The study objective was to determine patient satisfaction with physician assistants (PAs) in an emergency department (ED) fast track (FT). An additional goal was to determine if patients would be willing to wait longer to be seen primarily by an emergency physician (EP) rather than a PA. The study was conducted between March 1, 1999 and May 1, 1999 at a community hospital with an annual ED census of 48,644 patients; 18% are seen in the ED FT. All patients were seen primarily by a PA. An anonymous survey was given to patients at time of discharge. Patients rated their degree of satisfaction by placing an X on a 100 millimeter visual analogue scale. Patients also indicated if they would be willing to wait longer to be seen primarily by an EP rather than a PA. A total of 111 surveys were analyzed, for a response rate of 11%. Sixty-two patients (56%) were women and 49 men (44%), with a mean age of 28 years. Twenty-seven patients (24%) were younger than 18 years and required a legal guardian to complete the survey. The mean patient satisfaction score was 93 (95% CI: 90.27 to 95.73). Only 13 patients (12%) indicated they would be willing to wait longer to be seen primarily by an EP rather than a PA. Patients seen in an ED FT are very satisfied with the care rendered by a PA. Few patients would be willing to wait longer in such a setting to be seen primarily by an EP.