Patient satisfaction with general practitioners (GP) and pulmonary outpatient clinics has not been previously compared in patients with asthma and chronic obstructive pulmonary disease (COPD) in addition to the effect of patient education on this satisfaction. We randomly allocated 78 asthmatics and 62 patients with COPD after ordinary outpatient management to a control or an intervention group. Intervention consisted of educational group sessions and individual sessions administered by a trained nurse and physiotherapist. A self-management plan was developed. A patient satisfaction questionnaire was answered at baseline and at the 1-year follow-up. Before randomization, a higher proportion of asthmatics were satisfied with the overall handling of their disease by the outpatient clinic (86%) compared with their GPs (72%, P=0.027, chi2-test). Equal and high proportions of patients with COPD were satisfied with both their GPs (85%) and the outpatient clinic (87%) and in general seemed more satisfied with their GP than asthmatics (P=0.064). At the 1 year follow-up, 100% of the educated patients with COPD reported overall satisfaction with GPs compared with 78% in the control group (P=0.023), but not for asthmatics (75 and 78%, respectively, P=0.581). We conclude that before being given education, asthmatics are more satisfied with the pulmonary outpatient clinic than with GPs, regarding the overall handling of their disease. Patients with COPD seemed more satisfied with GPs than asthmatics. For patients with COPD, patient education seemed to improve overall patient satisfaction with GPs, but this was not true for asthmatics. At baseline, overall satisfaction with the outpatient clinic was so beneficial that we had little chance of detecting any improvement.