By AMERICAN HEART ASSOCIATION NEWS
Whenever a cartoonist wants to draw a doctor, the go-to shorthand is to have the character wear a stethoscope and a head mirror — a round concave mirror used to direct reflected light to examine a patient’s ear, nose and throat.
These days, however, the head mirror is practically obsolete, replaced by pen lights.
Now, a recent study portends that the same fate could be in store for the ubiquitous stethoscope, which in its earliest incarnation in 1816 was essentially a hollow tube that allowed doctors to listen to a patient’s lungs, heart, intestines, even blood.
The modern stethoscope, with its earpieces, flexible tubing and chest piece or drum, is used for the same purposes, but has become something of a talisman of the medical profession.
Medical practitioners hang them from their necks and dangle them from their pockets. Many newly minted doctors are given one as a graduation gift, they can be engraved for special occasions and pink versions are often presented to women doctors.
The recent study, presented at the American Heart Association Scientific Sessions 2015, compared a smartphone-compatible listening device to three different types of stethoscopes: a popular digital model; one like those used by most physician; and a disposable model commonly used in hospitals to reduce infections.
According to the study, the new device, called HeartBuds, performed better than the disposable stethoscope and just as well as other two.
HeartBuds, which is currently promoted as a way for expectant mothers to listen and record their babies’ heartbeats, has not yet been approved as a medical device by the Food and Drug Administration.
Some physicians quake at the thought of analog stethoscopes being replaced by digital devices.
“Losing the stethoscope would be one more excuse for doctors not to touch their patients,” said Dr. Jeffrey Steinbauer, professor of family medicine and chief medical information officer at Baylor College of Medicine in Houston. “It’s such a symbol of the doctor as healer – like the badge for a policeman or the fireman’s hat for a fire fighter – and of the patient-doctor relationship that we’re being challenged to maintain.”
However, even without HeartBuds, the traditional stethoscope may already be on the way out.
During the recent Ebola outbreak, for example, doctors wrestled with how to maintain a sterile barrier between them and their patients while still being able to examine them, including with a stethoscope.
Often they turned to electronic stethoscopes that consisted of disposable earbuds that can fit under a sterile hood and are attached by wires to a diaphragm-equipped microphone that acts as the bell and comes in contact with the patient.
For the past year, Dr. David Brown, a Washington University cardiologist at Barnes-Jewish Hospital in St. Louis has been using an electronic stethoscope he says is far superior to analog models.
“I let my residents listen to a patient’s heart murmur and their mouths drop open from the clarity,” Brown said about the device, which is made by a Colorado company called Thinklabs.
Still, he continued, most physicians will continue using traditional stethoscopes for the foreseeable future.
“Most surgeons or obstetricians don’t really need to know what the heart sounds like, so they’ll continue using analog models until the price goes down.”
The Thinklabs One digital stethoscope, for example, retails for about $500, compared to about $200 for what Brown called a “good quality” stethoscope or disposable models sold on Amazon in packs of 10 for only $20.