One of the most recognized tools of the medical profession could be on its way out, but not without a fight. The cold metal of the stethoscope is getting some competition from small ultrasound devices that fit into the palm of doctors' hands. In an editorial in the journal Global Heart, authors Jagat Narula and Bret Nelson from Mount Sinai School of Medicine in New York suggest the stethoscope, which was invented in 1816, will be replaced by the ultrasound, a product of the 1950s. Narula, editor of Global Heart, and Nelson ask why doctors aren't using ultrasounds on a broader scale, writing, "Certainly the stage is set for disruption; as LPs were replaced by cassettes, then CDs and mp3s, so too might the stethoscope yield to ultrasound." Ultrasound, commonly known for screenings in pregnancy, uses high-frequency sound waves to create an image of a part of the body such as the lungs or liver. Some of the ultrasounds, which resemble smartphones, are already in use in hospitals. Reid Blackwelder, president of the American Academy of Family Physicians, said speaking solely from a physician's standpoint, the predicted death of the stethoscope is premature. "In the foreseeable future, ultrasound may be used not as a replacement but as an augmentation, something available if you need additional information," said Blackwelder, a professor of family medicine at East Tennessee State University. "You can't replace the diagnostic aspect of doing physicals, listening to your patient's heart and evaluating for heart problems." Though the authors say ultrasounds will lead to greater accuracy in diagnosing heart, lung and other problems than the stethoscope, they admit the cost is a factor. The cheapest ultrasounds cost several thousand dollars, making accessibility for rural physicians and those in developing nations more difficult. Blackwelder said that although the small size of the ultrasound may be useful in combat zones and emergency rooms, he worries that replacing the stethoscope with ultrasound could lead to an increase in ordering costly diagnostic tests. "The moment you do a more advanced study like an ultrasound, there is a likelihood of finding a variation of what is normal, and almost always in medicine, when you find something abnormal, you do another test or procedure," Blackwelder said. "More testing leads to anxiety for the patient, and in these days with expensive care, the last thing we need to do is more tests that are not needed." Most likely, the stethoscope and ultrasound will find some sort of marriage, according to Blackwelder. Source
