Why Are Stethoscopes Still a Thing?(motherboard.vice.com)
motherboard.vice.com
Why Are Stethoscopes Still a Thing?
http://motherboard.vice.com/read/why-are-stethoscopes-still-a-thing
20 comments
The amount a doctor can learn about the functioning of one's heart and lungs via a cheap and simple tool like a stethoscope is amazing, and certainly nothing to look down on. Ultrasound tools may well one day be as commonly used but while ultrasound and other imaging tech can provide images and details stethoscopes cannot, they in turn cannot give the doctor any information about how ones breathing sounds, and cannot provide the instant and visceral connection of hearing your heartbeat directly.
Simple tools like stethoscopes are critical to medical care precisely because they are so cheap, easy to use, flexible, reliable, portable, quick to deploy, and give a direct human connection between doctor and patient. Why would you ever want to replace it? Supplement, sure. Improve, absolutely.
Simple tools like stethoscopes are critical to medical care precisely because they are so cheap, easy to use, flexible, reliable, portable, quick to deploy, and give a direct human connection between doctor and patient. Why would you ever want to replace it? Supplement, sure. Improve, absolutely.
Not to mention, it doesn't need a battery or power to work, meaning it can function under any conditions.
Medical student here- I completely agree. Auscultation is an important component of physical examination, and most of this article's arguments against it just seem silly. Ignoring the obvious etymological fallacy, it's just not cost effective to replace stethoscopes with imaging tools.
A "cheap" portable ultrasound machine is going to be in the thousands of dollars, and there's just no way that hospitals and clinics would be able to purchase enough of them so that one was available for every ongoing PE- not to mention the fact that US is billed separately, and could easily double the patient's cost for a brief office visit.
Plain film x-rays and CT scans expose the patient to ionizing radiation, so that's not a practical option either.
MRI is expensive, time-consuming, and a lot of rural hospitals might not have a machine, or if they do, it's very, very unlikely that they're going to have staff available to operate it 24 hours a day.
All of these tools, including the stethoscope, have their own separate uses and applications- they are not competitors.
A "cheap" portable ultrasound machine is going to be in the thousands of dollars, and there's just no way that hospitals and clinics would be able to purchase enough of them so that one was available for every ongoing PE- not to mention the fact that US is billed separately, and could easily double the patient's cost for a brief office visit.
Plain film x-rays and CT scans expose the patient to ionizing radiation, so that's not a practical option either.
MRI is expensive, time-consuming, and a lot of rural hospitals might not have a machine, or if they do, it's very, very unlikely that they're going to have staff available to operate it 24 hours a day.
All of these tools, including the stethoscope, have their own separate uses and applications- they are not competitors.
MRIs also have issues if you happen to have ferrous metals in your body. Ignoring obvious things like surgical pins, plates and screws used in orthopedics, and piercings, people in certain occupations have a high likelihood of picking up things like metal filings in their eyes, which can be catastrophic for them in a MRI.
It's simply that old non sequitur: it's 2016 and you shouldn't do X anymore. That's really their main argument. Stop using a 200 year old technology, even if it still works fine.
Funny : "yet doctors cling to a tool that was invented at a time when medical practitioners still regularly used leeches as a form of treatment."
They still do "cling" to leeches for some treatments as well. Leeches are hard to beat for a few conditions. It's got a name : hirudotherapy, and sees application in skin related conditions and wound cleaning, and saves hundreds of legs and arms from amputation on a yearly basis and even sees use in cosmetic medicine. Cleaning skin and wounds the way leeches do is not impossible but takes experts hours or days and introduces risks that treatment with leeches does not.
https://en.wikipedia.org/wiki/Hirudo_medicinalis#Today
They still do "cling" to leeches for some treatments as well. Leeches are hard to beat for a few conditions. It's got a name : hirudotherapy, and sees application in skin related conditions and wound cleaning, and saves hundreds of legs and arms from amputation on a yearly basis and even sees use in cosmetic medicine. Cleaning skin and wounds the way leeches do is not impossible but takes experts hours or days and introduces risks that treatment with leeches does not.
https://en.wikipedia.org/wiki/Hirudo_medicinalis#Today
In other news, why are construction workers still using this 1000 year old tool what with all the modern advances in construction technology
https://en.wikipedia.org/wiki/Hammer
https://en.wikipedia.org/wiki/Hammer
There's probably a startup somewhere working on an IoT connected version. With an app to keep track of number of hits, thumbs and misses...
Error: The Samsung Naildriver™ is not compatible with this brand of wood fastening device.
And it can unlock your work truck when you approach! /s
Honestly I see a lot of construction workers using pneumatic or power nailers and I'm sure it saves them a lot of time. That said, I think I'm more comfortable with everyone taking a break at the construction site when the power goes out than with doctors being unable to treat people whenever a disaster affects their delicate electronic equipment.
To add to that, those are tools optimised for specific tasks, with an up-front cost that only becomes worth it if said task starts to become a significant part of the job. And with those tasks, they do so much of the work that you could almost say that humans only happen to wield them (I mean, I'm oversimplifying but it's kind of a matter of aiming and pushing a button).
Meanwhile, hammers, even in their various shapes and sizes, are more general purpose tools that "enhance" the skills and abilities of the human that wields it. Knowing how to use it also requires knowledge of the material you are working with.
Similarly, I'd say that stethoscopes are a general enhancement of a human sense (hearing), whereas other imaging techniques mentioned are more expensive, time-consuming, and specialised.
Meanwhile, hammers, even in their various shapes and sizes, are more general purpose tools that "enhance" the skills and abilities of the human that wields it. Knowing how to use it also requires knowledge of the material you are working with.
Similarly, I'd say that stethoscopes are a general enhancement of a human sense (hearing), whereas other imaging techniques mentioned are more expensive, time-consuming, and specialised.
A skilled carpenter can work very fast with a hammer, sinking nails with one blow. But an unskilled laborer can work just as fast if they use a nailer. So I'd guess it's more about saving money than time.
I'm only vaguely familiar with either technology, but I don't understand how a handheld ultrasound scanner can possibly substitute for a stethoscope.
I know this is a flawed analogy, but I imagine somebody walking up to an electronics tech and saying "Hey, you don't need that oscilloscope anymore because we bought this thermal camera. Don't you know that oscilloscopes are old technology from the 19th century? Why, they didn't even know what electrons were back then!".
I know this is a flawed analogy, but I imagine somebody walking up to an electronics tech and saying "Hey, you don't need that oscilloscope anymore because we bought this thermal camera. Don't you know that oscilloscopes are old technology from the 19th century? Why, they didn't even know what electrons were back then!".
Why do doctors still use their eyes when looking at an injury.
This is literally the dumbest thing I've read on vice.com. And I just read an article about a girl that drank a bottle of marijuana personal lubricant.
What a strange article. It ends up damning the stethoscope with faint praise.
The value of a stethoscope comes not from the low-tech, lo-fi sounds that it picks up, but from the enormous knowledge base built up over hundreds of years and billions of examinations that allows a doctor to diagnose, say, mitral valve insufficiency, or pleural effusion, instantly.
By themselves, a muffled "whoosh" at a particular point in the cardiac cycle, or a particular kind of "rub" while breathing, mean nothing whatsoever. Any modern imaging technology could outperform the glorified tube of the stethoscope easily.
However, since we have built up an enormous database of clinical experience, it gives us a powerful ability to interpret otherwise useless sounds in a way that outperforms newer technologies for speed, efficiency, accessibility, and reliability.
If you arrive in ER with a pneumothorax, for example, you had better hope that there is someone waiting for you with a stethoscope to confirm the absence of breath sounds on the affected side. Even a handheld ultrasound may not be fast enough to get you a chest tube before you are irreversibly dead.