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 post-graduate 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.