Notes that the establishment and maintenance of long-term relationships with consumers is an important focus of marketing activities in many organizations. Examines gender differences in satisfaction and loyalty as influenced by the passage of time in a high-involvement service setting. The study was based on a survey of 150 women and 133 men at two separate time periods - immediately after receiving a health care service and again two years later. The results indicate that overall satisfaction and behavioral intentions declined between the initial time of the service encounter and the time of the follow-up survey for both men and women. However, women also experienced a decrease in composite satisfaction, as well as satisfaction with the physician, nursing staff, privacy and pain control, room, and surgery, whereas men only reported a decline in satisfaction with the physician and nursing staff.