OBJECTIVES: Although the relationship between physician waiting times and patient satisfaction has been examined, the influence of subsequent time spent with the physician on this relationship yet remains to be explored. This study examined the relationship between patient waiting times, time spent with the physician, and patient satisfaction ratings with primary care physicians. METHODS: Cross-sectional survey data on a sample of 5,030 patients who rated their physicians on a web-based survey developed to collect detailed information on patient experiences with health care. The survey included self-reported information on wait times, time spent with physician, and patient satisfaction. RESULTS: Longer waiting times were associated with significantly lower patient satisfaction (p<0.05); however, time spent with the physician was the strongest correlate of satisfaction with physician (partial rho=0.51, p<0.001). The decrement in satisfaction associated with long waiting times is substantially reduced with increased time spent with the physician (5 minutes or more). Importantly, the combination of long waiting time to see the physician and having a short physician visit is associated with very low overall patient satisfaction. CONCLUSION: The time spent with the physician is a stronger predictor of patient satisfaction than the time spent in the waiting room. These results suggest that shortening patient waiting times at the expense of time spent with the patient to improve patient satisfaction scores would be counter-productive.