given its rapidly evolving population health care needs and fiscal constraints mexico should develop primary care as a distinct medical speciality it would be worth investing serious effort to develop a national vision for primary care to counter any misconception that primary care is merely health care for the poor or marginalised in defining a new speciality of primary care the most important task will be to distinguish the current cohort of physicians working as community generalists who do not have substantial specialist postgraduate training from future primary care specialists this distinction should be unambiguously evident to patients and other health care professionals and be based upon extended knowledge skills roles and responsibilities