OBJECTIVES: This study examined patent's satisfaction with their physician. Patient satisfaction is a quality measure that affects treatment outcomes. More specifically it examines how perceived patients' perceptions of empathy from a physician affect patient satisfaction. METHODS: A cross-sectional Internet-based survey completed by patients visiting primary care physician offices resulted in a convenience sample of 20,901 patient respondents who rated their recent visit to a physician through a web-based survey. The survey included questions based on aspects of overall satisfaction with the physician care and office practice and more detailed items including demographics such as “friendliness”, empathy and time spent with doctor as well as areas that could be improved. These scales were then used to represent patient satisfaction. How “friendliness and caring” the physician was perceived to be was used as a measure of perceived empathy. RESULTS: Of the 20,901 patients surveyed from the online survey perceived empathy was the most strongly predominant correlate associated with patient satisfaction with their physician was that of empathy with a partial correlation of 0.87 (p<0.001) and a Pearson correlation of 0.92 (p<0.001). Patient satisfaction with the office setting was also highly correlated with empathy scores with a partial correlation of 0.72 (p<0.001) and a Pearson correlation of 0.83 (p<0.001). Other factors such as waiting time and problems with appointments, staff, records, parking doctor care, and ways of obtaining information also played a role in how the patients' perceived their overall satisfaction with the physician. CONCLUSION: The patient satisfaction ratings are strongly correlated to patient perception of empathy.