Medical malls help provide integrated medical services and the effective and efficient independent management of multiple clinics, pharmacies and other medical facilities. Primary care in an aging society is a key issue worldwide and the establishment of a new model for primary care in Japanese medical malls is needed. Understanding the requirements of integrated management that contribute to the improvement of medical mall founders' satisfaction levels will help provide better services. We conducted a questionnaire survey targeting 1840 medical facilities nationwide; 351 facilities responded (19.1%). We performed comparative analyses on founders' satisfaction levels according to years in business, department/area, founder's relationship, decision‐making system and presence/absence of liaison role. A total of 70% of medical malls in Japan have adjacent relationships with no liaison role in most cases; however, 60% of founders are satisfied. Integrated management requirements involve establishing the mall with peers from the same medical office unit or hospital, and establishing a system in which all founders can participate in decision‐making (council system) or one where each general practitioner (GP) independently runs a clinic without communicating with others. The council system can ensure the capability of general practitioners to treat many primary care patients in the future. © 2016 The Authors. The International Journal of Health Planning and Management Published by John Wiley & Sons Ltd