Patient loyalty is crucial for antenatal care (ANC) continuity, yet physician arrival punctuality remains a challenge. This study investigates the impact of physician punctuality on patient loyalty, with patient satisfaction as a mediating variable, at the Obstetrics and Gynecology Outpatient Clinic of RS Permata Bekasi. A sequential explanatory mixed-method design was employed. The quantitative phase involved a cross-sectional survey of 98 ANC patients using a Likert-scale questionnaire. Patient satisfaction was measured using non-tangible SERVQUAL dimensions. Data were analyzed using linear regression and mediation testing (Baron & Kenny, Sobel test). Qualitative interviews provided explanatory insights. Quantitative analysis demonstrated that physician arrival punctuality significantly influenced both patient loyalty (B=0.210; p=0.002) and patient satisfaction (B=1.798; p=0.000). Patient satisfaction significantly predicted loyalty. Furthermore, satisfaction fully mediated the relationship between punctuality and loyalty. The Sobel test produced a z-value of 4.72. Qualitative findings revealed that empathetic communication could mitigate negative perceptions of delays. Clear information delivery could also mitigate negative perceptions of delays. Professional conduct could further mitigate negative perceptions of delays. These findings reinforce satisfaction as the key mechanism. The results confirm that physician punctuality is important. However, its effect on loyalty is fully channeled through patient satisfaction. Qualitative data elucidate how positive interpersonal interactions can compensate for waiting times. Professional interactions can similarly compensate for waiting times. Therefore, fostering satisfaction through reliable service and empathetic communication is the primary pathway to building patient loyalty. This pathway remains effective even when punctuality challenges occur. Healthcare providers should prioritize enhancing patient satisfaction. This serves as a buffer against systemic punctuality issues.