The Great Debate

Is the stethoscope still the quintessential physician’s tool?

Two hundred years after its invention, physicians debate whether the stethoscope is still at the heart of medicine.

The stethoscope has come a long way since its invention in 1816 when Dr. René Théophile Hyacinthe Laënnec rolled up a sheet of paper to listen to his patient’s heart. Today, the stethoscope is one of the most commonly used medical instruments. But is it on the verge of being replaced by newer tools such as the pocket or portable ultrasound?

Some in the medical community argue that technological breakthroughs have paved the way for tools that are even more effective than the stethoscope, while others say the stethoscope remains a key tool that allows them to stay connected to their patients.

It’s all about communication

Portable or pocket ultrasounds offer physicians more of an opportunity to interact with their patients than the stethoscope does, says Dominic Valentino, DO, who uses both instruments. Ultrasounds produce an image that both patient and physician can view together, he notes.

Peter Bidey, DO, works with Brooke Trettin, OMS IV, on proper technique of the stethoscope. (Photo courtesy of Bruce Fairfield, PCOM.)

“The ultrasound gives physicians a chance to talk about what they’re seeing, which could engage patients more about what’s happening,” says Dr. Valentino, the director of osteopathic medical education at Mercy Catholic Medical Center in the Philadelphia area. “That’s something you can’t really do with a stethoscope.”

But you can use a stethoscope to better listen to patients—and listening is at the heart of the osteopathic approach to care.

“Listening is the most important sense that physicians use; it helps us gain the trust of our patients,” says Martin C. Burke, DO, a cardiologist and professor of medicine at the University of Chicago. “I know one of the reasons people want to do away with the stethoscope is that when you start training with the stethoscope, you don’t hear anything, but as a professor once told me, ‘You just have to keep listening. Just keep listening.’ And that’s very true.”

Michael A. Becker, DO, the vice chair of the family medicine department at the Philadelphia College of Osteopathic Medicine (PCOM), echoes these sentiments.

“It’s incredibly valuable to be able to hear the inner workings of your patient,” he says.

The power of touch

Touch can be reassuring for patients during a visit to the physician.

DOs often speak about the importance of touch, says Peter Bidey, DO, the medical director at one of PCOM’s clinics.

“The stethoscope is one of the ways to incorporate touch,” explains Dr. Bidey. “One of my mentors refers to the stethoscope as an extension cord that connects me to my patients, and I really believe in that.”

Dr. Becker agrees.

“When I have the stethoscope in my ears and on my patient, that strengthens the connection between us,” he explains. “And I believe that connection is completely different when you use something like an ultrasound.”

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