Stethoscopes are on their way out, after 200 years - experts say - as they are
replaced by "smartphone-style" devices
It would be like a policeman without his truncheon or a fireman lacking a
ladder.
But the stethoscope – which has adorned the necks of doctors for decades –
seems to be on its way out.
An editorial in a leading scientific journal is predicting the demise of the
instrument, as it is overtaken by new technology.
It claims that a new generation of hand held ultrasound devices, modelled on
smartphones, are now able to perform the same task of helping to diagnose
various conditions.
The article, in Global Heart – the journal of the World Heart Federation –
says: “At the time of this writing several manufacturers offer hand-held
ultrasound machines slightly larger than a deck of cards, with technology
and screens modelled after modern smartphones.”
They add: “Many experts have argued that ultrasound has become the stethoscope
of the 21st century.”
There have been concerns that the smaller modern devices offer inferior image quality compared with larger ultrasounds. But the article suggests that these are outweighed by the speed with which some diagnoses can be made.
Indeed, the authors – Professor Jagat Narula, the editor, and Associate Professor Bret Nelson, both from Mount Sinai School of Medicine, in New York – claim that ultrasound can diagnose heart, lung, and other problems with much more accuracy than the 200-year-old stethoscope.
The device – which allows for the monitoring of the lungs, heart and intestines, as well as blood flow – was invented in France in 1816, by René Laennec, a French physician, to get around problems in dealing with an overweight patient who had problems with her heart.
Before the stethoscope, doctors would place their ear directly onto the patient’s chest, a practice called auscultation. But because of the young woman’s size, Laennec, thought it would be improper and inadequate to do so.
Instead, he rolled up a sheet of paper into a tube and placed one end on the patient. The tube magnified sound, and Laennec found he could hear her lung sounds easily by putting his ear to the open end.
The paper was soon replaced by early versions consisting simply of a wooden tube, similar to an ear trumpet. Over the course of the nineteenth century, this design was replaced by something more recognisable as the device still used today. Electronic stethoscopes that amplify the sounds in the chest and produce graphs were developed in the 1970s.
The authors claim that the high cost of the modern “smartphone-style" devices – which can cost thousands of pounds – has been hampering their spread, but predict their growth will continue.
“Certainly the stage is set for disruption; as LPs were replaced by cassettes, then CDs and. mp3s, so too might the stethoscope yield to ultrasound,” they write.
However, they do reflect that some doctors might be unwilling to hang up their stethoscopes, suggesting that “as some audiophiles still maintain the phonograph provides the truest sound”, some clinicians may “cling to the analog acoustics of the stethoscope?”
Dr Michael Dixon, chairman of the College of Medicine and a Devon GP, said: "I remain pretty addicted to my stethoscope. It is so much a part of what we do and is very symbolic. It suggests treatment as well as diagnosis, and a connection.
"The problem for many is the alienation between doctor and patients that comes from computers. If you start to introduce more machines, it could have a negative effect."
There have been concerns that the smaller modern devices offer inferior image quality compared with larger ultrasounds. But the article suggests that these are outweighed by the speed with which some diagnoses can be made.
Indeed, the authors – Professor Jagat Narula, the editor, and Associate Professor Bret Nelson, both from Mount Sinai School of Medicine, in New York – claim that ultrasound can diagnose heart, lung, and other problems with much more accuracy than the 200-year-old stethoscope.
The device – which allows for the monitoring of the lungs, heart and intestines, as well as blood flow – was invented in France in 1816, by René Laennec, a French physician, to get around problems in dealing with an overweight patient who had problems with her heart.
Before the stethoscope, doctors would place their ear directly onto the patient’s chest, a practice called auscultation. But because of the young woman’s size, Laennec, thought it would be improper and inadequate to do so.
Instead, he rolled up a sheet of paper into a tube and placed one end on the patient. The tube magnified sound, and Laennec found he could hear her lung sounds easily by putting his ear to the open end.
The paper was soon replaced by early versions consisting simply of a wooden tube, similar to an ear trumpet. Over the course of the nineteenth century, this design was replaced by something more recognisable as the device still used today. Electronic stethoscopes that amplify the sounds in the chest and produce graphs were developed in the 1970s.
The authors claim that the high cost of the modern “smartphone-style" devices – which can cost thousands of pounds – has been hampering their spread, but predict their growth will continue.
“Certainly the stage is set for disruption; as LPs were replaced by cassettes, then CDs and. mp3s, so too might the stethoscope yield to ultrasound,” they write.
However, they do reflect that some doctors might be unwilling to hang up their stethoscopes, suggesting that “as some audiophiles still maintain the phonograph provides the truest sound”, some clinicians may “cling to the analog acoustics of the stethoscope?”
Dr Michael Dixon, chairman of the College of Medicine and a Devon GP, said: "I remain pretty addicted to my stethoscope. It is so much a part of what we do and is very symbolic. It suggests treatment as well as diagnosis, and a connection.
"The problem for many is the alienation between doctor and patients that comes from computers. If you start to introduce more machines, it could have a negative effect."
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