200 years of the Stethoscope: How Much Longer will it Last?

We all remember buying our first stethoscopes, we couldn't recognise any bowel/heart/respiratory sound then but we still paraded around in wards hanging it around our neck.

And to be honest we still feel a sense of pride when we accessorize with a Littmann while in hospital. We love it, adore it and get sad if we lose it.

But where did it all begin?

Birth of stethoscope

2016 marks 200 years of the birth of stethoscope.

In 1816, French physician Rene Laennec invented the first stethoscope using a long, rolled paper tube to funnel the sound. He did that because he was embarrassed in placing his ear on chest of a young female patient he was examining (which was the method of auscultation back then). Though his design was simple, but it was effective. It looked something like this.

Twenty-five years from then, George P. Cammann of New York, invented the first stethoscope with an earpiece for each ear. This model of stethoscope was used for more than 100 years with very few modifications. This is what it looked like.

Finally 1960s, Dr. David Littmann, a Harvard Medical School professor, patented a revolutionary new stethoscope with impressively improved acoustical performance. His invention helped to transform a simple listening device into a powerful diagnostic tool. Since then, numerous modifications helped improve and technologically update the present-day stethoscope. Which looks something like this.

Declining trend of stethoscope

But now, stethoscope is having a crossroads moment. Perhaps more than at any time in its two-century history, this global tool of the medical profession is at the centre of debate over how medicine should be practiced.

In recent years, the sounds it transmits from the heart, lungs, blood vessels and bowels have been digitized, amplified, filtered and recorded. This is leading to the declining trend of the stethoscope.

Technological reforms; bane for the stethoscope

The widespread use of echocardiograms and the development of pocket-sized ultrasound devices are raising questions about why doctors and others continue to sling earphones and rubber tubing around their necks.

In 2016, the device remains one of the last instruments that health care providers use to infer the nature of a problem, rather than viewing it directly. The demands of electronic medical records have further eaten into time with patients.

For decades now, it has been easier to send a heart patient for an echocardiogram, and that increasingly sophisticated imaging test has proven more accurate than scope-to-chest interpretation of the lub-dubs, clicks, gallops and whooshes produced by the human heart.

Stethoscopes retain their value for listening to lungs and bowels for clues of disease, experts agree. But for the cardiovascular system, doctors prefer an echocardiogram instead of a stethoscope.

Inaccuracy to identify the trouble

In certain research, it was found that the hand-held instruments are at least superior to physical examination. Cardiologists using them accurately identified 82 % of patients with heart abnormalities, while cardiologists using physical examination caught just 47%.

One thing on which we agree, however, is that not all doctors are good at using stethoscopes — and haven't been for a long while. According to a study, "both internal medicine and family practice trainees had a disturbingly low identification rate for 12 important and commonly encountered cardiac events."

Conclusion

Conclusively, a stethoscope exam is an opportunity to create a bond between doctor and patient. The link between patient and physician is unlike any other relationship between two non-related people." You can't trust someone who won't touch you."

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