For initial visits to a longitudinal-care internal medicine clinic, we elicited patients' requests for problems to be addressed, measured patients' assessments of request fulfillment, and determined correlates of request fulfillment. Patients rated all requests as fulfilled in 62 of 71 cases (87 per cent). Fewer pre-encounter patient-reported problems, discretionary features of the doctor-patient encounter including more time spent eliciting history of present illness, and greater completeness of laboratory testing were associated with request fulfillment.