Eight hundred patient visits to the walkin clinic of the Childrens Hospital of Los Angeles were studied by means of tape recording the doctor-patient interaction and by follow-up interview. Seventy-six percent of the patient visits resulted in satisfaction on the part of the patient's mother; in 24% there was dissatisfaction. A number of communication barriers between pediatrician and patient's mother were found to contribute significantly to patient dissatisfaction: notably lack of warmth and friendliness on the part of the doctor, failure to take into account the patient's concerns and expectations from the medical visit, lack of clearcut explanation concerning diagnosis and causation of illness, and use of medical jargon.