DeadCactus

SDN Lifetime Donor
Lifetime Donor
10+ Year Member
Oct 28, 2006
2,589
675
Status
Resident [Any Field]
I thought it was time to come and beat this dead horse and get some input.

Preliminary survey of prices:
$160 Elite
$136 Cardiology III
$75 Classic II

My thoughts:
From what I can tell, the elite is definitely the best acoustically engineered of the bunch. The Cardiology III sacrifices acoustic quality to be a bit cheaper and more versatile (tunable diaphragm drops audio quality, but lets you have an adult and pediatric stethoscope at the same time).

Then there's the part of me that says "Stop being stupid. You won't hear a real difference between the three. The Classic II is half the cost and offers the same 'versatility' (for better or worse) as the Cardiology III."

In short:
Elite - Seems to have the best acoustic quality.

Cardiology III - Cheaper, more versatile. Appealing because the specialties most interesting to me see both adult and pediatric patients. (Do you even need a pediatric stethoscope for things like FM and EM, or will an adult size work for what you'd be listening for?)

Classic II - "Stop wasting money are **** you don't need."



Thoughts?
 

Dwindlin

ASA Member
10+ Year Member
7+ Year Member
Jan 31, 2009
2,533
205
Status
Attending Physician
FWIW, I have a Cardiology III that I purchased for pre-hospital use and I love it. Also, check All-Heart.com as they typically sell all those for cheaper than what you've listed. Brand new my stethoscope was only $126.00 when it was retailing for $200+
 

TexasTriathlete

HTFU
10+ Year Member
5+ Year Member
Aug 19, 2007
6,211
26
The ATL
www.myspace.com
Status
Medical Student
I have the Harvey Elite, and I have been commended on my auscultation skills by some of the residents where I am doing research.

I will be the first to tell you that I suck badly at auscultation. I really think anything I am doing right can be attributed to my steth.

One of the residents I work with has one as well, and she loves it.
 

Orbo

10+ Year Member
Sep 18, 2007
2,046
164
Status
Resident [Any Field]
These discussions always reminds me of the ski slopes. You see scrubs all decked out in the latest awesome ski fashion clothing and the bestest shiniest boots and skis. And they're on their asses on groomed joker bunny runs. Then you venture out into the deeps where the pros are. Some have great gear, others have years-old hand me downs. But they're all still ripping it up.




MORAL: Equipment means jack diddly if you don't know how/don't have the skills to use it. Ask yourself this: how many years of training is it going to take before you can really tell the difference between these stethoscopes? Including the fact that you won't be using your stethoscope for anything meaningful for the first 2 years of med school, I'm willing to bet > 6 years.
 
OP
D

DeadCactus

SDN Lifetime Donor
Lifetime Donor
10+ Year Member
Oct 28, 2006
2,589
675
Status
Resident [Any Field]
These discussions always reminds me of the ski slopes. You see scrubs all decked out in the latest awesome ski fashion clothing and the bestest shiniest boots and skis. And they're on their asses on groomed joker bunny runs. Then you venture out into the deeps where the pros are. Some have great gear, others have years-old hand me downs. But they're all still ripping it up.




MORAL: Equipment means jack diddly if you don't know how/don't have the skills to use it. Ask yourself this: how many years of training is it going to take before you can really tell the difference between these stethoscopes? Including the fact that you won't be using your stethoscope for anything meaningful for the first 2 years of med school, I'm willing to bet > 6 years.

While I agree to an extent, I think learning a musical instrument is a better analogy. Say you want to learn guitar. You could go drop $70 for a Target brand guitar, $200 for an entry level guitar from a major manufacturer, or $2500 for a Gibson Les Paul. Now a Les Paul is a fantastic guitar, but odds are a beginner isn't ever going to make it sound fantastic and is a waste of money.

But the $70 Target guitar is a PoS that is inherently less comfortable and will never sound great. So on top of already trying to learn a difficult skill, your problems are compounded by a crappy tool. Or going back to the ski analogy, would you really want to learn to ski with bindings that come loose?

There's a sweet spot in the middle where the equipment is good enough to not get in your way, but not so good that you are wasting money for a benefit you can't appreciate...

"Ask yourself this: how many years of training is it going to take before you can really tell the difference between these stethoscopes?"

That would be the question of the day. I think there would be a noticeable increase in quality with the Harvey Elite just because of the lack of a tunable diaphragm. Between the Cardiology III and the Classic II, I don't know. But that's the point of the thread. Is the cost worth the improvement to make it easier to hear sounds while I'm still learning what they sound like? Is it worth giving up the 2-in-1 design?
 
Last edited:

stickshift

Automatics are for noobs
May 31, 2009
62
2
With a clutch pedal
Status
Medical Student
While I agree to an extent, I think learning a musical instrument is a better analogy. Say you want to learn guitar. You could go drop $70 for a Target brand guitar, $200 for an entry level guitar from a major manufacturer, or $2500 for a Gibson Les Paul. Now a Les Paul is a fantastic guitar, but odds are a beginner isn't ever going to make it sound fantastic and is a waste of money.
Well, the thing about guitars is that if you shelled out for a Gibson Les Paul, you'd be more motivated to learn guitar and play it well (and when you do, it sounds GREAT). Compared to the GLP, with a POS guitar you wouldn't know how to tweak your technique to improve and sound better.

I would say get the Cardiology III. More flexible than the Littman Elite, and sounds *almost* as good - if the Elite's acoustics were rated 10/10, then the Cardiology III would be like a 9.5/10.
 
  • Like
Reactions: Graywolf

alphaholic06

Doctor, Who? Me?
15+ Year Member
Jan 14, 2004
873
26
Status
Attending Physician
That was my 500th post. Sweet!!!!
 

Orbo

10+ Year Member
Sep 18, 2007
2,046
164
Status
Resident [Any Field]
Well, the thing about guitars is that if you shelled out for a Gibson Les Paul, you'd be more motivated to learn guitar and play it well (and when you do, it sounds GREAT). Compared to the GLP, with a POS guitar you wouldn't know how to tweak your technique to improve and sound better.

I would say get the Cardiology III. More flexible than the Littman Elite, and sounds *almost* as good - if the Elite's acoustics were rated 10/10, then the Cardiology III would be like a 9.5/10.

So wait, if you had a classic s.e. II it'd actually factor into your mind to make you less wanting to study medicine? OH COME ON
 

Rendar5

15+ Year Member
Nov 12, 2003
6,999
625
Florida
Status
Attending Physician
I thought it was time to come and beat this dead horse and get some input.

Cardiology III - Cheaper, more versatile. Appealing because the specialties most interesting to me see both adult and pediatric patients. (Do you even need a pediatric stethoscope for things like FM and EM, or will an adult size work for what you'd be listening for?)

Thoughts?
I'm in EM and I use a Littman III. Yes, I use the pediatric size every now and then when I'm working with a small child. It isn't for hearing better, since I can hear what I need to hear. Quality of a murmur isn't nearly as important as the timing and location anyway for my purposes. I do it because the larger diaphragm would be too big to press firmly on a small child. I also use the smaller diaphragm to listen to carotids on adults too, again because you can apply it fully to the surface easier.

Honestly though, get whichever stethoscope you feel like getting. Unless you're going into cardiology, the overall quality of the instrument is less important than your happiness with it. If you're happy with a nursing stethoscope, get that then.
 

fahimaz7

10+ Year Member
15+ Year Member
Jul 18, 2004
3,286
216
Colorado
Status
Attending Physician
These discussions always reminds me of the ski slopes. You see scrubs all decked out in the latest awesome ski fashion clothing and the bestest shiniest boots and skis. And they're on their asses on groomed joker bunny runs. Then you venture out into the deeps where the pros are. Some have great gear, others have years-old hand me downs. But they're all still ripping it up.




MORAL: Equipment means jack diddly if you don't know how/don't have the skills to use it. Ask yourself this: how many years of training is it going to take before you can really tell the difference between these stethoscopes? Including the fact that you won't be using your stethoscope for anything meaningful for the first 2 years of med school, I'm willing to bet > 6 years.
Except the local pros are in 4 buckle boots with damn nice bindings and planks. If not, they are on tele skis and they speak for themselves. After years of skiing, I've never seen a local badass on a ****ty pair of skis (unless it's early backcountry skiing).
 

ZagDoc

Ears, Noses, and Throats
10+ Year Member
Jul 12, 2007
1,411
24
Status
Resident [Any Field]
MORAL: Equipment means jack diddly if you don't know how/don't have the skills to use it. Ask yourself this: how many years of training is it going to take before you can really tell the difference between these stethoscopes? Including the fact that you won't be using your stethoscope for anything meaningful for the first 2 years of med school, I'm willing to bet > 6 years.
Good moral. I remember I agonized about "which stethoscope is the very best... which should I buy" before starting med school.

The fact is that any of the scopes in the $75+ range will allow you to hear the PE findings a med student is expected to pick up on. No stethoscope will "give you advantage." Listening to a ton of patients will.
 

45408

aw buddy
10+ Year Member
7+ Year Member
Jun 14, 2004
16,976
47
Status
Resident [Any Field]
Except the local pros are in 4 buckle boots with damn nice bindings and planks. If not, they are on tele skis and they speak for themselves. After years of skiing, I've never seen a local badass on a ****ty pair of skis (unless it's early backcountry skiing).
And cardiologists have expensive stethoscopes. That was kind of the connection there. The point is that we're not cardiologists.


I spent way more on my ski boots than on my stethoscope, lol. Boots = $300. Scope = $60 for the SE II.
 

Orbo

10+ Year Member
Sep 18, 2007
2,046
164
Status
Resident [Any Field]
Except the local pros are in 4 buckle boots with damn nice bindings and planks. If not, they are on tele skis and they speak for themselves. After years of skiing, I've never seen a local badass on a ****ty pair of skis (unless it's early backcountry skiing).
I have, but they're usually older gentlemen who couldn't care less about style. Those guys are gooood.
 

Xerxes1729

10+ Year Member
May 15, 2007
186
57
Status
Attending Physician
Buy the cheap one. It's fine for what you need, and if it gets lost or walks away, you're only out half as much.
 

Depakote

Pediatric Anesthesiologist
Moderator Emeritus
Lifetime Donor
10+ Year Member
Nov 2, 2004
20,811
102
SOCMOB
Status
Attending Physician
The Classic II will get you through med school, but if you go into an auscultation heavy field, you'll need to upgrade.

Personally, I have a Harvey DLX (very similar to the Elite). I'm happy with it and to my surprise, I've actually heard a couple of murmurs.
 

45408

aw buddy
10+ Year Member
7+ Year Member
Jun 14, 2004
16,976
47
Status
Resident [Any Field]
I've got the SE II, and I hear murmurs all the time, including a few that have escaped the attendings. Hearing murmurs is mostly about focus and not just holding it on their chest while you or the patient is talking.
 

TopSecret

Removed
Jul 14, 2009
1,095
4
949, 310
Status
Attending Physician
I use the Classic II SE. I had the Cardio III before it got stolen. It was a good stethoscope although a bit bulky and hard to coil and stuff into a coat pocket.

The Classic II SE is good for most applications and probably the one most suitable for medical students who also need to carry a ton of stuff in their pockets.
 

TopSecret

Removed
Jul 14, 2009
1,095
4
949, 310
Status
Attending Physician
Avoid the Classic. You'll be fine with the others. Just make sure you label it (engrave).
Yeah, labeling is a good thing to do. It would've kept my Cardio III from growing legs and walking away.

But regarding the Classic II, I like it even more than the Cardio III because it's light, you could hear a lot with it, and it's cheap. Medical students who want to cram as much into their pockets as possible should probably buy a Cardio II because they would still look respectable with it. If an attending were to ask why he or she doesn't have a Cardio III, the student could always say that they have no money and the attending would probably agree and leave it at that.
 
Jul 2, 2009
182
2
Status
Resident [Any Field]
Harvey Elite is a great stethoscope. Having a real bell has been helpful.
 

Pinkertinkle

2003 Member
10+ Year Member
15+ Year Member
Oct 16, 2003
5,004
79
Status
Attending Physician
who needs a stethescope when u can order an echo yay
 

OnDemond

Long Live the DX7
10+ Year Member
7+ Year Member
Nov 26, 2008
72
13
Maryland, USA
www.MondMusic.com
Status
Post Doc
But regarding the Classic II, I like it even more than the Cardio III because it's light, you could hear a lot with it, and it's cheap. Medical students who want to cram as much into their pockets as possible should probably buy a Cardio II because they would still look respectable with it. If an attending were to ask why he or she doesn't have a Cardio III, the student could always say that they have no money and the attending would probably agree and leave it at that.
I'm with you on that, but what happens if I get the SE II and then, perhaps as early as MS-III/MS-IV, discover that a cardio III would really be more useful? Will I have to adapt to the differences in sound and usage of the cardio III, or will that not be an issue?
 

bambi

Junior Member
10+ Year Member
15+ Year Member
Aug 5, 2003
827
32
England
Visit site
Status
Resident [Any Field]
I had a classic II but bought a cardiology III and definitely notice the difference.
 

OnDemond

Long Live the DX7
10+ Year Member
7+ Year Member
Nov 26, 2008
72
13
Maryland, USA
www.MondMusic.com
Status
Post Doc
I had a classic II but bought a cardiology III and definitely notice the difference.
Yes, but I'm asking if you had to get used to the difference? Did switching over to the cardio III actually impair you auscultation skills before you get used to your new steth? Will it be a drawback?
Will it be like switching from a $200 guitar to a Gibson Les Paul and having to get used to the lower action?
Thanks!
 

Pinkertinkle

2003 Member
10+ Year Member
15+ Year Member
Oct 16, 2003
5,004
79
Status
Attending Physician
Come on guys, medical students have such crummy auscultation skills it hardly matters if you're using a Cardio III or a cup with a string in it.
 

Orbo

10+ Year Member
Sep 18, 2007
2,046
164
Status
Resident [Any Field]
Even better when those cardiology III toting medical students can't get a blood pressure reading right. Durrrrrr.
 

Depakote

Pediatric Anesthesiologist
Moderator Emeritus
Lifetime Donor
10+ Year Member
Nov 2, 2004
20,811
102
SOCMOB
Status
Attending Physician
I've heard Littmann's Cup with a String is good and that's what most of my class has, but the Harvey Cup with a String is designed with concert-grade piano string for superior acoustic performance. I just can't decide. Help?
 

TopSecret

Removed
Jul 14, 2009
1,095
4
949, 310
Status
Attending Physician
I'm with you on that, but what happens if I get the SE II and then, perhaps as early as MS-III/MS-IV, discover that a cardio III would really be more useful? Will I have to adapt to the differences in sound and usage of the cardio III, or will that not be an issue?
It's not an issue. Most likely the attending's hearing will be worse than yours and you will appreciate more heart sounds with a Classic II than an attending could with a Cardio III.
 

bambi

Junior Member
10+ Year Member
15+ Year Member
Aug 5, 2003
827
32
England
Visit site
Status
Resident [Any Field]
Yes, but I'm asking if you had to get used to the difference? Did switching over to the cardio III actually impair you auscultation skills before you get used to your new steth? Will it be a drawback?
Will it be like switching from a $200 guitar to a Gibson Les Paul and having to get used to the lower action?
Thanks!
No
 

OnDemond

Long Live the DX7
10+ Year Member
7+ Year Member
Nov 26, 2008
72
13
Maryland, USA
www.MondMusic.com
Status
Post Doc
Thnks for the reassurance and the humor.
BTW, Littman cups with strings have a master version with double-string design. One high-C piano string for high frequencies, and one low-G for the low frequencies. The cup is Dixie Extra-tough with a non-chill rim...
 
May 30, 2009
3
0
Canton, MI
Status
Medical Student
Thnks for the reassurance and the humor.
BTW, Littman cups with strings have a master version with double-string design. One high-C piano string for high frequencies, and one low-G for the low frequencies. The cup is Dixie Extra-tough with a non-chill rim...
Cups on a string are for chumps; If you really want to hear heart sounds, you need a tin can on a string. Also, I've heard amazing things about the electronic tin cans on a string.
 

physiologyguy

Member
10+ Year Member
5+ Year Member
Jul 1, 2006
150
0
Status
Medical Student
I started with the Littman 3 and eventually just decided it wasn't worth it. I now use the old-fashioned-but-good "ear to the chest and back" to hear. It looks funny and some patients act uncomfortable (probably b/c they're just not used to it!), but it works great.
 

TopSecret

Removed
Jul 14, 2009
1,095
4
949, 310
Status
Attending Physician
I started with the Littman 3 and eventually just decided it wasn't worth it. I now use the old-fashioned-but-good "ear to the chest and back" to hear. It looks funny and some patients act uncomfortable (probably b/c they're just not used to it!), but it works great.
You probably don't want to try that on a woman, though, no matter how great your skills are.
 

howelljolly

10+ Year Member
Aug 30, 2007
2,059
6
Status
Resident [Any Field]
OK Ive arrived.

Go for the Welch Allyn Harvey Elite.

The price you found is too high... they usually run for $135.

Avoid the Classic II SE. There aren't a whole lot of "studies" on it, since it isnt marketed as a cardiology grade scope. However, there is one good study which I dont feel like searching for, which compared the bell and diaphragm within each scope. It looked for a significant difference between the frequency range of each side. It found that there was no significant difference between the bell and the diaphragm of the Classic II SE. Kinda intuitive really, the bell doesnt really look much different from the diaphragm.
The most significant difference was in the Elite.


I really like the guitar analogy.
 

Blue Dog

Fides et ratio.
Gold Donor
10+ Year Member
Jan 21, 2006
12,251
4,986
Status
Attending Physician

xanthomondo

nom nom nom
Removed
10+ Year Member
Apr 2, 2006
15,650
20
the island of Doctor Moreau
Status
Resident [Any Field]
I had the Classic II. When I took blood pressures the only thing I could hear was the crackling of my knuckles. I also had a tough time holding the bell/diaphragm because my fingers are so fat (lol). I got a Cardio III and it is 1000x better than the II. The bell is much bigger so I can hold it and I no longer hear my knuckles when listening. The extra money is definitely worth it.
 

azntxn

10+ Year Member
Mar 1, 2008
74
1
Status
Resident [Any Field]
I say get the Littmann Electronic Stethoscope only cost an arm and a leg
 

MossPoh

Textures intrigue me
10+ Year Member
7+ Year Member
Apr 24, 2006
7,990
43
Tally/Willkillya County
psu.facebook.com
Status
Medical Student
and you look like a tool unless you have hearing problems.
 

student1799

"Señora” to you, hombre
10+ Year Member
5+ Year Member
Jul 8, 2008
1,484
7
Status
Medical Student
As a first-year student who recently had to buy a scope, I was all set to get a Littmann, because that's what "everyone" gets. But I searched SDN first, and found [post=3289972]these very interesting comments[/post] by Blue Dog, who loves the Welch Allyn Harvey Elite and dislikes all current Littmanns (they now have tunable diaphragms, which very hard for students to get the hang of). His post and favorable comments from a number of others (see [thread=302679]this thread[/thread]) convinced me to go with Welch Allyn.

I've now been using the scope for a month or so, and I like it very much. (FYI, I'm using the flat diaphragm.) I'm not pretending that I can detect exotic heart sounds yet, but I can hear the basic lub-dub sounds much more clearly with the Harvey than with my classmates' Littmanns. Sounds from the Harvey are fairly quiet, but much clearer to my ears than from a Littmann scope, and with much less background noise.

As far as price is concerned, I couldn't find the scope for the $135 many people claim they've seen. But if you go to the Welch Allyn website and register as a medical student, you can buy the Harvey Elite directly from them for about $145, plus $10 shippping. I bought mine from a medical supply website called steeles.com, which offered the same student price but also engraved my name on the scope (additional fee).
 
Last edited:
  • Like
Reactions: farmedic823
Oct 12, 2009
27
0
Status
Resident [Any Field]
I had a Littman Cardiology III in med school, and had it in the beginning of internship as well. I then lost it halfway through internship, and being poor, I began using a disposable ICU stethoscope. Honestly, I heard a lot more with the $10 disposable stethoscope than the ~$120 Littman. I immediately noticed a difference, so it wasn't just that I was more experienced or whatever. Just my $.02. One difference, and something that I've heard from others as well, is that the disposable one had hard earpieces, not rubber. Some say that makes a difference.
 

xanthomondo

nom nom nom
Removed
10+ Year Member
Apr 2, 2006
15,650
20
the island of Doctor Moreau
Status
Resident [Any Field]
and you look like a tool unless you have hearing problems.
I love this mentality.

My friend does have hearing problems, and she did buy the electronic stethoscope (and it works for her) but holy hell EVERYONE bats crazy-ass eyes at her and assumes toolage right off the bat. Everytime she has something that requires her stethoscope she pretty much has to explain herself.

You want to wear your "normal" stethoscope while playing pool or ping pong in a building 15 miles from a patient because you have a standardized patient 4 hours from then? Perfectly normal. But OH GOD, DO NOT buy a better stethoscope than what most medical students splurge for. *THAT would be SOO toolish.*
 

MossPoh

Textures intrigue me
10+ Year Member
7+ Year Member
Apr 24, 2006
7,990
43
Tally/Willkillya County
psu.facebook.com
Status
Medical Student
That is why I said unless you have hearing problems. If you have hearing problems then it is perfectly acceptable because you need the amplification. It is the same thing as buying a 2000 dollar guitar if you don't know how to play yet.

The buy the most expensive mentality is toolish in every area of life. More expensive does not equate to better. Not to mention stethoscopes develop legs and walk away, so if you want to plop the 300 dollars and have it stolen then go for it.
 
  • Like
Reactions: Athens

end stage fibro

die lauded
Lifetime Donor
10+ Year Member
Feb 12, 2005
78
4
Status
Attending Physician
i have a harvey elite and i love it. the only problem with it is the actual diaphragm seems like it's made out of laminated construction paper- i dunno how durable it is. also, it is a tad bit shorter than the littmanns, but i dont mind.

i bought mine on sale from steeles.com for about $130 shipped. if you buy the student version it comes with a free pediatriac diaphragm kit. you can check on ebay too, sometimes they are sold dirt cheap