To evaluate the expectations of patients and parents regarding physicians' attire, physicians in three clinics were dressed formally with a white coat and a necktie some of the time, and informally, in street clothes, the remaining times. Interviews were conducted with the children and parents. Prior to the examination, 87 (55%) children wanted the physician to wear a white coat, 59 (37%) preferred casual attire, and the remaining 13 (8%) were indifferent. Of the 284 parents, 144 (51%) expected the physician to wear a white coat, 83 (29%) preferred casual attire, and 57 (20%) were indifferent. Following the examination of the 87 children who preferred a white coat, 16(18%) changed their minds, compared with 12 of 57 (20%) who preferred casual attire. Some 70% of patients 10 years or older wanted the physician to wear a white coat. Of the 284 parents, 144 (51%) preferred that the physician wear a white coat and 83 (29%) preferred casual attire. Preexamination parental preference was independent of the child's age. Following the examination, 13 of 103 parents changed their preference when the physician dressed according to their choice compared with 40 of 106 when the physician's attire was different from the initial preference (χ2 = 10.5, p = 0.0012). The change of preference was unrelated to the child's age, but was more pronounced among parents who preferred a white coat prior to the examination. To evaluate the perception among physicians regarding the preferred dress style during the examination of young children, a short questionnaire was sent to 165 physicians. Of these, 137 (83%), 70 males and 67 females, completed the questionnaire. Forty-nine (36%) never wear a white coat, 44 (32%) wear a white coat at least some of the time, and 44 (32%) always wear a white coat. Many physicians (66%) strongly believe that their attire affects the physician-patient relationship. However, they are almost evenly split as to those who believe that casual attire is the right one, and those who believe that formal attire is proper. Although there is no consensus as to which is the more appropriate attire, physicians of both philosophies believe that this is an important issue. The study also demonstrates that although many factors influence the physician-patient relationship, the physician dress style creates the initial impression, and many parents and older children prefer a formally dressed physician.