This study examines the relative roles of external recommendations and internal satisfaction in influencing patient loyalty to physicians in India. The results indicate that recommendations result in preliminary loyalty formation by the patient toward the physician, but only until the patient formulates individual loyalty based upon their own personal experiences. At that point, the significance of external sources of recommendation in the determination of patient loyalty becomes insignificant. Physicians should strive at fostering bonds of emotional attachment in their present patients so they become strongly loyal and spread positive word-of-mouth, which, in turn, may result in new patients to the physician.