A wealth of literature reflects the progress made in developing tools to monitor and improve the quality of health care. In developing countries, however, interest in the issue has been surprisingly low until recently. This is so, in spite of overwhelming published and anecdotal evidence of low quality of care in these countries .
In Ethiopia, health services are limited and of poor quality  and the country has extremely poor health status relative to other low-income countries. To solve this problem, the government has focused on improving the organization and quality of health services delivered to the population. This is because improving the poor quality of care delivered to patients is one of the strategies to reduce the burden of communicable diseases and plays a significant role in attaining the Millennium Development Goals (MDGs). This intention of the government was reflected in the 1993 health policy and the health sector development plans of the country. In such efforts towards improving quality of health care, patient satisfaction is integral component of health services provided to the population [3–11].
It is generally agreed that satisfaction data play significant role in the strategy and tactics health care providers use in delivering services for clients. In addition, measurement of patient satisfaction is increasingly playing important role in the growing push towards accountability among health care providers. It is also viewed as an established indicator of quality of care despite it was overshadowed by measures of organizational aspects in the quality of health care equation [12, 13].
Empathy, which is a core component of consultation, is often seen as crucial to the effective achievement of patient satisfaction in that it encapsulates sensitivity to both the informational and emotional aspects of communication . Even though, many standards and codes of practice refer to the importance of empathy in medical consultation, it is an aspect of practice which is too often overlooked [15, 16]. Non-verbal cues and languages convey information which words alone often do not. Providers who appear fully attentive, avoid distractions, smile, and sit on the same level as the patient all convey an important message of caring, listening, and empathy . Besides, studies have documented that patient enablement also plays a significant role in patients' overall satisfaction [17, 18]. It is also clear from the literature that although system aspects such as cost, access, availability and waiting time are related to patient satisfaction, they have always been identified as being less important than the human aspect of medical care. However, system factors asymmetrically guzzle much of the research topics regardless of their little contribution [4, 5]. This is particularly true in the case of developing countries such as Ethiopia where much of the scientific inquiries in the areas of patient satisfaction exclusively focus on organizational aspects [18–20].
Furthermore, established evidences depicted that even though technical aspect of care has its impact on satisfaction, it is through interpersonal communication that the technology of western world reaches the patients and curing occurs. In addition, it is recognized more than ever that the quality of health care for the 21st century is built on the premise that optimal health care can best be achieved in the context of long term relationship between providers and patients [1, 6]. However, the issue of patient-provider interaction and its effect on the quality of care rendered at health care facilities is often ignored in medical researches and rarely subjected to scientific inquiry. Therefore, this study aimed to assess patient satisfaction with health care provider interactions and its influencing factors among out-patients of six health centres in West Shoa, Central Ethiopia. Hence, the research question of this study was: "what are the major determinants of patient satisfaction with their health care provider interaction in resource poor settings such as public health centres in Central Ethiopia?"