In this paper, we outline a framework for understanding the different kinds of knowledge required for medical practice and use this framework to show how scientism undermines aspects of this knowledge. The framework is based on Michael Polanyi’s claim that knowledge is primarily the product of the contemplations and convictions of persons and yet at the same time carries a sense of universality because it grasps at reality. Building on Polanyi’s ideas, we propose that knowledge can be described along two (...) intersecting “dimensions”: the tacit–explicit and the particular–general. These dimensions supersede the familiar “objective−subjective” dichotomy, as they more accurately describe the relationship between medical science and medical practice. Scientism, we argue, excludes tacit and particular knowledge and thereby distorts “clinical reality” and impairs medical practice and medical ethics. (shrink)