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)

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

Dr. Bonnie Henry, provincial health officer, updates British Columbians about COVID-19 at a press conference earlier this week. (B.C. Government image)
B.C.’s 1st case of COVID-19 confirmed a year ago today

Here’s a look at some of the key dates in the province’s fight against the novel coronavirus

People skate on a lake in a city park in Montreal, Sunday, January 10, 2021. THE CANADIAN PRESS/Graham Hughes
The end of hugs: How COVID-19 has changed daily life a year after Canada’s 1st case

Today marks the one year anniversary of COVID-19 landing in Canada

Wet’suwet’en supporters and Coastal GasLink opponents continue to protest outside the B.C. Legislature in Victoria, B.C., on Thursday, February 27, 2020. THE CANADIAN PRESS/Chad Hipolito
‘We’re still in it’: Wet’suwet’en push forward on rights recognition

The 670-km Coastal GasLink pipeline was approved by B.C. and 20 elected First Nations councils on its path

A health-care worker prepares a dose of the Pfizer-BioNTech COVID-19 vaccine at a UHN COVID-19 vaccine clinic January 7, 2021. THE CANADIAN PRESS/Nathan Denette
Employers might be able to require COVID-19 vaccination from employees: B.C. lawyer

‘An employer must make the case’ using expert science, explains lawyer David Mardiros

The COVID-19 outbreak at the two Coastal GasLink workforce lodges has officially been declared over. (Lakes District News file photo)
COVID-19 outbreak at Coastal GasLink worksites declared over

In total, 56 cases were associated with the outbreak in the Burns Lake and Nechako LHAs

British Columbia Health Minister Adrian Dix looks on as Provincial Health Officer Dr. Bonnie Henry addresses the media during a news conference at the BC Centre of Disease Control in Vancouver B.C. (THE CANADIAN PRESS/Jonathan Hayward)
B.C. announces 485 new COVID-19 cases, fewest deaths in months

‘The actions we take may seem small, but will have a big impact to stop the virus,” urges Dr. Henry

Rodney and Ekaterina Baker have been ticketed and charged under the Yukon’s Civil Emergency Measures Act for breaking isolation requirements in order to sneak into a vaccine clinic and receive Moderna vaccine doses in Beaver Creek. (Facebook/Submitted)
B.C. couple accused of flying to Yukon to get COVID-19 vaccine to appear in court

If convicted, the pair could serve up to six months in jail

Grad student Marisa Harrington and her supervisor Lynneth Stuart-Hill say preliminary results from a study into the affects of stress on hospital nurses show an impact on sleep and heart variability. (Courtesy of Marisa Harrington)
University of Victoria study shows stress impact on B.C. nurses

Stress may be impacting sleep, heart health of hospital nurses in Victoria region

Sooke’s Amy McLaughlin holds Theodore, a bunny who will be going to a new owner in Nanaimo within the coming days if all goes will at an upcoming bunny play-date. (Aaron Guillen/News Staff)
Vancouver Island woman looking to hop into bigger space for bunny rescue operation

Amy McLaughlin has rescued more than 400 bunnies, pushing for the capacity to help more

Keith Thorpe/Peninsula Daily News
Search called off for small plane that went down in rough water south of Victoria

Plane bound for Port Angeles from Alaska believed to have one occupant, an Alaskan pilot

Royal B.C. Museum conservator Megan Doxsey-Whitfield kneels next to a carved stone pillar believed to have significance as a First Nations cultural marker by local Indigenous people. The pillar was discovered on the beach at Dallas Road last summer. Museum curatorial staff have been working with Songhees and Esquimalt Nation representatives to gain a clearer picture of its use. (Photo courtesy Royal BC Museum)
Stone carving found on Victoria beach confirmed Indigenous ritual pillar

Discussion underway with the Esquimalt and Songhees about suitable final home for the artifact

Join Black Press Media and Do Some Good
Join Black Press Media and Do Some Good

Pay it Forward program supports local businesses in their community giving

Former Vancouver Giants forward Evander Kane is seen here in Game 7 of the second round of the 2009 WHL playoffs against the Spokane Chiefs (Sam Chan under Wikipedia Commons licence)
Gambling debts revealed in details of bankruptcy filing by hockey star Evander Kane

Sharks left winger and former Vancouver Giants player owes close to $30 million total

Othman “Adam” Hamdan, pictured in front of Christina Lake’s Welcome Centre, was acquitted of terrorism related charges in 2017. He has been living in Christina Lake since November 2020. Photo: Laurie Tritschler
Man acquitted on terrorism charges awaits deportation trial while living in Kootenays

Othman Ayed Hamdan said he wants to lead a normal life while he works on his upcoming book

Most Read