Primary care systems in South Korea and Japan: a comparative review

The primary care system (PCS) is an essential national health infrastructure defined by the delivery of comprehensive, integrated, and accessible services that serve as the patient's first and sustained point of contact with the healthcare system. A comparative review was performed through searches of PubMed, KoreaMed, and J-STAGE databases using terms including "primary care," "general practitioner," "family physician," "gatekeeping," "Korea," and "Japan." Gray literature from the Japan Medical Association, Korea Medical Association, and OECD (Organisation for Economic Co-operation and Development) was also reviewed. Clinical case examples from one author's practice were included to illustrate real-world general practitioner (GP) challenges. Both Japan and South Korea feature universal health insurance but differ substantially in physician training pathways, gatekeeping enforcement, and community care integration. Japan is transitioning toward a kakaritsuke-i (registered home doctor) model with a nascent GP specialty board, whereas South Korea relies primarily on specialist-led private clinics for primary care delivery. International evidence suggests that structured, continuous family physician (FP) training is associated with improved chronic disease management, preventive care utilization, and patient satisfaction. Strengthening South Korea's PCS requires a clearly defined mandatory FP residency framework, reinforced gatekeeping mechanisms, and greater investment in community-based integrated care. Japan's ongoing reforms offer a useful regional comparator, while international FP models provide a proven evidence base for structural improvement.