For a retrospective cohort study, the researchers wanted to determine if there was a link between preoperative depression and patient experience in patients who had cervical spine surgery. In the United States, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used to assess patient satisfaction, and its results have a direct impact on reimbursement. Although it was well-known in the literature that untreated depression was linked to worse patient-reported outcomes in cervical spine surgery, no previous research had looked into the link between depression and patient satisfaction in the patients. A tertiary care facility collected HCAHPS survey results from patients who had cervical spine surgery between 2013 and 2015. Patients’ responses to the HCHAPS survey were connected to demographic information as well as patient-reported quality of life (QOL) indicators such as the Patient Health Questionnaire, EuroQol 5 Dimensions index, and Visual Analog Scale for Neck Pain. Preoperative depression was defined as a score of 10 or more than 10 on the PHQ-9 (moderate to severe depression). The relationship between preoperative depression and top-box scores on numerous components of the HCAHPS survey was investigated using univariable and multivariable analysis. Depressed patients were on average younger, had higher preoperative neck pain scores, and had a lower health-related QOL in the researcher’s 145-patient sample. Patients who were depressed were less likely to respond positively to questions on doctor respect (P=0.020) and doctors listening (P=0.030). After controlling for confounders, multivariable logistic regression analysis revealed that patients with preoperative depression were less likely to feel appreciated by their doctors (odds ratio=0.14, 95% confidence interval: 0.02–0.87, P=0.035). Preoperative depression was found to have a negative relationship with patient views of clinician communication as judged by the HCAHPS survey in patients undergoing cervical spine surgery. The findings pointed to depression as a risk factor for patients having a difficult time interacting with their spine surgeon.