Background: The concept of shared decision making received large research interest in the last decade. Patient participation in medical decisions is largely relevant in primary care, as this setting is characterized by the most frequent patient-clinician contact. Evidence on the impact of shared decision making on satisfaction with the primary healthcare provider is currently sparse. Objectives: The association of shared decision making and satisfaction with the primary care provider was investigated in a general population sample. Methods: Baseline data of a three arm cohort study was analysed. The sample consisted of 2000 participants. Psychometrically tested instruments were administered to asses patients’ preferences for being involved in medical decision making (Autonomy Preference Index; API), the involvement of patients in decision making (Shared Decision-Making Questionnaire; SDM-Q), the satisfaction with decisions (Decisional Conflict Scale; DCS), and the satisfaction with the primary care provider (self-constructed questionnaire). Structure equation modelling was used to explore multiple associations. A model was developed in a sub-sample and cross-validated in a confirmatory sample (split-half method). Demographic and medical characteristics were accounted for as possible confounders. Results: Shared decision making proved to predict higher satisfaction with the general practitioner. Half of the variance of patient satisfaction could be explained through patients’ preference for involvement, shared decision making, and quality of life. Conclusions: Shared decision making is associated with increased satisfaction with health care and thus may indicate a key concept in quality improvement strategies. However, findings of this study in a rural German region should be generalized to other countries and settings with caution. Acknowledgments: The project was conducted in cooperation with Gesundes Kinzigtal GmbH, Health Insurance Fund AOK Baden-Württemberg, Health Insurance Fund LKK Baden-Württemberg, and the Department of Medical Sociology, University of Freiburg.