The underlying positivist philosophy of medicine and the emphasis on 'knowing' can induce a shame response when doctors perceive they have failed. In contrast to guilt, shame affects the whole of the self and may diminish the doctor's ability to accept his or her own illness, respond to a disciplinary complaint, or consider clinical supervision. Consideration of the polarities of practice can help doctors respond to mistakes, errors, or wrongdoing with guilt rather than with shame. This places a perceived failure outside the self of the doctor, enabling restoration of relationships and learning from clinical experience. This will benefit both doctors and patients.