OBJECTIVES We wanted to establish the gap between physicians’ and patients’ understanding of patient needs in a hospital setting. METHODS The study was run in the four of the Bulgarian Cardiac Institute clinics. We used questionnaires and within a period of two months, first we asked 30 physicians and 50 patients about what patient needs are according to their understanding. Based on the answers we defined 10 categories for each of the two groups. Then we asked 143 physicians and 500 patients to define which category is most and least important for them by using the Maximum Difference Scaling technique. RESULTS Courtesy, after discharge recommendations and information about the discharge drugs were the top three most important patient needs according to the patients. Life-saving activities, improvement of quality of life and improve the longevity were the top three most important patient needs according to the physicians. CONCLUSIONS There is a tremendous gap between patients’ and physicians' perceptions of patient needs. It is very hard for the hospitals to increase patient satisfaction relying on medical services only. Further research is needed to find ways to close that gap.