The stethoscope is dead?!

A Washington Post piece this week features a prominent cardiologist’s contention that stethoscopes must be–and are being–replaced with echocardiography. “The stethoscope is dead,” he states. image

The article presents as counterpoint a pediatric cardiologist who states that cardiac auscultation won’t be replaced with costly imaging.  The article notes that the easier availability of echocardiography and other pressures have led to a decline in cardiology-related auscultation skills, and provides a link to a site where you can refresh your own skills.

Only later does the piece mention the stethoscope’s utility in listening to lungs and abdomen (although they don’t mention its utility as a reflex hammer). A similar story on National Public Radio noted that a stethoscope is less than $20, whereas handheld ultrasound machines are “less than $10,000”.

In the emergency department, the “obsolete device” is alive and well, despite access to emergent echocardiography.  The stethoscope provides key information for diagnosis–the silent bowel sounds of an ileus, the sandpapery rub of a pericardial effusion, the asymmetric breath sounds of an inhaled peanut–and response to treatment–the new gallop in fluid overload, the improving aeration in response to asthma treatments.

Is the stethoscope obsolete? What do you think?

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