OBJECTIVES: Very few studies have attempted to document differences in patient satisfaction between first and return visits. Therefore, we examined the differences in patient satisfaction with their primary care physician at first visit compared to return visits. METHODS: We conducted a cross-sectional national web based survey study consisting of anonymous patients rating their physicians on the basis of treatment satisfaction received from their most recent outpatient visit. The user-friendly validated survey was designed to help patients identify their physicians as per specialties and rate them on a scale of 0 (“not at all satisfied”) to 10 (“extremely satisfied”). The association between satisfaction with primary care physician and patient ratings of total care between first visit and return visits was accessed using robust regression analysis. RESULTS: A total of 9974 patients who rated physicians belonging to the categories of first visit and return visits were included in this study. Other things being equal, return visits have a sizable effect on patient satisfaction. For unit change from first to return visits the coefficient of patient satisfaction for the return visits was 10.5 higher than that of the first visit (p<0.000). We tested the null that the coefficient on the number of visit is equal to zero.  We rejected the null hypothesis that the coefficient on the number of visits dummy variable is equal to zero (p<0.000). CONCLUSIONS: Our study finds that return visits are associated with higher patient satisfaction than first visit. Furthermore, the dummy variable of the number of visit explains patient satisfaction score well.