How do you want your doctor to dress? White coat? Suit and tie? Open shirt and jeans? Skirt? Slacks? Sneakers?

Or does it matter at all? You decide.

It can be an issue among doctors -- and some patients. It has been an issue this year in the Journal of the American Medical Association.

A group of Boston and San Francisco researchers -- the same ones who asked patients whether they wanted to be called by their first or last names -- took up this issue, too. We've reported on this before, briefly, in the Health section, but it has been getting further attention. ::

These investigators asked their questions in two teaching hospitals where the residents and interns who gave most of the care variously (and depending on gender) wore white coats, suits and ties, open-necked shirts, dresses, jeans and either dress shoes or sneakers.

Some patients cared how their doctors looked. Some didn't. Of 200 questioned (in round numbers, which sometimes total over 100), 65 percent thought their doctor should wear a white coat (13 percent disagreed, 29 percent didn't care); 52 percent thought physicians shouldn't wear jeans (43 percent thought it O.K., 15 percent had no opinion); 37 percent thought male doctors should wear neckties (33 percent disagreed, 31 percent had no opinion).

Forty-eight percent found sneakers acceptable (27 percent disagreed, 27 percent had no opinion). Only 34 percent thought women doctors should wear dresses or skirts (while 27 percent disagreed and 40 percent didn't care).

The upshot? The results aren't clear.

The poll dealt only with reactions to how an "intern, resident or medical student {who} is seeing you" should dress, not the way a patient might expect to find a doctor dressed in a private office or clinic. The questions were also poorly worded; they sought responses to strong positive statements one way or the other -- for example, "tennis shoes are acceptable wear for a doctor who is seeing you" -- instead of asking in a more neutral way, "Which do you prefer, tennis shoes or dress shoes?"

Still, a lot of patients did care about these things, one way or the other. And the less affluent -- those who didn't have health insurance -- were more likely to want their doctors to dress well. Go into any clinic treating poor patients, and you're likely to see more physicians dressed informally than you'd see in private doctors' offices. Sure, the private doctors have more money to dress well. But I remember once seeing a study that showed that patients at a clinic in a poor neighborhood in New York preferred doctors who dressed well and drove good-looking cars, just like the doctors who cared for the rich.

A witness to this event told me how "a group of medical students -- juniors and seniors -- decided to start a free clinic in a poor Puerto Rican area in Buffalo. They went door to door first to see if the clinic would be welcome. They went in their jeans, and many of the residents refused to let them come in because "they didn't look like doctors." ::

Doctors have since written the medical journal with varying opinions and reports of differing results.

Doctors at Los Angeles Children's Hospital confronted adolescent patients with a group of physicians "randomly dressed in four styles from jeans to suit and tie." The adolescents were asked to report their "comfort level" with each doctor and their preferences about dress.

Forty-three percent said dress made no difference to them; 26 percent voted for a white coat, 14 percent liked pants and shirts, 10 percent preferred jeans, only 4 percent preferred suit and tie.

Dr. Anastassios Koumbourlis of St. Agnes Hospital in Baltimore objected strenuously to the San Francisco and Boston doctors' recommendation that physicians should "adopt conservative habits to avoid displeasing a substantial segment of the population."

The majority of their patients were middle-aged and older, she pointed out, while "adolescents and teen-agers usually feel more comfortable with somebody who dresses like them," and "children often perceive the white coat as threatening." Also, she said, "it would be more beneficial if physicians attempted to make patients aware of some of the realities" doctors face . . . "Everybody who has been through a residency knows that neckties, regular shoes or dresses, while they do not contribute anything to one's performance, are highly impractical for a 24-hour or 36-hour working shift . . . As for advice to house officers: They should learn how to be good physicians, not just how to look like good physicians." ::

Some University of Louisville researchers made 12 photographs of men and women, dressed in various ways, and showed them to 90 patients, asking them to choose which doctor they would prefer to see, based on appearance.

Three fourths said dress did influence them. Nearly all attached importance to a white coat. Few took offense at slacks, sneakers or presentable jeans. But about a third were put off by either worn, faded jeans or business suits -- or beards. "However" -- a big however -- "overall neatness was of more concern than specific items of dress."

Also: "All patients commented on the physician's demeanor. Facial expression overrode concern over attire. Of the 12 photographs, a majority of patients selected one of two individuals as their primary choice. Both had pleasant expressions and wore white coats, but neither wore a tie.

"One of the two wore a sport shirt, dress jeans, white socks and running shoes. Our impression was that it is not necessary to dress in traditional conservative fashion, but to be somewhat casual, wear a white coat, and have an overall clean, neat appearance, displaying confidence and concern."

I vote for that. I hope my doctors will always look like that. But I couldn't do it all the time. So I hope my doctor will do it most of the time. ::

All right, I guess I myself expect a doctor to look pretty professional -- either white coat or suit or shirt and tie or, for a woman, suit or slacks -- most of the week. I don't care much how he or she looks if I'm ailing on a weekend or evening. I think appearance may sometimes indicate how much respect a doctor has for the medical calling -- and for patients. I remember virtually fleeing once from a doctor with dirty fingernails. ::

One more view:

In his humorous new book, "Kill as Few Patients as Possible" ($7.95, Ten Speed Press), Dr. Oscar London tells of the bar mitzvah where a "stricken salesman fell to his knees, clutching his throat."

A young Dr. Shapiro swiftly performed a successful Heimlich maneuver to dislodge the food he was choking on, saving his life.

"When the salesman regained consciousness," however, "he looked up at his young savior and cried, 'Get me a doctor.'

" 'But I am a doctor,' protested Shapiro.

" 'Get outa here,' said the salesman. 'You're wearing a polyester suit and a floral-print tie and you call yourself a doctor?' "