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Most patients have explicit desires or requests when they visit their physicians. Identification of patients' requests and needs is the starting point of a patient-centered approach to care. The frequency with which physicians met their patients' desires for services and that frequency's association with patient satisfaction were examined for 243 patients with chronic disease in general medicine clinics of a Department of Veterans Affairs hospital. Patients desired a mean of 11.9 services, of which an average of 67 percent were met. However, many patients' desires for information and most of their desires for help with emotional and family problems were not met. Patients with the most unmet desires for services, especially services related to information, were significantly less satisfied with their physicians than were those with fewer unmet desires. Factor analysis was used to develop a short, 16-item Requests for Services Questionnaire that appeared to cover the range of services that patients with chronic conditions desire. Enhancing physicians' ability to recognize and respond to patients' desires for services by using short patient request questionnaires may have the potential to improve patient satisfaction and other health care outcomes.