Background: To deal with emergency department crowding and long waits before patient care, many institutions have placed a doctor in the triage area to initiate treatment and testing. Objective: to determine the effect of a doctor in triage on patient satisfaction scores. Methods: This is an observational study comparing the patient satisfaction scores from days when a physician was in triage to days when a physician was not present. The study was conducted in the ED of an urban academic medical center with excellent primary care resources and payer mix (7% self pay, 11% Medicaid). Results: There was a mean of 4 (95% CI 3.1 - 4.5) surveys returned for each day when there was a doctor in triage and a mean of 5 (95% CI 4.3 - 5.7) surveys for each day without a doctor in triage. Overall satisfaction for the days with a doctor in triage was 79.9 ± 10.5 (95% CI 77.7, 82.1) compared to 78.8 ± 9.2 (95% CI 76.5, 81.1) (p = 0.9) on days without a doctor in triage. Conclusion: In this setting, there was no effect of a doctor in triage on patient satisfaction scores. While a doctor in triage may be valuable and cost effective in some settings, it may not provide appropriate benefit in all settings. We suggest that facilities trial a physician in triage program and measure predetermined outcomes such as patient satisfaction scores, length of stay and the percentage of patients left without being seen before investing in additional staffing and cost to sustain such a program.