Abstract Revisiting debates about philosophical approaches in medical geography suggests that logical positivism may have been prematurely discarded. An analysis of authoritative texts in medical geography and their sources in human geography shows that logical positivism has been conflated with Comtean positivism, science, empiricism, quantification, science politics, scientism and so on, to produce the “standard version” of the all-purpose pejorative “positivism”, which it is easy to dismiss as an evil. It is argued that the standard version fails to do justice to logical positivism, being constructed on sources which are at some distance from the logical positivist movement itself. An alternative approach is then developed, an historically and geographically situated interpretation of logical positivism as a deliberately and knowingly constructed oppositional epistemology within an oppressive and anti-scientific culture predicated on idealist intuitionism. Contrasting the standard version with this alternative reading of logical positivism suggests that much may have been lost in human, and thus, medical geography, by throwing out the logical positivist baby with the “positivism” bath water. It is concluded that continuing to unpack the standard version of logical positivism may identify benefits from a more nuanced appreciation of logical positivism, but it is premature to take these to the level of detailed impacts on the kinds of medical geographies that could be done or the ways of doing them.