Introduction

The consequences of poor access and quality of healthcare services in developing countries are widely recognised by international agencies such as WHO.1 Moreover, with the HIV/AIDS pandemic wreaking havoc in sub-Saharan Africa, availability of trained physicians is essential for providing antiretroviral treatment to large numbers of individuals.2 Owing to emigration of physicians and nurses from developing countries, WHO has suggested codes for recruitment of health personnel by developed countries.3 The biomedical and social science issues surrounding the benefits of healthcare uptake for health outcomes are complex. It is therefore puzzling that Javier Hidalgo in his article4 dismisses the need for meticulous health policy formulation. Instead, he contrives a ‘defence’ for the practice of recruitment of healthcare workers by developed countries through a misleading interpretation of the evidence from country-level data presented by Bhargava and Docquier.5 It would be useful to proceed by outlining some methodological difficulties in investigating the links between physician emigration and population health outcomes.