Literature on the potential implications of international trade in health services has focused only on the exchange of health care providers and patients across borders or mal-distribution of health resources across urban and rural areas (4, 5). An analysis of current trade patterns based on a ‘four modes of supply’ framework has focused on location and movement of suppliers and consumers; (4) however, this framework may be too simplified for health care professionals, especially physicians. The four modes – cross-border supply, consumption abroad, commercial presence, and movement of individual service providers – did not touch upon the production of suppliers, which is also included in the current context. No framework that integrates both pre- and post-production as well as migration of health care professionals in ASEAN has been proposed in the literature.