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Japan is facing an extraordinary rapid ageing rate: approximately 40% of people will be≥ 65 years of age in 2060. 1 The Japanese Ministry of Health, Labour and Welfare (MHLW) have highlighted the importance of primary care physicians for coping with the ageing population and reducing healthcare expenditure. 2 However, a range of stakeholders such as MHLW and the Japan Medical Association (JMA) have been debating the necessity of family medicine as a medical discipline in the Japanese healthcare system. We examined the necessity of family medicine based on the existing discussion in the Japanese healthcare system and propose future research in this area.

The main characteristics of the healthcare system in Japan are universal health insurance and a free-access system, whereby patients are free to choose any healthcare facility, regardless of their insurance status or severity of illness. 3 All residents of Japan including foreign nationals with a residence card are required by law to be enrolled in a health insurance programme. 4 The free-access system allows patients to visit a hospital directly without referral from a family physician. 3 Although the Japanese healthcare system has achieved better healthcare outcomes, such as long life expectancy and low infant mortality, it is facing two major challenges: financial sustainability of the system and a rapidly ageing population. 3 Therefore, the MHLW has emphasised strengthening primary care.