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

A second wave of COVID-19 is probable, if history tells us anything

B.C.’s top doctor says that what health officials have learned this round will guide response in future

Water recovery team stands down search for missing man in Stellako River

Jason Bouchard was in a boat with a friend that overturned in the river May 16

COVID-19: PG Community Foundation to disperse community support funds

$197,630 in funding announced by the Prince George Community Foundation

CGL workforce will gradually increase to 650 workers by end of May

The pipeline company provided a project update on May 21.

With wildfire season approaching, here are some tips to be ‘FireSmart’ this year

Q & A with Lindsay King, FireSmart Educator for the Regional District of Bulkley-Nechako

Kelowna man charged with harming a hamster

The 20-year-old Kelowna man faces several animal cruelty charges

High tech fish transport system set up to ‘whoosh’ salmon past Big Bar landslide

Fish will spend roughly 20 seconds inside the system, moving at roughly 20 metres per second

Trudeau to seek 10 days of paid sick leave for Canadian workers, says talks are ongoing

Paid sick leave is key to keeping COVID-19 spread under control, prime minister says

Snowbirds jets will not be leaving Kamloops, just yet

The Snowbirds have been in Kamloops since May 17 when a plane crashed killing Capt. Jennifer Casey

Introducing the West Coast Traveller: A voyage of the mind

Top armchair travel content for Alaska, Yukon, BC, Alberta, Washington, Oregon and California!

COVID-19 checkpoints ‘up to them,’ Bonnie Henry says of remote B.C. villages

Support local tourism economy, but only if you’re invited in

Vancouver Island hasn’t seen a new homegrown case of COVID-19 in two weeks

Island’s low and steady transmission rate chalked up to several factors

Eight people arrested in Victoria homeless camp after enforcement order issued

Those living in tents were given until May 20 to move indoors

Most Read