Medical services for nursing homes have been in discussion in Iceland among primary care physicians, geriatricians and the general public the last few years. Physician responsibility for the care of patients in nursing homes is poorly defined, few quality measures are being used and no regular public quality control in use. In the article the authors describe their view on what constitutes a good medical service in nursing homes. The authors base their views on the nursing home literature, their experience and legal surroundings in Iceland. They recommend the use of RAI instrument as base for health promotion, surveillance of health and function. The article describes what physicians who take care of patients in nursing homes need to master.