This study examines the relationship between four variables and patient satisfaction in an emergency department setting in a small community hospital in Suffolk County New York. Patients were assessed utilizing four variables: communications with doctors, communications with nurses, communications with ancillary staff, and environment of ED care. The study adds to the literature on which factors have the greatest influence on patient satisfaction in an emergency department setting. The purpose of the present study was to explore how ED patient satisfaction was influenced by their communications with physicians, nurses, and ancillary staff. Pearson correlation coefficients resulted in a statistically significant correlation between all variables and patient satisfaction. Path analysis showed the interrelationship between the four variables and patient satisfaction. Regression analysis predicted the extent to which each variable influenced patient satisfaction. The strongest predictor of patient satisfaction was communications with ancillary staff.