Family medicine is a linchpin of most successful health systems in the industrialized world, and is increasingly being seen as crucial in the current distressed financial climate. Japan has not had a robust family medicine infrastructure, but recently has begun to develop family medicine in several locations around the country. However, few of these programs are adequately training the type of family physicians Japan needs. This article discusses the background of what family medicine entails, an example of what a successful family medicine university program can do, and the potential benefits to Japan in adopting true family medicine.