VIDEO: Is the stethoscope dying? High-tech options pose threat

World-renowned cardiologist believes the device is just a pair of ‘rubber tubes’

A page from a 1869 catalog of instruments and medical supplies with diagrams of various models of stethoscopes. (National Library of Medicine via AP)

Two centuries after its invention, the stethoscope — the very symbol of the medical profession — is facing an uncertain prognosis.

It is threatened by hand-held devices that are also pressed against the chest but rely on ultrasound technology, as well as artificial intelligence and smartphone apps that help detect leaks, murmurs, abnormal rhythms and other problems in the heart, lungs and elsewhere. Some of these instruments can yield images of the beating heart or create electrocardiogram graphs.

Dr. Eric Topol, a world-renowned cardiologist, considers the stethoscope obsolete, nothing more than a pair of “rubber tubes.”

It “was OK for 200 years,” Topol said. But “we need to go beyond that. We can do better.”

In a longstanding tradition, nearly every U.S. medical school presents incoming students with a white coat and stethoscope to launch their careers. It’s more than symbolic: Stethoscope skills are still taught, and proficiency is required for doctors to get their licences.

Over the last decade, though, the tech industry has downsized ultrasound scanners into devices resembling TV remotes. It has also created digital stethoscopes that can be paired with smartphones to create moving pictures and readouts.

Proponents say these devices are nearly as easy to use as stethoscopes and allow doctors to watch the body in motion and actually see things such as leaky valves. “There’s no reason you would listen to sounds when you can see everything,” Topol said.

At many medical schools, it’s the newer devices that really get students’ hearts pumping.

Those at the Indiana University’s medical school, one of the nation’s largest, learn stethoscope skills, but also get training in hand-held ultrasound in a program launched last year by Dr. Paul Wallach, an executive associate dean. He created a similar program five years ago at the Medical College of Georgia and predicts that within the next decade, hand-held ultrasound devices will become part of the routine physical exam, just like the reflex hammer.

The devices advance “our ability to take peek under the skin into the body,” he said, though he added that, unlike some of his colleagues, he isn’t ready to declare the stethoscope dead.

He envisions the next generation of physicians wearing “a stethoscope around the neck and an ultrasound in the pocket.”

READ MORE: B.C. researcher gets $1.08 million to study the link between sugar, immune cells and cancer

Modern-day stethoscopes bear little resemblance to the first stethoscope, invented in the early 1800s by Frenchman Rene Laennec, but they work essentially the same way.

Laennec’s creation was a hollow tube of wood, almost a foot long, that made it easier to hear heart and lung sounds than pressing an ear against the chest. Rubber tubes, earpieces and the often cold metal attachment that is placed against the chest came later, helping to amplify the sounds.

When the stethoscope is pressed against the body, sound waves make the diaphragm — the flat metal disc part of the device — and the bell-shaped underside vibrate. That channels the sound waves up through the tubes to the ears. Conventional stethoscopes typically cost under $200, compared with at least a few thousand dollars for some of the high-tech devices.

But picking up and interpreting body sounds is subjective and requires a sensitive ear — and a trained one.

With medical advances and competing devices over the past few decades, “the old stethoscope is kind of falling on hard times in terms of rigorous training,” said Dr. James Thomas, a cardiologist at Northwestern Medicine in Chicago. “Some recent studies have shown that graduates in internal medicine and emergency medicine may miss as many of half of murmurs using a stethoscope.”

ALSO READ: Ottawa spending $24.5M to research health benefits, risks of pot use

Chicago pediatrician Dr. Dave Drelicharz has been in practice for just over a decade and knows the allure of newer devices. But until the price comes down, the old stalwart “is still your best tool,” he said.

“During my work hours in my office, if I don’t have it around my shoulders,” he said, “it’s as though I was feeling almost naked.”

The Associated Press

Like us on Facebook and follow us on Twitter

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

BUSINESS BUZZ: Rising from the ashes, city eyes up to $200M in projects

Darren Davidson’s monthly column about business in Nelson

NDP acclaims Brittny Anderson as Nelson-Creston candidate

The provincial election will be held on Oct. 24

Nelson plans major renovation to Civic Centre as part of COVID-19 stimulus plan

Project would upgrade energy efficiency and provide a concourse to access all parts of the building

Without federal aid, the future of B.C. air transport is bleak

Air traffic remains down 75 to 85 per cent

Go By Bike Week hits the road in Nelson

The event runs Sept. 28 to Oct. 4

Liberals vow wage-subsidy extension to 2021, revamp of EI system in throne speech

Canadian labour market was hammered by pandemic, when lockdowns in the spring led to a loss of 3 million jobs

‘It’s a boy’: Southern Resident killer whale calf born to J Pod is healthy, researchers say

J35 had previously done a ‘Tour of Grief,’ carrying her dead calf for 17 days

People ‘disgusted’ by COVID-19 election call, B.C. Liberal leader says

Andrew Wilkinson speaks to municipal leaders from Victoria

Incumbent MLA ‘disappointed’ premier has called snap election

Doug Clovechok will be seeking re-election on Oct. 24.

Is it time to start thinking about greener ways to package cannabis?

Packaging suppliers are still figuring eco-friendly and affordable packaging options that fit the mandates of Cannabis Regulations

Join Black Press Media and Do Some Good

Pay it Forward program supports local businesses in their community giving

Horgan blasts B.C. Greens for refusing youth overdose detention

Lack of support key to B.C. election call, NDP leader says

Canada’s active COVID-19 cases top 10,000 as daily new cases triple over the past month

Dr. Tam repeated her warning to young people, who have made up the majority of recent cases

Grand jury indicts police officer in Breonna Taylor death

Officer Brett Hankison was charged with three counts of wanton endangerment

Most Read