Methodological discussions within healthcare research have traditionally described a methodological dichotomy between qualitative and quantitative methods. The aim of this article is to demonstrate that such a dichotomy presents unnecessary obstacles for good research design and is methodologically and philosophically unsustainable. The issue of incommensurability is not a question of method but rather a question of the philosophical premises underpinning a given method. Thus, transparency on the philosophical level is important for validity and consistency as well as for attempts to integrate or establish an interface to other research. I argue that it is necessary to make a distinction between methodology and philosophical assumptions and to ensure consistency in these correlations. Furthermore, I argue that the question of incommensurability is best answered at this basic philosophical level. The complexity of health care calls for methodological pluralism and creativity that utilises the strength of both qualitative and quantitative approaches. Transparency and consistency on the philosophical level can facilitate new mixed methods research designs that may be promising methodological assets for healthcare research. I believe we are ill served by fortified positions that continue to uphold old battle lines. Empirical research begins in the field of practice and requires a certain amount of pragmatism. However, this pragmatism must be philosophically informed.