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

An aerial shot of Cedar Valley Lodge this past August, LNG Canada’s newest accommodation for workers. This is where one employee is still currently isolating after a COVID-19 outbreak was first declared on Nov. 19. (Photo courtesy of LNG Canada)
54 positive COVID-19 cases associated with LNG Canada site outbreak

There’s been a two-person increase in positive cases since Tuesday (Dec. 1)

K-J Millar/The Northern View
8 confirmed COVID-19 deaths in the Northern Health Authority

Since Nov. 27, there have been 191 new cases reported in NHA

A coal-fired power plant seen through dense smog from the window of an electric bullet train south of Beijing, December 2016. China has continued to increase thermal coal production and power generation, adding to greenhouse gas emissions that are already the world’s largest. (Tom Fletcher/Black Press)
LNG featured at B.C. energy industry, climate change conference

Hydrogen, nuclear, carbon capture needed for Canada’s net-zero goal

Victoria’s Royal Jubilee Hospital took in two COVID-19 patients from Northern Health as part of a provincial agreement. (Black Press Media file photo)
Victoria hospital takes in two COVID-19 patients from Northern Health

Royal Jubilee Hospital takes patients as part of provincial transport network

An aerial shot of Cedar Valley Lodge this past August, LNG Canada’s newest accommodation for workers. This is where several employees are isolating after a COVID-19 outbreak was declared on Nov. 19. (Photo courtesy of LNG Canada)
52 positive COVID-19 cases now associated with LNG Canada site outbreak

Eight cases still active, 44 considered recovered

Unofficial holidays: Here’s what people are celebrating for the week of Dec. 6 to 12

Mountain Day, Dewey Decimal System Day and Lard Day are all coming up this week

Demonstrators, organized by the Public Fishery Alliance, outside the downtown Vancouver offices of Fisheries and Oceans Canada July 6 demand the marking of all hatchery chinook to allow for a sustainable public fishery while wild stocks recover. (Public Fishery Alliance Facebook photo)
Angry B.C. anglers see petition tabled in House of Commons

Salmon fishers demand better access to the healthy stocks in the public fishery

(Hotel Zed/Flytographer)
B.C. hotel grants couple 18 years of free stays after making baby on Valentines Day

Hotel Zed has announced a Kelowna couple has received free Valentines Day stays for next 18 years

Farmers raise slogans during a protest on a highway at the Delhi-Haryana state border, India, Thursday, Dec. 3, 2020. Prime Minister Justin Trudeau rejected the diplomatic scolding Canada’s envoy to India received on Friday for his recent comments in support of protesting Indian farmers. Tens of thousands of farmers have descended upon the borders of New Delhi to protest new farming laws that they say will open them to corporate exploitation. THE CANADIAN PRESS/AP-Manish Swarup
Trudeau brushes off India’s criticism for standing with farmers in anti-Modi protests

The High Commission of India in Ottawa had no comment when contacted Friday

Nurse Kath Olmstead prepares a shot as the world’s biggest study of a possible COVID-19 vaccine, developed by the National Institutes of Health and Moderna Inc., gets underway Monday, July 27, 2020, in Binghamton, N.Y. U.S. biotech firm Moderna says its vaccine is showing signs of producing lasting immunity to COVID-19, and that it will have as many as many as 125 million doses available by the end of March. THE CANADIAN PRESS/AP-Hans Pennink
Canada orders more COVID vaccines, refines advice on first doses as cases reach 400K

Canada recorded its 300,000th case of COVID-19 on Nov. 16

Apartments are seen lit up in downtown Vancouver as people are encouraged to stay home during the global COVID-19 pandemic on Thursday, Dec. 3, 2020. British Columbia’s deputy provincial health officer says provincewide data show the most important area B.C. must tackle in its response to the COVID-19 pandemic is health inequity. THE CANADIAN PRESS/Marissa Tiel
Age, income among top factors affecting well-being during pandemic, B.C. survey shows

Among respondents earning $20,000 a year or less, more than 41 per cent reported concern about food insecurity

Information about the number of COVID-19 cases in Abbotsford and other municipalities poses a danger to the public, the Provincial Health Services Authority says. (Photo: Tyler Olsen/Abbotsford News)
More city-level COVID-19 data would jeopardize public health, B.C. provincial health agency says

Agency refuses to release weekly COVID-19 case counts, citing privacy and public health concerns

Victoria-based driving instructors are concerned for their own and the community’s safety with the continued number of residents from COVID hotspots in the Lower Mainland coming to the city to take their driving road tests. (Black Press Media file photo)
Students from COVID hotspots travel to Vancouver Island for driving tests

Union leader calls on government to institute stronger travel ban

British Columbia Health Minister Adrian Dix wears a face mask to curb the spread of COVID-19, during an announcement about a new regional cancer centre, in Surrey, B.C., on Thursday, August 6, 2020. THE CANADIAN PRESS/Darryl Dyck
PHSA bought faulty respirators; spent money on catering, renovations: Dix

Such spending included ‘unnecessary, unbudgeted renovations’ to the authority’s headquarters in Vancouver

Most Read