Two networks of medical care have grown up in Japan: 1 network based in hospitals and 1 based in private clinics. Most physicians in clinics practice general medicine, although only a small proportion of them are trained in primary care. Postgraduate medical education is oriented toward the training of specialists. Owing to the impending retirement of the cohort of clinic-based physicians who have dominated medical politics in Japan, the system is expected to change substantially in the next decade. Among the reformers is a small group of physicians who are attempting to introduce family practice.