The stethoscope's 200 year reign may soon be coming to an end as ultrasound devices become cheaper

Death of the stethoscope as ultrasound comes of age

The stethoscope may soon be obsolete as more accurate and compact ultrasound devices drop in price, according to two US heart experts.

The simple listening tube for monitoring abnormal heartbeats and wheezing lungs has been a common sight draped around the necks of doctors since its invention in 1816, but according to the experts the falling price of new technology and changes in medical training could eventually see the stethoscope supplanted by pocket-sized ultrasound probes.

Professor Jagat Narula and Dr Bret Nelson, both from Mount Sinai School of Medicine in New York, point out that several manufacturers already make hand-held ultrasound machines "slightly larger than a deck of cards".

Currently even a top-of-the-range stethoscope costs only a fraction of the several thousand dollars needed to buy the cheapest ultrasound device, but the price is falling and evidence suggests that, compared with the stethoscope, the devices can reduce complications, assist in emergencies and improve diagnostic accuracy.

Writing in the journal Global Heart, of which Prof Narula is editor-in-chief, the authors conclude: "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. Their mentors will increasingly use point-of-care ultrasound in clinical environments to diagnose illness and guide procedures.

"They will see more efficient use of comprehensive, consultative ultrasound as well – guided by focused sonography and not limited by physical examination alone. And as they take on leadership roles themselves, they may realise an even broader potential of a technology we are only beginning to fully use.

"At that point, will the 'modern' stethoscope earn a careful cleaning, tagging, and white-glove placement in the vault..?"

Despite the advantages of the new technology, there will still be traditionalists who prefer to hang on to the old ways, like music buffs lovingly preserving their vinyl records, the experts suggest.

They pose the question: "As some audiophiles still maintain the phonograph provides the truest sound, will some clinicians yet cling to the analogue acoustics of the stethoscope?"

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