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.
 R. Ding, M. L. McCarthy, J. S. Desmond, et al., “Characterizing Waiting Room Time, Treatment Time, and Boarding Time in the Emergency Department Using Quantile Regression,” Academic Emergency Medicine, Vol. 17, No. 8, 2010, pp. 813-23. doi:10.1111/j.1553-2712.2010.00812.x
 T. A. Bruce, J. M. Bowman and S. T. Brown, “Factors That Influence Patient Satisfaction in the Emergency Department,” Journal of Nursing Care Quality, Vol. 13, No. 2, 1998, pp. 31-37. doi:10.1097/00001786-199812000-00005
 B. H. Rowe, X. Guo, C. Villa-Roel, et al., “The Role of Triage Liaison Physicians on Mitigating Overcrowding in Emergency Departments: A Systematic Review,” Academic Emergency Medicine, Vol. 18, No. 2, 2011, pp. 111-112. doi:10.1111/j.1553-2712.2010.00984.x
 T. C. Chan, J. P. Killeen, D. Kelly and D. A. Guss, “Impact of Rapid Entry and Accelerated Care at Triage on Reducing Emergency Department Patient Wait Times, Lengths of Stay, and Rate of Left without Being Seen,” Annals of Emergency Medicine, Vol. 46, No. 6, 2005, pp. 491-497. doi:10.1016/j.annemergmed.2005.06.013
 M. F. Kamali, A. Jain, M. Jain and S. M. Schneider, “Patient with Access to Primary Care Call Their Doctors before Coming to the Emergency Department with Lower Acuity Illness,” Annals of Emergency Medicine, Vol. 58, No. 4, 2011, p. S234. doi:10.1016/j.annemergmed.2011.06.196
 R. W. Rosmulder, J. J. Krabbendam, A. H. Kerkhoff, et al., “‘Advanced Triage’ Improves Patient Flow in the Emergency Department without Affecting the Quality of Care,” Nederlands Tijdschrift Voor Geneeskunde, Vol. 154, 2010, p. A1109.
 D. Ng, G. Vail, S. Thomas and N. Schmidt, “Applying the Lean Principles of the Toyota Production System to Reduce Wait Times in the Emergency Department,” Canadian Journal of Emergency Medicine, Vol. 12, No. 1, 2010, pp. 50-57.