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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

I read with interest the article by Barondess¹ regarding the pressures on professionalism in medicine and his suggested solutions. He frames professionalism as a social contract in which the primary value for the public social value has been eroded by internal and external pressures related to increasing complexity in health provision, especially with regard to fiscal restraint. His solution is to focus on improving individual physician awareness of professionalism.

I would argue that medical professionalism has to be framed within the broader context of a social construct in order to understand the ways in which it has inhibited quality provision of health care and in order to develop remedial strategies.

The utilitarian components of professionalism outlined by Barondess (such as competence, engagement, reliability, dignity, agency, and concern for quality) are necessary and commendable assets for provision of quality medical care. However, the fundamental problem with professionalism lies not in the . . . [Full Text of this Article]

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