The concept of professionalism is not unique to medicine. However, medical professionalism has endured in its centrality to the identity of physicians. From the Hippocratic oath to more recent codes of ethics, medical professionalism is rooted in the well-being of the patient. Beyond this, physicians are expected to consider their actions vis-à-vis society and the systems in which they practise. These expectations are often referred to as the “social contract of medicine,” whereby physicians act in the best interests of their patients and society in exchange for privileges, such as professionally led regulation. Changes in practice and expectations of the public, of governments, and within the profession have begun to call into question the nature and scope of the social contract. Increasingly, there are suggestions that physicians may not always be holding up their end of the bargain.