Professional Attire Dress Codes for PharmD Programs Should Not Be Mandatory

To the Editor: I would like to thank Naughton and colleagues for their insightful article, “Expanding Dress Code Requirements in the Doctor of Pharmacy Program.”¹ Professionalism is extremely important in many practice settings, but it is particularly vital to health care professionals because it impacts both patient and health care colleague perceptions. Numerous schools of pharmacy have adopted varying levels of mandatory professional dress codes, including for didactic lectures. The article by Naughton and colleagues thoughtfully discusses in detail both the arguments for and against requiring professional dress codes across all PharmD programs. However, the authors took liberties to extrapolate conclusions beyond the published data, which do not correlate to the success of pharmacy students or their professional development. Additionally, there are many other aspects apart from attire that contribute to professionalism that are not enhanced by dress codes.

Professionalism is a multifaceted skill embodying the attributes, behaviors, commitments, values, and goals that characterize a profession, while attire is merely a symbol of professionalism.^1,2 A recent systematic review by Petrilli and colleagues examined patients’ perceptions of physicians based on their dress.³ The review concluded that patients’ perceptions of physicians were multifactorial and varied based on age, population, geographic location, and context.³ While patients initially preferred professionally dressed physicians in pictures, they did not take preference after having actual physician encounters.³ Petrilli and colleagues noted, “Sartorial style is skin-deep and not a surrogate for medical knowledge or competence; the best-dressed physicians are likely to fare poorly in the eyes of patients if medical expertise is perceived absent.”³ The same may be inferred to the pharmacy profession; it is intellect, effective communication, and professional behavior that is most important for patient perceptions and preferences of health care providers.

Many schools of pharmacy around the country require professional dress attire for students in experiential environments, such as during Introductory Pharmacy Practice Experiences and Advanced Pharmacy Practice Experiences. This requirement is logical because pharmacy students are representing their school and the profession while interacting with patients in the clinical setting. However, there is limited literature to support these dress codes in pharmacy or medical professional training settings. The articles highlighted by Naughton and colleagues supporting the implementation of a dress code focused mainly on individuals’ self-perception of intelligence and productivity outside of the pharmacy profession. Furthermore, these references lack evidence to support an improvement in academic or occupational performance. A cornerstone of pharmacy practice is using a consistent evidence-based approach to all activities and recommendations. Why then should all 135 pharmacy schools across the country be mandated to comply with a dress code with such limited evidence to support it? It would be similar to say that all practitioners should start treating their patients with diabetes to a new hemoglobin A1c goal based solely on a few case reports and expert opinion.

The knowledge, research, and communication skills that students acquire in pharmacy school are more important factors to academic and professional success than their attire. While some schools require professional dress throughout the entire curriculum, there is limited evidence to substantiate this mandate with regards to improving professional development. Schools of pharmacy should continue to focus on enhancing the quality and content of their curriculum rather than implementing a policy that would have only speculative success.

• © 2017 American Association of Colleges of Pharmacy