The study aimed to illuminate different perspectives between public library users and librarians in perceiving the major challenges for consumer health information services and suggest how to reduce the gap between them. The study employed phenomenography, a qualitative approach, and conducted semi-structured intensive interviews with 40 public library users and 20 reference librarians at 12 public libraries in Florida and Maryland. Findings identified gaps between user needs and the assistance that librarians provide for them. Privacy issues affect the types of health information resources users prefer, where budget constraints influence the ones on which librarians focus. While traditional reference interviews stress clear communication between users and librarians, the present study underscores that non-verbal communication is crucial in helping users protect their privacy. Understanding the different perspectives of consumer health information services can provide insights for design and evaluation strategies of such service, and training and education of librarians and users.