Portable Hi-Tech Alternative May Replace Stethoscope
By Dr. James Palermo // January 30, 2014
HAND-HELD ULTRASOUND PROVIDES ABILITY TO 'WITNESS LIVING ANATOMY AND PHYSIOLOGY'
ABOVE VIDEO: A handheld ultrasound provides a picture of what is happening inside your body. Cardiologist Dr. Tara Narula joins the “CBS This Morning” co-hosts to explain why this new technology could be replacing the stethoscope.
Forty years ago, advancing from my second year into my third year of medical school, I, like the other 99 students in my class, was awarded a Littmann stethoscope, the most recognizable and cherished symbol of the medical profession.
However, according to an editorial in the World Heart Federation‘s journal Global Heart this week, the stethoscope is in danger of becoming obsolete and being consigned to medical history by new point-of-care ultrasound technology.
TODAY’S STETHOSCOPE HAS BEEN IN USE OVER 150 YEARS
Used to listen to the internal sounds of the human body, particularly the heart, lungs and abdomen, the stethoscope has been around for nearly 200 years. Before, doctors had placed their ear to the patient’s chest to hear the sounds of the lungs and heart.
However, to spare the blushes of a female patient, stethoscope inventor French doctor, Rene Laennec, rolled up sheets of paper and placed one end to his ear and the other to her chest, discovering that he could hear the sounds loudly and clearly.
He subsequently made models out of wood, known as monaural stethoscopes because they had only one earpiece. Binaural stethoscopes with two earpieces, the version still used today, came into use in the 1860s.
HAND-HELD ULTRASOUND MODELED AFTER SMARTPHONE
The lead author of the editorial, Dr. Bret Nelson of the Mount Sinai School of Medicine, writes, “The point-of-care ultrasound may be better at reducing complications, assisting in emergency procedures, and aiding in diagnoses than the stethoscope.”
He also points out that, “More than 20 medical specialties already include point-of-care ultrasound as a core skill.”
According to Nelson ultrasound technology is becoming more accurate, the devices are reducing in size and their cost gradually decreasing, with “several manufacturers offering hand-held ultrasound machines slightly larger than a deck of cards, with technology and screens modeled after modern smart phones.”
COST MAY STILL BE PROHIBITIVE FOR MOST CLINICIANS
However, although the devices are already available, most clinicians have not made the move because they are expensive and they “must make a financial decision weighing the increased diagnostic accuracy against increased cost,” Nelson explained.
While the cheapest stethoscope is literally disposable, the cost of the cheapest ultrasound device is still several thousands of dollars.
Nelson adds that ultrasound technology is “still a new field relative to traditional imaging” and many “older clinicians completed training long before ultrasound use was part of standard practice.”
TOOL OF CHOICE FOR NEXT GENERATION OF PHYSICIANS
The stethoscope will probably remain the main tool in many “seasoned” physician’s physical exam toolkit, but it is likely that point-of-care ultrasound will ultimately be the tool of choice in the future.
The authors concluded: “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. Medical students will train with portable devices during their preclinical years, and witness living anatomy and physiology previously only available through simulation.
