Is listening through a stethoscope a dying art?

[wdlove]

For nearly 200 years, doctors have confidently slung stethoscopes around their necks, and listened to hearts flutter, bowels rumble, and blocked arteries swoosh.

But as doctors increasingly rely on technology to diagnose heart disease, a growing chorus of mostly younger cardiologists is questioning the value of the stethoscope.

For many doctors, the low-technology amplification doesn't compare to the high-tech images and more precise data they can gather from an echocardiogram. Over the past seven years, the number of "echoes" ordered nationally has nearly doubled -- from 11 million in 1996 to 21 million in 2003, according to a study published annually by Pennsylvania-based Arlington Medical Resources Inc.

http://www.boston.com/news/globe/health_science/articles/2004/05/25/is_listening_through_a_stethoscope_a_dying_art/

 

[virividox]

well it would seem pretty bad if a doctor couldnt use that tool; what if they are out in a 3rd world country without all the high tech equiptment

 

[JesseJames]

I wonder what a fart sounds like internally when it is expelled. Would you hear just a whoosh?

 

[Capt Underpants]

My doctor still uses a stethoscope. I went into the doctor yesterday for a yearly exam thing. I told him that I had been having an sudden heart beat, then back to normal, which only happens about 5 times a day. He listened to my heart for less than a minute, and heard it. Which I thought was pretty cool. The chances of him hearing it were 1 out of 1,440, and he heard it. I went in for a EKG today, and they didn't see anything abnormal (duh... it only happens like 5 times a day). Anyways, now I'm all worried and stuff...

Why did I just post that here? That was really off topic, lol. It was, in a round-about way, about a stethoscope. Maybe . Anyways, my doctor is an old guy, and he'll probably use a stethoscope for a long time.

 

[wdlove]

I wonder what a fart sounds like internally when it is expelled. Would you hear just a whoosh?

It's called listening to bowl sounds. It sounds like gurgling. I worked on surgical floor. My patients were always excited to know if I could hear bowl sound. It means that flatus is moving along the intestinal track. A sign that anesthesia is wearing off. At that point a patient can go off clear liquids at actually start eating.

 

[wdlove]

My doctor still uses a stethoscope. I went into the doctor yesterday for a yearly exam thing. I told him that I had been having an sudden heart beat, then back to normal, which only happens about 5 times a day. He listened to my heart for less than a minute, and heard it. Which I thought was pretty cool. The chances of him hearing it were 1 out of 1,440, and he heard it. I went in for a EKG today, and they didn't see anything abnormal (duh... it only happens like 5 times a day). Anyways, now I'm all worried and stuff...

Why did I just post that here? That was really off topic, lol. It was, in a round-about way, about a stethoscope. Maybe . Anyways, my doctor is an old guy, and he'll probably use a stethoscope for a long time.

I also fear that the art of using the stethoscope will be lost. The older generation doctors were very adept diagnosticians. The art of listening to the patient tell his story, physical exam, and stethoscope. Loosing this art only means higher medical costs because the physician is dependent on expensive diagnostic tools instead of using simple well tested methods.

 

[bousozoku]

My doctor still uses a stethoscope. I went into the doctor yesterday for a yearly exam thing. I told him that I had been having an sudden heart beat, then back to normal, which only happens about 5 times a day. He listened to my heart for less than a minute, and heard it. Which I thought was pretty cool. The chances of him hearing it were 1 out of 1,440, and he heard it. I went in for a EKG today, and they didn't see anything abnormal (duh... it only happens like 5 times a day). Anyways, now I'm all worried and stuff...

Why did I just post that here? That was really off topic, lol. It was, in a round-about way, about a stethoscope. Maybe . Anyways, my doctor is an old guy, and he'll probably use a stethoscope for a long time.

If he's that old, he might not be using it for a long time. Then again, to you, 30 is probably old.

Hope you'll be okay. Besides, you should worry about being abnormal. <ducks>

 

[James L]

It's called listening to bowl sounds. It sounds like gurgling. I worked on surgical floor. My patients were always excited to know if I could hear bowl sound. It means that flatus is moving along the intestinal track. A sign that anesthesia is wearing off. At that point a patient can go off clear liquids at actually start eating.

Actually, bowl would be like throwing a round ball at a bunch of pins, such as BOWLing. I think you are thinking of Bowel sounds, which are indicative of a functional intestinal tract.

With regards to stethoscopes, it will be a LONG time before they go out of fashion. Auscultating (listening) to cardiac sounds, lung sounds, bowel sounds, arterial blood flow, etc is easily done with a stethoscope. Will technology get better and better... yes. Will stethoscopes be around... yep.

Incidently, I work as a paramedic, and good luck lugging some of those machines around!

Cheers,

James

 

[topicolo]

For nearly 200 years, doctors have confidently slung stethoscopes around their necks, and listened to hearts flutter, bowels rumble, and blocked arteries swoosh.

But as doctors increasingly rely on technology to diagnose heart disease, a growing chorus of mostly younger cardiologists is questioning the value of the stethoscope.

For many doctors, the low-technology amplification doesn't compare to the high-tech images and more precise data they can gather from an echocardiogram. Over the past seven years, the number of "echoes" ordered nationally has nearly doubled -- from 11 million in 1996 to 21 million in 2003, according to a study published annually by Pennsylvania-based Arlington Medical Resources Inc.

http://www.boston.com/news/globe/health_science/articles/2004/05/25/is_listening_through_a_stethoscope_a_dying_art/

heheh, anything that'll allow you to turf your patients cardiology and collect more fees is good for a physician

 

[ecche]

I wonder what a fart sounds like internally when it is expelled. Would you hear just a whoosh?

Ask any Microsoft guy! They have "brownies nights" every second Friday.

 

[wdlove]

Actually, bowl would be like throwing a round ball at a bunch of pins, such as BOWLing. I think you are thinking of Bowel sounds, which are indicative of a functional intestinal tract.

With regards to stethoscopes, it will be a LONG time before they go out of fashion. Auscultating (listening) to cardiac sounds, lung sounds, bowel sounds, arterial blood flow, etc is easily done with a stethoscope. Will technology get better and better... yes. Will stethoscopes be around... yep.

Incidentally, I work as a paramedic, and good luck lugging some of those machines around!

Cheers,

James

Thank you for catching my grievous error. Spell check didn't help me when I forgot an "E." That is very embarrassing since I'm a nurse!

 

[Angelus]

Personally i think that it will be a very sad state of affairs if the use of a stethoscope dies out. It would indicate a growing tendency to rely more and more on technology and expensive tests to tell them things which could be easily diagnosed with a physical examination. The ability to physically examine a patient is the badge which defines a doctor. The stethoscope has so many uses:
Auscultation of the cardiovascular system,respiratory system,bowel sounds.
Add a sphygomanometer and you have yourself a cheap and easy way to measure blood pressure.
Technology is wonderful but if we rely on it for even the basic things then we will lose the art of clinical examination to a bunch of MRI,CT and ultrasound scans.
Of course, it's no surprise that doctors are being pushed along this route when the threat of legal action is always on the horizon.

 

[bousozoku]

I remember going to a car repair facility when I had my first car. The owner listened to the car for a few minutes and started naming various things that were problematic like burnt valves. Others that I'd met around that time were depending on electronic gadgets to do the same thing but would say things like "There's nothing wrong--you're imagining things." He always knew because he was more than a technician, he was a mechanic.

Good doctors and nurses are perceptive this way too. Obviously, they can't help you with your car much, but with your heart, they're everything.

 

[Rolerboy]

Stethescopes will remain

As one who passes gas... in the operating room to provide painless surgery, having a stethescope is an indespensible tool. A computer will never tell you the quality of heart tones and breath sounds and guide you in how much or how litte anesthetic to give. and when the power fails, it tells you that air is still moving in the lungs, and the heart is still beating strong, and when the computerized blood pressure cuff tells you that the BP is skyrocketing through the roof, a quick manual check with your stethescope will tell you everything is all right!

 

[wdlove]

As one who passes gas... in the operating room to provide painless surgery, having a stethoscope is an indispensable tool. A computer will never tell you the quality of heart tones and breath sounds and guide you in how much or how little anesthetic to give. and when the power fails, it tells you that air is still moving in the lungs, and the heart is still beating strong, and when the computerized blood pressure cuff tells you that the BP is skyrocketing through the roof, a quick manual check with your stethoscope will tell you everything is all right!

Rolerboy, I have heard one in your profession tell me, "The job is hours of monotony with minutes of panic." Do you do any work outside of the operating room to assist patients to alleviate pain?

 

[jsw]

I would guess that the availability of more advanced imaging and acoustic tools will merely augment the stethoscope, not ever replace it. Carpenters have had pneumatic tools forever, and you won't see one without a hammer.

 

[Mantat]

Stethoscope are an important instrument BUT the thing that scare me is the fact that my GF who is a vetenarian (sp?) has a better stethoscope than most doctors. I dont understand why they dont buy the top of the line stethoscope. They make a lot of money, yet they cant spend 1-2h of work to get a good instrument. Its probably because they have to pay for it from their how pocket instead of the clinic paying it for them.

The reason why stethoscope will still be there for a while is that its a symbole of power in an hospital. Notice that even doctors who dont use theirs often still carry it around because it shows to everyone that he is a doctor. I find it quite funny ;-)

 

[James L]

Stethoscope are an important instrument BUT the thing that scare me is the fact that my GF who is a vetenarian (sp?) has a better stethoscope than most doctors. I dont understand why they dont buy the top of the line stethoscope. They make a lot of money, yet they cant spend 1-2h of work to get a good instrument. Its probably because they have to pay for it from their how pocket instead of the clinic paying it for them.

The reason why stethoscope will still be there for a while is that its a symbole of power in an hospital. Notice that even doctors who dont use theirs often still carry it around because it shows to everyone that he is a doctor. I find it quite funny ;-)

The most expensive does not mean the most useful.

I work as a paramedic. I have a great stethoscope that cost big $$$. My partner uses an $18 POS he got at some college bookstore years ago. We have compared notes on many patients many times, and he hears all the same stuff I hear.

Maybe he is part bat, who knows? The bottom line however is he sees no need to buy the expensive stethoscope when his works just fine for him.

Cheers!

James

 

[amin]

As a physician, I agree with the idea that the most expensive stethoscope is not necessary. You just have to find one that works well for you. Many physicians become emotionally attached to the one they used during med school or residency.

Echocardiography in itself cannot replace scopes. Still, I believe it's short-sighted to say that nothing ever will. You know the little diagnostic thing Bones had on the original Star Trek? Someday, I'm gonna buy one of those .

 

[Rolerboy]

hours of monotony...

WDlove....

yes that is an interesting description of the anesthetists job. but what a wild ride those few moments are!

To answer your question, yes, I do go to other floors as part of a pain service, we place epidurals in the backs of women in labor before birth, and to trauma patients, we give thoracic epidurals and "rib" blocks to those who ride their harley davidson's through boat warehouses with out a helmet on!

 

[wdlove]

WDlove....

yes that is an interesting description of the anesthetists job. but what a wild ride those few moments are!

To answer your question, yes, I do go to other floors as part of a pain service, we place epidurals in the backs of women in labor before birth, and to trauma patients, we give thoracic epidurals and "rib" blocks to those who ride their harley davidson's through boat warehouses with out a helmet on!

Thank you Rolerboy. My wife has said that pain has become and issue especially in home care. That it's considered to be the 5th vital sign. I think that relieving a patient's pain is very rewarding.