Considerable disagreement exists regarding whether emotions are an important aspect of intuition.
60,61 Some authors suggest that affections may have a direct influence on intuitive thinking
60,62 or that intuitive processes may be facilitated by emotions.
60,63 The reliability of intuitive responses may be influenced by the emotional state of the practitioner toward his or her patients.
9,64 Hence, it may be unrealistic to consider that diagnostic reasoning relies only on objective judgements without emotions.
9,64 For example, a practitioner's lack of clinical empathy, an essential element of quality care,
65,66 can substantially influence medical decision making in that practitioners may underappreciate a patient's needs, leading to suboptimal decisions regarding management and care.
67 Within the context of osteopathic patient-centered care, a few studies
68-70 found that empathy in osteopathic medical students grows or does not decline during progression through training. However, one study
71 suggested that empathy among osteopathic medical students does decline.