Patient satisfaction has become a significant component of health care outcomes and an increasingly important component of quality assessment. Selecting the appropriate methods to measure patient satisfaction is a critical challenge for health care managers, yet, there is limited knowledge of the methods used to develop patient satisfaction instruments. In this brief report, we provide insights into the development of a patient satisfaction instrument for outpatient care at the Duke Private Diagnostic Clinic (PDC). We surveyed the 12 medical directors and asked them to rate 15 concept areas for inclusion in an outpatient satisfaction survey. We then constructed a patient satisfaction survey by drawing selected subscales from the publicly available PSQ-18 (Patient Satisfaction Questionnaire) and CAHPS (Consumer Assessment of Health Plans) surveys to address the seven highest rated concept areas: 1) general/overall satisfaction; 2) courteousness of office staff; 3) courteousness of physicians; 4) doctor/patient communication; 5) professionalism; 6) ease and time to get appointment; and 7) technical quality of care.