Examines services, queries, problems, librarian training and health collection resources. The findings have special meaning for academic librarians as they delineate their unique role in the health information system and, with public librarians, seek to devise effective means for responsive library service in today’s competitive health information resources environment.

The competence of academic librarians promises to be a foremost issue for academic librarianship in the twenty‐first century. New subject specialties, unprecedented information technologies, and increasingly interdisciplinary university curricula and research mean ever‐faster outdating of the library science degree. Currently, within ten to 12 years of receiving their diplomas, academic librarians are estimated to be half as competent to meet professional demands as they were at graduation. Continuing education is, therefore, ever more vital in maintaining a staff of library professionals who are capable of providing continually relevant service to library users.