Seventy-five physicians at primary health care centers in Spain described their emotions and thoughts during interviews with frequent attenders. Emotion scales were developed by factor and reliability analysis. Positive emotions were associated with younger physician age and with the thought "This patient really needs me." Feelings of lack of control were associated with rural centers and with the thoughts "Oh my God, him/her again!" and "This patient is really a pain." Anxiogenic emotions were associated with greater workload, requests for tests, requests to see the doctor outside regular hours, and the thoughts "Oh my God, him/her again!" and "I think this patient is trying to use me." Guilt feelings were associated with a lower perceived ability to solve the patient's problem, and with a poor physician-patients relationship. Sadness was associated with more frequent referrals to specialists. Awareness and acceptance of their emotions may improve physicians' emotional intelligence and physician-patient relationships.