Is Your Stethoscope Going to Join Your Typewriter in the Storage Closet? — Physician’s First Watch

Medical News |
January 24, 2014

Is Your Stethoscope Going to Join Your Typewriter in the Storage Closet?

By Joe Elia

Point-of-care ultrasound devices, available on eBay for roughly the price of a fancy digital camera, seem poised to be "the stethoscope of the 21st century," according to a review and commentary in Global Heart.

The review's authors praise ultrasound's advantages, especially in the emergency department and the ICU, where treatment decisions have often had to rely on other imaging devices that need to be scheduled and require radiation shielding. They argue for the earlier introduction of the technology into medical school curricula.

Editorialists echo those sentiments, reminding readers that ultrasound has been called a "disruptive technology," in that it's simpler, cheaper, more convenient, and more accessible than those other devices, which rely on highly trained subspecialists to interpret the images.

Reader Comments (20)

Carlos A Selmonosky,MD Physician, Family Medicine/General Practice, Visiting faculty IFHospital

The combination of a ultrasound portable device and the use of a non contact skin thermometer will increase exponentially the diagnostic accuracy in the Primary Care Physicians offices.
An accurate diagnosis is the main predictor of the outcome and the expenses needed to arrive to the diagnosis.BMJ 2008;336:398

Maxime GAUTIER, MD Physician, Emergency Medicine, Paris, France

It's just a wonderful technology and a big evolution of patient care.
It should be considered as an extension of the physical exam and not something that take it place.
Every tool to be more performant and fast is ti be used, especially in the ER where time is crucial and errors are frequent.

* * Physician, Cardiology, Retired

I have done echocardiography for over 25 years and always examened my patients clinicaly and I was proud of my auscultation capacity. I was always gratified when after I had examened a patient someone else performed an Echo and the residents comments were: It shoes exactly what you said it would.

Melody Ross Physician, Cardiology

Even with the advancement of technology ... it's always great to use the good old traditional stethoscope. That still won't go away!

phd Physician, Cardiology, king saud university saudia arabia

it will be wounderfull tool for immediate result and to be documented within the clarking sheet of the patients

HERBERT D LEWIS Physician, Internal Medicine, retired

Not withstanding its name, can an ultrasound hear rales, coarse or fine, a wheeze, a rub, a click? It is an extremely valuable tool that adds to but does not replace our diagnostic armamentarium. We need them all.

Roberto Franken Md PHd Physician, Cardiology, Santa Casa Sao Paulo Medical School

I agree with everithig but we can´t forgett the patient´s symbol meaning of the use of the stethoscope, by the doctor, during his first examination. As we wrote in arquivos brasileiro de cardiologia vol.100 no.1 São Paulo Jan. 2013
Hands as Diagnostic Tools in Medicine. Should Physicians Touch
Their Patients?

Jon Wilcox FRNZCGP Physician, Family Medicine/General Practice, Auckland

I have been using an office USS for 2 years for obstetrics and it has been very helpful. Simple things like urgent dating measurements for Down screening referrals and so on. I was planning to also try and use it for medical and surgical applications, though the primary care list is and probable should stay limited. We can get good at doing it with practice eg. splinters, stones, aneurysms etc. We cannot stop progress and the images will also get so much better in time - the more we use it the more we low what we are looking at.

Amir-ansar MD Physician, Nephrology, London

The problem is that US is operator dependant so who would suffer while the operator is going through the learning gurve?!

Adriano Souza Physician, Internal Medicine, Brazil

An examination of the eyes as depentende the examiner will be so imprecise when the hands and ears are currently for physical examinatio

Hamid Mukhtar MD PhD FRCP Physician, Hospital Medicine

I have always been a strong proponent of Point of care ultrasound. In my mind, ultrasound has wrongly been named as a "test:. It is really an examination technique.
I use point of care ultrasound all the time and it has provided me the highest professional staisfaction

TINA DOBSEVAGE Physician, Internal Medicine, Solo practice

Ultrasound at point of care in an ER saved my life by expediting my care. And echocardiography at point of care is useful. It takes a long time to learn to interpret ultrasound images correctly and this should be integrated into medical school curricula. However, it needs to be combined with the ability to look at and SEE the patient and do an excellent physical exam.


we have used stethoscope for many years and we are clinically trained to diagnose with this. ultrasound is a v. useful tecgnology and is sure to take its place.

Phil Grimm, MD Physician, Radiology

One of the most enduring egotistical traits I have developed over 3- years in this business is the conviction that I could do a better physical exam than ANY internist I have ever met.

Strictly because of the immediate feedback of ultrasound: I KNOW what the gallbladder feels like, I know what the left lobe of the liver feels like, I know what a AAA feels like. The spleen, etc. I know what a prolapsed mitral valve sounds like because I could also see it prolapse.

I have no doubts, because I can see beneath the skin.

The problem with learning to use ultrasound is that it is hard to get to that ah-ha moment. One of the best internists I know spent six months and $3,000 learning how to do an ultrasound exam and within the first six weeks of officially becoming an ultrasoundographer, he missed gallstones and never touched a transducer after that. He had integrity, a lot of people don't.

Further, we had more than a few ER doc's who went crazy because of a hand-held transducer that "lead them astray."

Gabrielle Schwilk, FNP-BC Other Healthcare Professional, Family Medicine/General Practice

I completely agree with you. We need to quit doubting what works and where needed, people can home those exam skills.

Prof HARSONO SALIMO Physician, Pediatric Subspecialty, Surakarta, Central Java, Indonesia

I am agree finding and that ultrasound maybe will be introduced into the medical school curricula.

Alvaro Terán Physician, Other, ULTRAMED

Exactly ultrasound go back the ears and hands to be the ears and hands.

JOSEPH TOULOUSE Physician, Emergency Medicine, multi-state locum tenens

I'm looking forward to this disruptive change. I'm looking forward to the increased diagnostic information and greater treatment efficacy in those situtations which for so many years we have practiced our best in relative diagnostic darkness.

Moti Gurbaxani Other, Other, RETIRED


Roland, deluca Physician, Internal Medicine, Merano, Italy

Dear autor,

I can't find a handheld ultrasound device for the price of a fancy digital camera on ebay. Please send me the link.

Your sincerely Roland

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