This study investigated the role of perceptions of service quality and sacrifice in patients attending the accident and emergency (A&E) departments with minor medical conditions that can be treated by their general practitioner (GP). Perceptions of service quality were measured using modified service quality performance indicators. Perceptions of monetary and non-monetary sacrifice were also captured. Questionnaire-based data were gathered prospectively through a random sample of adult patients who exhibited minor medical conditions at a UK teaching hospital A&E department. Service quality perceptions played a major part in the decision to attend A&E, whereas sacrifice perceptions did not. Perceptions of competence and credibility were the most important quality determinants and were rated higher for A&E than GP. Given that there were some misconceptions about the quality and nature of services each setting provides, recent reforms bringing about an ever-expanding range of healthcare service options may cause further confusion in patient decision-making.