Increasing consumerism poses many challenges for health care providers, particularly for those in primary care. Quality improvement to meet patients' heightened demand for service excellence will require effective, continuous measurement of patient perceptions. The study described in this article evaluated the psychometric properties of a new instrument designed to survey patients' experiences with the delivery of primary care and assessed the factors that contribute to patient retention and likelihood to return. By systematically measuring patient satisfaction and perceptions of quality, medical practices can increase the effectiveness of primary care, improve patient outcomes, and control costs.