A recent CMAJ editorial stated that it may be difficult to overcome the “culture of entitlement” in which physicians believe that they are entitled to receive the pharmaceutical enticements that accompany continuing medical education.¹ The editorial went on to suggest that “we need to disentitle physicians and adopt a more principled approach.”¹ Many physicians have long since recognized that neither we nor the pharmaceutical industry benefit from continuing medical education that in any way resembles product marketing. Most of us prefer continuing medical education opportunities that focus on a disease-related issue and that use techniques demonstrated to be effective for adult learning.

The tone of the editorial was disturbing, particularly given the clear culture of entitlement apparent on the part of medical journals that rely on the pharmaceutical industry for their existence. In the 174-page issue of CMAJ in which this editorial appeared, there were 79 pages of pharmaceutical advertising and 42 pages of research or educational material. Perhaps it is time that medical journals recognize the necessity for “… a radical change in [their] approach to funding.”¹ Would CMAJ's editors be willing to argue that pharmaceutical advertising should be completely banned from the Journal to change that culture of entitlement? This represents a clear double standard. Perhaps it is time for CMAJ to lead by example.