Littmann 3200 worth the investment?

[actnow]

http://www.amazon.com/exec/obidos/t..._shr?_encoding=UTF8&m=A367RFIQRDER75&v=glance


I have heard of the importance of getting a great stethoscope. This electronic microscope has been ranked in the top 10 inventions of 2009 and "Nine Technologies To Save Money For Our Healthcare System." http://www.popsci.com/technology/article/2010-02/nine-technologies-save-money-our-health-care-system

It costs around $380 and am trying to decide if it would be worth the investment. It is pretty amazing what it can do. Check it out.


I will be entering medical school this fall 2010. Should I wait till rotations? Or will there be a need for it in years 1 and 2?


Edit - I simply ran across this steth and thought it was pretty cool. I do not infer that I will cure world disease, hunger, and poverty with it (ie Resident tkim)!

---

Members don't see this ad.

 

[gatewasani]

I would wait...you're probably not gonna need it now anyway, maybe you'll get it as a gift or something later

Also, I wouldn't pay $380 for a stethescope but thats just me

 

[tkim]

You should not get it. Get a decent non-electronic one during clinical years unless your school requires them earlier for early patient exposure.

It's a little much for an entering med student to have. And if you really want one, getting it this early may prevent you from getting it cheaper or a better one two years later.

 

[Cheshyre]

Agree with everybody else - don't get it. I have a Littmann Classic SE that I bought for EMT use (Rush University Bookstore had them for cheap a year ago) that is perfectly fine for most people. It's got a tunable diaphragm and two sides. That pretty much covers daily use.

The only good reasons I've heard for getting an electronic one are either if you want to record what you hear OR if you're working on an ambulance and need something to cancel out the noise of the rig.

 

[actnow]

The only good reasons I've heard for getting an electronic one are either if you want to record what you hear OR if you're working on an ambulance and need something to cancel out the noise of the rig.

This one has additional features. Look at the link. You can use a program to analyze the sounds among other useful apps.

 

[BassCaster]

seems like a pretty cool gadget. don't know why, but a 1st year med student using this electronic stethoscope reminds me of the indian premed kid in my organic 2 class wearing full scrubs to the final. don't even think there's a correlation between the two, but the word excessive comes to mind. if i had one, it feels like the interns, residents, and attendings would be laughing behind my back...

 

[actnow]

seems like a pretty cool gadget. don't know why, but a 1st year med student using this electronic stethoscope reminds me of the indian premed kid in my organic 2 class wearing full scrubs to the final. don't even think there's a correlation between the two, but the word excessive comes to mind. if i had one, it feels like the interns, residents, and attendings would be laughing behind my back...

I felt there would be a response like this.


I thought quality of care was most important, not image. Technology is the future of healthcare, embrace it! Call me a geek so be it. All I care about is delivering the best error free healthcare to patients and if a "cool gadget" can do that then why not? Thousands of murmurs are missed every year. In 10-20 years, electronic stethoscopes will be the norm, no doubt. They are already pretty common today. There is a huge difference between excessive and practical.

I see it is better to wait til clinical years. I will take that advice.

 

[ChiDO]

Some schools will give you a steth as a gift. Wait until you get into school.

 

[nascardoc]

I agree to wait until clinical years. You won't use it enough during the first 2 years to warrant the cost. Plus, its just gonna sit on a shelf or in the box most of the time. If you really want this steth, which is fine, wait until the end of 2nd year to purchase it. The cost, hopefully, will go down by then, plus, who knows what time will bring in 2 years. Technology is always changing.

Personally, I find the electronic steths awesome and would love to have one, but the cost is a huge issue. So, I am going to wait until residency to look seriously at them. I think it would be a great tool for teaching purposes, plus you can put them in the EMR chart, which is pretty cool. Plus, to have interesting sounds on your computer from real pts would be very nice, especially when it comes time to give a lecture or presentation.

I would recommend getting a "regular" steth as well in case attendings want you to use that instead. Know how to use both 😉

 

[BassCaster]

I felt there would be a response like this.


I thought quality of care was most important, not image. Technology is the future of healthcare, embrace it! Call me a geek so be it. All I care about is delivering the best error free healthcare to patients and if a "cool gadget" can do that then why not? Thousands of murmurs are missed every year. In 10-20 years, electronic stethoscopes will be the norm, no doubt. They are already pretty common today. There is a huge difference between excessive and practical.

I see it is better to wait til clinical years. I will take that advice.

I typed and was referring to a 1st year med student. It's excessive and not practical as a first year. You're taking this way out of context. Extrapolating what i said to talking about quality of care vs. image? please...

 

[tkim]

I felt there would be a response like this.

I thought quality of care was most important, not image. Technology is the future of healthcare, embrace it! Call me a geek so be it. All I care about is delivering the best error free healthcare to patients and if a "cool gadget" can do that then why not? Thousands of murmurs are missed every year. In 10-20 years, electronic stethoscopes will be the norm, no doubt. They are already pretty common today. There is a huge difference between excessive and practical.

All I see is a premed who got accepted to med school, who has yet to matriculate but has already changed his status to that of 'med student'. If that isn't all about 'image' then I don't know what is.

The thought of you and your electronic stethoscope going out and conquering disease and detecting heretofore undetected murmurs saving thousands of lives is laughable and full of hubris.

I guarantee you, that if you show up to school with one during preclinical people will laugh at you.

If you wait until clinical and bring one on rotations, you will be admonished for not being able to recognize murmurs without electronic help, and probably told not to use it.

Mark it.

 

[actnow]

All I see is a premed who got accepted to med school, who has yet to matriculate but has already changed his status to that of 'med student'. If that isn't all about 'image' then I don't know what is.

The thought of you and your electronic stethoscope going out and conquering disease and detecting heretofore undetected murmurs saving thousands of lives is laughable and full of hubris.

I guarantee you, that if you show up to school with one during preclinical people will laugh at you.

If you wait until clinical and bring one on rotations, you will be admonished for not being able to recognize murmurs without electronic help, and probably told not to use it.

Mark it.

Did you know that the stethoscope cures AIDS, TB, and Malaria also.

Nice psychoanalysis of me you are right on! IIII think I know what residency you are in....huh?

When I created my file, I was already accepted to med school so just chose "med-student". I didn't realize I created a SDN mortal sin. I really didn't think twice about it.

 

[actnow]

I typed and was referring to a 1st year med student. It's excessive and not practical as a first year. You're taking this way out of context. Extrapolating what i said to talking about quality of care vs. image? please...

Sorry I thought you were talking about them in general, not just for 1st year. Yes I extrapolated a little then, my bad.

 

[ShyRem]

Also, you are not permitted an electronic stethoscope during COMLEX level 2.

 

[Old Grunt]

http://www.amazon.com/exec/obidos/t..._shr?_encoding=UTF8&m=A367RFIQRDER75&v=glance


I have heard of the importance of getting a great stethoscope. This electronic microscope has been ranked in the top 10 inventions of 2009 and "Nine Technologies To Save Money For Our Healthcare System." http://www.popsci.com/technology/article/2010-02/nine-technologies-save-money-our-health-care-system

It costs around $380 and am trying to decide if it would be worth the investment. It is pretty amazing what it can do. Check it out.


I will be entering medical school this fall 2010. Should I wait till rotations? Or will there be a need for it in years 1 and 2?


Edit - I simply ran across this steth and thought it was pretty cool. I do not infer that I will cure world disease, hunger, and poverty with it (ie Resident tkim)!

I wouldn't get it. In all seriousness, your classmates will think you are probably a dork (that might not be a good reason). I am on an internal medicine rotation right now, and I've only seen one electronic stethoscope in the entire hospital and that belonged to a cardiothoracic surgeon. All the residents and attendings have the regular Littmann's or the Tyco ones.

At my school, we had to plunk down money for a whole mess of clinical stuff (otoscope, opthalmoscope, etc) and I got my cheapie Tyco stethescope that I use. It seems to do the trick, and I've even opted against buying a more expensive Littmann. My logic is that, like learning to play on a crappie guitar, things will be that much easier when I bump up.

Even more important, I would think, is developing your own ear and clinical competency. If you can't catch a gallop with a regular stethoscope because you don't know what to listen for, you won't catch it with an expensive one either.

Finally, you'll do hunky dory in Med School without a cyborg stethoscope. Then it is on to residency. What in the hell are you going to do if you end up doing a residency that is not stethoscope heavy?

Just my opinion on the matter.

 

[tkim]

Did you know that the stethoscope cures AIDS, TB, and Malaria also.

Nice psychoanalysis of me you are right on! IIII think I know what residency you are in....huh?

Obviously, you do not.

When I created my file, I was already accepted to med school so just chose "med-student". I didn't realize I created a SDN mortal sin. I really didn't think twice about it.

Dunno about you, but when I see 'med student' I assume that that person is currently a med student. Unless you mean to tell me that there is no difference between you and a current med student.

It's kind of like me - a resident, about to graduate in four months, calling myself an 'attending'. I'm going to graduate soon and be an attending, so I really don't need to think twice about it. Right?

 

[cyclohexanol]

http://www.amazon.com/exec/obidos/t..._shr?_encoding=UTF8&m=A367RFIQRDER75&v=glance


I have heard of the importance of getting a great stethoscope. This electronic microscope has been ranked in the top 10 inventions of 2009 and "Nine Technologies To Save Money For Our Healthcare System." http://www.popsci.com/technology/article/2010-02/nine-technologies-save-money-our-health-care-system

It costs around $380 and am trying to decide if it would be worth the investment. It is pretty amazing what it can do. Check it out.


I will be entering medical school this fall 2010. Should I wait till rotations? Or will there be a need for it in years 1 and 2?


Edit - I simply ran across this steth and thought it was pretty cool. I do not infer that I will cure world disease, hunger, and poverty with it (ie Resident tkim)!

While it is a "cool" gadget it is super impractical, especially for a pre-clinical med student. I know you're excited to begin your education and whatnot, but don't buy this... here is why

1) $380 is about 2-4x more than you should spend on a steth at any stage in your training.
2) As noted, its toolish.
3) As noted, its not allowed on COMLEX Level 2 PE.
4) Similar to the argument against getting a panoptic ophthalmoscope, you don't learn to use the regular ones, which are FAR more common and available.
5) Stethoscopes are -frequently- lost or stolen, especially fancy ass ones.

And lastly, you posted on a forum whether you thought it was worth it to buy. After numerous posts to the contrary from people who have "been there done that", you rattle back about how you should get it under the guise of providing better care. If you want the ****ing steth, just buy it despite what everyone is trying to tell you. However, don't be an ass to the people trying to stop you from making a $380 mistake. 👍

I'd wait until you start to see if your school gives you one (unlikely ) and if not, find yourself a nice Littmann classic II, cardiology III, or similar for $75-$140.

Good luck!

 

[DrMom]

The only reason to get an electronic stethoscope and pay that kind of money is if you have a hearing loss and that stethoscope helps you hear what you are supposed to hear. If your hearing is okay, you will hear fine with a regular stethoscope.

 

[J-Rad]

I also would advise against the electronic stethoscope for the time being for a few reasons additional to those (appropriately) cited above:

1. Early in your education, it may prove to be an impediment to your learning. I think the art of physical examination should be learned organically at first. When the fundamentals are learned, then the layers of technology can be embraced. When you invariably lose or misplace (be it permanently or temporarily) your electronic stethoscope (or the batteries go dead-even more of an inevitability), you want to have the fundamental ability to use a standard device (which sometimes is a piece of crap at the patient's bedside if they're in the NICU or in isolation for some reason. BTW, do you want to use your $300+ steth on someone colonized with some drug-resistant funbugginess requiring gobs of killerpenem and gadzooksafloxacin?)

2. Some people find that the amplification of lung sounds overwhelms the heart sounds; and lung sounds aren't "ambient environment" to filter out. One of our staff pediatric cardiologists had this problem (and the battery-dead problem).

3. At this stage, do you know you are going into a field that requires "the best" stethoscopy has to offer? If you are personally wealthy, that's one thing, but a lot of med students aren't and fronting that much bank at the beginning is quite a bit. If you go into path or rads, you'll hang that bad boy up forever. Surgery? You'll buy some cheapo that you don't care about. Like others have said, if time comes that you're heading into a field that it will be helpful the tech will likely be better and cheaper. Another aside: don't buy the ridiculously overpriced and undervaluable oto/ophthalmoscope and sphygmomanometer set either (and most definitely not the "glorious" Panoptic). Buy a cheap but usable blood pressure cuff and get an inexpensive set of the Pocket oto/ophthlamoscopes on ebay (the latter you might actually find use for since they fit in a lab coat without weighing it down. I still use my Pocket otoscope on my kids). Selling those things to incoming med students is the biggest scam running.

 

[Old Grunt]

3. At this stage, do you know you are going into a field that requires "the best" stethoscopy has to offer? If you are personally wealthy, that's one thing, but a lot of med students aren't and fronting that much bank at the beginning is quite a bit. If you go into path or rads, you'll hang that bad boy up forever. Surgery? You'll buy some cheapo that you don't care about. Like others have said, if time comes that you're heading into a field that it will be helpful the tech will likely be better and cheaper. Another aside: don't buy the ridiculously overpriced and undervaluable oto/ophthalmoscope and sphygmomanometer set either (and most definitely not the "glorious" Panoptic). Buy a cheap but usable blood pressure cuff and get an inexpensive set of the Pocket oto/ophthlamoscopes on ebay (the latter you might actually find use for since they fit in a lab coat without weighing it down. I still use my Pocket otoscope on my kids). Selling those things to incoming med students is the biggest scam running.

Yup, we got a pan-ophthalmoloscope in our "clinic package" that sits in my office unused. At you noted, it's not any better than the cheaper versions that are readily available, and even if it was, is too bulky to carry around.

We didn't have a choice in the matter, it was automatically added to our tuition.

I find it ironic that, as a student, the things I use the most (scope, micro-filament, tuning fork, and reflex hammer) are all relatively cheap. Which is why I don't sweat losing them.

I can understand being excited to start school, but I think it's a huge mistake to rely on a technological crutch when you are supposed to be learning the basics.

Sounds like the OP has his mind made up, though. Can't say he wasn't warned.

OP, if you buy this, make you you always have spare batteries so you aren't lugging a $400 paper weight around your neck.

 

[actnow]

Ok then the majority opinion is that this is a bunch of BS:

The stethoscope is older than the x-ray, the ballpoint pen, Popular Science and pretty much everything else in your doctor's office. Now, 190 years after its invention, the go-to diagnostic tool hanging around every doc's neck has earned a modern makeover. The sound-amplifying 3M Littmann Electronic Stethoscope 3200 listens to a patient's heartbeat—lub-DUB, lub-DUB—and beams the beats to Cardioscan software that detects abnormalities.
Even top physicians have trouble discerning the swishing sounds that result from irregular surges of blood after the lub from the ones that follow the DUB. Called murmurs, the former are harmless, but the latter can indicate ailments such as congenital heart defects, holes in the heart wall, and constricted or leaky heart valves that interrupt blood flow. If the heartbeat sounds remotely atypical, many doctors prescribe a conclusive, and expensive, echocardiogram test.
3M's stethoscope eliminates that guesswork. It transmits heart sounds to a doctor's PC by Bluetooth, and Cardioscan renders a near real-time graphical representation of the sounds onscreen. The software then analyzes the sound waves and highlights minute abnormalities that signal harmful murmurs. The doctor can play the sound back at half speed to diagnose a problem more confidently, save the file to the patient's chart, and e-mail it all to a cardiologist to confirm the diagnosis. Early tests of the system suggest that it could eliminate more than eight million unnecessary echocardiograms and cardiologist visits a year, saving some $9.4 billion and, even better, catch more of the dangerous murmurs. For doctors, and anyone with a heart, this stethoscope's upgrades are well worth the two-century-long wait"
http://www.popsci.com/bown/2009/pro...ope-model-3200-zargis-medical-corp-cardioscan


I am going to get it, just a matter of when. I am just surprised my some of the posts, narrow mindedness.

You see, people do not go into healthcare with the intention of making a mistake. However MISTAKES HAPPEN! Let me repeat that, MISTAKES HAPPEN! You might think you are perfect and won't miss anything, however, I live in reality.

If you read the title of the thread, I ask if it should be a good investment. Investment meaning good for future use. Future use meaning beyond medical school and into practice. Some people have given me helpful opinions to wait until clinical years. I will do that.


Cyclohexanol,
If you ever make a preventable mistake that this steth could have prevented your response would be "Its toolish!" Ok I understand.
And paying 2x to 4x more than what the average is a valid reason? Ensuring mistake free healthcare vs the chance of making a mistake (well none in your case)? Ok I understand. It seems so "super impractical." Right.


I am 100% for learning the right way and not having to rely on electronics! I plan to. However, my concerns of whether this was a good investment had to with this being a valuable learning tool while in medical school, being very practical or not in residency. I know the rest and how valuable it will be beyond then. My point is: WHY NOT HAVE TECHNOLOGY BACK YOU UP, even if it is only for a few tests. (I know i will get more, "go save the world responses")


I dont think you should be allowed to use the steth on COMLEX II !! Learn the right way first !



Conclusion: (according majority vote on sdn) "The Health Grand Award Winner" is waste of money. 🙄

Key word: INVESTMENT


Off to save the world with my steth!

 

[tkim]

http://www.amazon.com/exec/obidos/t..._shr?_encoding=UTF8&m=A367RFIQRDER75&v=glance


I have heard of the importance of getting a great stethoscope. This electronic microscope has been ranked in the top 10 inventions of 2009 and "Nine Technologies To Save Money For Our Healthcare System." http://www.popsci.com/technology/article/2010-02/nine-technologies-save-money-our-health-care-system

It costs around $380 and am trying to decide if it would be worth the investment. It is pretty amazing what it can do. Check it out.


I will be entering medical school this fall 2010. Should I wait till rotations? Or will there be a need for it in years 1 and 2?


Edit - I simply ran across this steth and thought it was pretty cool. I do not infer that I will cure world disease, hunger, and poverty with it (ie Resident tkim)!

I can't believe you edited your original post to take a jab at me. What a jackass.

 

[DrMom]

Spending $380 on something you do not need (because you can hear) for a need (having a stethoscope) that you can fill very well with something that costs $160 is not a good investment.

 

[Cheshyre]

I can't believe you edited your original post to take a jab at me. What a jackass.

I can't believe he created this thread in order to ignore every single opinion given.

 

[Old Grunt]

Ok then the majority opinion is that this is a bunch of BS:

Sigh..........

"Nobody wants advice. Only corroboration."

- John Steinbeck.

Why bother to ask people's opinion if you have your mind made up?

I mean, you now have fellows, Residents, and Med Students who have given you a plethora of reasons why this is a bad idea, but you aren't interested in anyone's advice.

Where did you get this "majority opinion"? When I read this "majority opinion" aka "advertisement" I had to laugh. It obviously was written for the naive.

Even top physicians have trouble discerning the swishing sounds that result from irregular surges of blood after the lub from the ones that follow the DUB. Called murmurs, the former are harmless, but the latter can indicate ailments such as congenital heart defects, holes in the heart wall, and constricted or leaky heart valves that interrupt blood flow. If the heartbeat sounds remotely atypical, many doctors prescribe a conclusive, and expensive, echocardiogram test.

If an advertisement has to tell a potential buyer what a murmur is, then they are a sucker if they buy the product. This ad makes it sound like you can't ausciltate PDAs, VSDs, ASDs, valvular defects, rubs, gallops, etc with a regular stethescope. As if physicians haven't been detecting these items for a 100 years with regular scopes. How do you think they were discovered?

I've yet to see a Dr. prescribe an echo because they were just certain that there was a murmur that they couldn't auscultate with there stethoscope. I'd like to see that Order. "Echo. Re: Heart murmur that I can't hear with my stethescope."

Now if the electronic stethoscope can give you an ejection fraction or determine degrees of stenosis or prolapse, I will be adequately impressed.

3M's stethoscope eliminates that guesswork. It transmits heart sounds to a doctor's PC by Bluetooth, and Cardioscan renders a near real-time graphical representation of the sounds onscreen. The software then analyzes the sound waves and highlights minute abnormalities that signal harmful murmurs. The doctor can play the sound back at half speed to diagnose a problem more confidently, save the file to the patient's chart, and e-mail it all to a cardiologist to confirm the diagnosis.

LMAO.

I am going to get it, just a matter of when. I am just surprised my some of the posts, narrow mindedness.

Not some. All. You are universally being told this is a bad idea by people in multiple levels of their training.

You see, people do not go into healthcare with the intention of making a mistake. However MISTAKES HAPPEN! Let me repeat that, MISTAKES HAPPEN! You might think you are perfect and won't miss anything, however, I live in reality.

You are right. Mistakes happen. Even with $400 dollar stethoscopes.

BTW, you are supposed to make mistakes as a med student. That's how you learn.

Case in point, the other day I missed a gallop on a person with CHF because, well, I had my head up my ass. I wouldn't have caught it with a fancy scope either because the problem wasn't the equipment, it was the operator.

So when I went over my physical exam findings and said the heart was RRR. The resident politely corrected me when I was done and it was a good learning point.

Won't do that again.

If you read the title of the thread, I ask if it should be a good investment. Investment meaning good for future use. Future use meaning beyond medical school and into practice. Some people have given me helpful opinions to wait until clinical years. I will do that.

Bookmark this thread. I've got money that says you won't.

Cyclohexanol,
If you ever make a preventable mistake that this steth could have prevented your response would be "Its toolish!" Ok I understand.
And paying 2x to 4x more than what the average is a valid reason? Ensuring mistake free healthcare vs the chance of making a mistake (well none in your case)? Ok I understand. It seems so "super impractical." Right.

As a medical student, you are part of the patient care equation to learn. Not to be the final line of defense against medical mistakes. That's what residents and attendings are for.

I am 100% for learning the right way and not having to rely on electronics! I plan to. However, my concerns of whether this was a good investment had to with this being a valuable learning tool while in medical school, being very practical or not in residency. I know the rest and how valuable it will be beyond then. My point is: WHY NOT HAVE TECHNOLOGY BACK YOU UP, even if it is only for a few tests. (I know i will get more, "go save the world responses")

Again:
1.) It's not a good investment.
2.) It's not a good learning tool.
3.) It's not practical as a student.
4.) You are going to look like the kid whose parents bought him an expensive guitar but who can't play a lick.

Since our opinions don't seem to matter, do some of your own research. If you volunteer at a hospital, do manual count of how many of the staff have regular equipment versus this thing.

Conclusion: (according majority vote on sdn) "The Health Grand Award Winner" is waste of money. 🙄

BTW, what in the hell is the "Health Grand Award Winner"?

Is it an award given out by physicians or by tech heads who have to read a brochure to know what a murmur is?

 

[Cheshyre]

Why bother to ask people's opinion if you have your mind made up?

Haha! I get it! The OP is a shill from 3M. I mean, you've gotta have this electronic stethoscope or people are GOING TO DIE. Then, you'll be sued for malpractice and end up on the streets. Also, your mother will hate you. You will have brought shame upon your family.

But wait! There's more! You too can have a successful life! Just buy this Littmann 3200! It slices! It dices! Are you getting this, camera guy? If you act now, you'll even get a sphygmomanometer, ABSOLUTELY FREE!

 

[actnow]

I can't believe he created this thread in order to ignore every single opinion given.

I came in with the intention of seeking opinions and taking advice (Some people were very helpful, Thank You). When I get majority answers that it is "toolish to have this steth" and get personally insulted than it gets to where I stand now and I question the opinions given.


I am thru arguing it will just get nowehre from here. It is too IMMATURE.

 

[tkim]

I am thru arguing it will just get nowehre from here. It is too IMMATURE.

 

[tkim]

http://www.ncbi.nlm.nih.gov/pubmed/15882458?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed

BMC Med Educ. 2005 May 9;5(1):14.
Cardiac auscultation training of medical students: a comparison of electronic sensor-based and acoustic stethoscopes.

Høyte H, Jensen T, Gjesdal K.

University of Oslo, Faculty of Medicine, Oslo, Norway. [email protected]

BACKGROUND: To determine whether the use of an electronic, sensor based stethoscope affects the cardiac auscultation skills of undergraduate medical students. METHODS: Forty eight third year medical students were randomized to use either an electronic stethoscope, or a conventional acoustic stethoscope during clinical auscultation training. After a training period of four months, cardiac auscultation skills were evaluated using four patients with different cardiac murmurs. Two experienced cardiologists determined correct answers. The students completed a questionnaire for each patient. The thirteen questions were weighted according to their relative importance, and a correct answer was credited from one to six points. RESULTS: No difference in mean score was found between the two groups (p = 0.65). Grading and characterisation of murmurs and, if present, report of non existing murmurs were also rated. None of these yielded any significant differences between the groups. CONCLUSION: Whether an electronic or a conventional stethoscope was used during training and testing did not affect the students' performance on a cardiac auscultation test.

http://www.ncbi.nlm.nih.gov/pubmed/16824835?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed

Am Heart J. 2006 Jul;152(1):85.e1-7.
Effect of teaching and type of stethoscope on cardiac auscultatory performance.

Iversen K, Søgaard Teisner A, Dalsgaard M, Greibe R, Timm HB, Skovgaard LT, Hróbjartsson A, Copenhagen O, Copenhagen S, Copenhagen K.

Clinic of Cardiology, Rigshospitalet, Copenhagen Ø, Denmark. [email protected]

BACKGROUND: Auscultation of the heart is a routine procedure. It is not known whether auscultatory skills can be improved by teaching or with the use of an advanced stethoscope. METHODS: This study was a randomized trial with a 2 x 2 factorial design. Seventy-two house officers were randomized to a simple or an advanced stethoscope and to a 4-hour course in auscultation or no course. The doctors auscultated 20 patients' hearts and categorized findings as normal or as one or more of 5 categories of heart diseases. Patients were selected such that 16 had a known heart disease as well as a corresponding murmur and 4 had no heart disease or murmur. Auscultatory performance was assessed as concordance with echocardiographic findings and interobserver variation. RESULTS: Doctors using the advanced stethoscope diagnosed 35% of the patients correctly, as compared with doctors using the simple stethoscope who did 33% of the patients (P = .27). Similarly, 34% of the patients were diagnosed correctly by doctors who had received teaching as compared with 33% of those who were by doctors who had received no teaching (P = .41). The kappa values were higher for doctors who had received teaching for aortic stenosis (0.43 vs 0.28, P = .004) and ventricular septum defect (0.07 vs 0.01, P = .003). There was no difference between groups for any other single murmur or for the detection of murmurs as such. CONCLUSION: Heart auscultation findings were in poor accordance with echocardiographic findings and had high interobserver variation. Neither outcome improved to any important extent with the subjects' use of an advanced stethoscope or attending of a course in heart auscultation.

 

[actnow]

I doubt ppl have even taken the time to read through this article and the comments about the steth.


This isn't just a typical electronic steth like everyone believes.

All I ask is to please actually read it b4 mocking it! The first thing in an argument is to fully understand both sides. Stop siding with your biases and grow up. Thats all! The source is def credible.

http://www.popsci.com/bown/2009/pro...ope-model-3200-zargis-medical-corp-cardioscan

 

[J1515]

Stop siding with your biases and grow up. Thats all! The source is def credible.

http://www.popsci.com/bown/2009/pro...ope-model-3200-zargis-medical-corp-cardioscan

Jeez dude, we read it. They aren't biases, they are real life experiences. It's unecessary. The only doctors I've ever seen with this waste of money is the occasional cardiologist. Otherwise no one else uses it. Let's see, you have medical students, residents, and attendings telling you it's not worth the money and won't make a difference, but you somehow think it will despite not setting foot in a medical school yet.

Quote:
3M's stethoscope eliminates that guesswork. It transmits heart sounds to a doctor's PC by Bluetooth, and Cardioscan renders a near real-time graphical representation of the sounds onscreen. The software then analyzes the sound waves and highlights minute abnormalities that signal harmful murmurs. The doctor can play the sound back at half speed to diagnose a problem more confidently, save the file to the patient's chart, and e-mail it all to a cardiologist to confirm the diagnosis.

Great. But all of this is unecessary and a waste of money and time.

Quote:
If the heartbeat sounds remotely atypical, many doctors prescribe a conclusive, and expensive, echocardiogram test.

I hate to tell you, but here in the real world of medicine (I know it's not the realistic pre-med world of medicine 🙄) you will be ordering an echo no matter what. You will never make the diagnosis of a congenital defect or leaky/calcified/vegatative valve without an echo, I don't care how accurate this machine claims to be. That's just how medicine is. You do not replace a gold standard diagnostic test with a machine that interprets heart sounds.

I'll never understand why pre-meds think they know more than practicing physicians because of what they've read on the interwebs. Much like the patient who hands you a printout about cavernous sinus thrombosis from WebMD and demands antibiotics for her URI, you really don't know more than residents and doctors.

 

[Old Grunt]

I doubt ppl have even taken the time to read through this article and the comments about the steth.


This isn't just a typical electronic steth like everyone believes.

All I ask is to please actually read it b4 mocking it! The first thing in an argument is to fully understand both sides. Stop siding with your biases and grow up. Thats all! The source is def credible.

http://www.popsci.com/bown/2009/pro...ope-model-3200-zargis-medical-corp-cardioscan

I am beginning to suspect you are trolling.

If not, then why don't you do some reading?

As in, read the peer reviewed article from a respected source as opposed to some goofy advertisement.

BTW, the comments on your article are hilarious. "Wow! Look at all the money this is going to save! I am all for it!"

"Wow, this makes hearing pneumonias so much easier."

Until you get to this guy:

This stethoscope creates an electronic "phonocardiogram" which is a graphical representation of the aucoustic information.
In 1980, CMS (centers for medicare and medicaid) stopped paying for "phonocardiograms" because they were outmoded and of little diagnostic utility. All insurance companies then stopped paying for this test. As a result, virtually all doctors stopped doing phonocardiograms as part of diagnostic workup.
Recording the phonocardiogram and transmitting it digitally to a computer adds little diagnostically.
Legends abound of the "days of the giants" when doctors had wonderful diagnostic skills and make exact diagnoses based on auscultory (stethoscope) findings alone. Except that those days didn't exist! If they did, we wouldn't have needed to develop all these other fancy diagnostic tests! The stethoscope has lots of utility incorporated as part of the physical exam and gives the doctor clues as to the presence or absence of pathology. However in the same way a mechanic needs to listen to a car's noises to get information about what might be wrong, he/she doesn't rely on the noises alone to make a diagnosis.
We shouldn't fall into the trap of thinking that if we just "listen hard enough" or "computer analyze" the information, that the sounds the heart makes will tell us all we need to know about the heart.
Barry Love, MD
Pediatric Cardiology
Mount Sinai Medical Center
New York, New York

Which basically says what we've been saying.



But hey, what does he know, right?



He just doesn't appreciate the technology of the thing!

 

[Old Grunt]

Haha! I get it! The OP is a shill from 3M. I mean, you've gotta have this electronic stethoscope or people are GOING TO DIE. Then, you'll be sued for malpractice and end up on the streets. Also, your mother will hate you. You will have brought shame upon your family.

But wait! There's more! You too can have a successful life! Just buy this Littmann 3200! It slices! It dices! Are you getting this, camera guy? If you act now, you'll even get a sphygmomanometer, ABSOLUTELY FREE!

I am thinking a shill or someone who is really bored and is yucking it up.

If this poster is for real, you have to admire the youthful enthusiasm. "If I just plunk down $400 dollars on a cool stethescope, I will become a cardiology whiz without having to do all that nasty legwork!"

 

[nascardoc]

No one is doubting the utility or usefulness of an electronic scope. It's amazing what you can do with it. That isn't the argument. What is being debated is when you get it. I personally don't think it will teach you any better that a regular one (unless you have hearing difficulties). It is not a learning tool for a green medical student, but an attending doc who wants to record interesting sounds and use them for his/her students. I have a friend who has the other 3M electronic steth (its cheaper and has a MUCH longer battery life....months vs hours), but he uses the regular steth more than the electronic. Now, is he a tool for having one....no....and I think thats a stupid argument because most students would want to try it if a classmate brought one to school. You aren't going to use the software while on rotations either, so you will only be using it for its increased volume.

So, sit back, relax and think about buying it in a couple years. Get a decent regular steth, learn on that, and if you feel you need to have the electronic steth later on.....go for it. Just because it may be a good investment doesn't mean to need to jump on it right away.

 

[Cheshyre]

I'd like to see that Order. "Echo. Re: Heart murmur that I can't hear with my stethescope."

 

[tkim]

I doubt ppl have even taken the time to read through this article and the comments about the steth.


This isn't just a typical electronic steth like everyone believes.

All I ask is to please actually read it b4 mocking it! The first thing in an argument is to fully understand both sides. Stop siding with your biases and grow up. Thats all! The source is def credible.

http://www.popsci.com/bown/2009/pro...ope-model-3200-zargis-medical-corp-cardioscan

The 'source' is Popular Science - a magazine for the lay reader which was basically a rehash of the 3M advert, versus my two peer-reviewed articles from medical journals taken from Pubmed. Which is more credible?

The bias here is clear. Yours.

But then again, since you are still a 'lay reader', I guess you'd take the word of Popular Science magazine over Pubmed articles. That's what a layperson would do.

 

[tkim]

Get this - the murmur detection software is optional. You can get it - for another $400:

http://www.allheart.com/zazc0005.html?campaign=csegoogle&CAWELAID=477202166

So you can get the steth and murmur software for about $800.

Yeah, I'd rather pay my mortgage for a month.

 

[Cybii]

You all are arguing over a stethoscope. I enjoyed reading the thread, nevertheless.

 

[tkim]

You all are arguing over a stethoscope. I enjoyed reading the thread, nevertheless.

Actually, no. We aren't arguing about a stethoscope. We are arguing about an attitude. You dig?

 

[Cybii]

Actually, no. We aren't arguing about a stethoscope. We are arguing about an attitude. You dig?

I can dig it. I should have said an argument started over a steth debate to be accurate. 😎

 

[Instatewaiter]

I can dig it. I should have said an argument started over a steth debate to be accurate. 😎

removed

 

[J-Rad]

I still fundamentally believe that buying and using the electronic steth at the beginning of one's training will be an impediment. Even if the (even more expensive) electronic "interpretation" software was proven to work, you need to know how to interpret those sounds yourself. So much money is wasted on tests that aren't needed (echoes) because people aren't willing to learn how to listen; esp. in my world of pediatric cardiology. Yes, digitized recordings can and will be routinely tranmitted in the future, but 1) the listening cardiologist (at least in the near future) will be utilizing the skills they learned in plain old auscultation (along with the clinical data available) 2)It still costs money and time to send that transmission and have it interpreted when say, for example, an astute primary pediatrician/FP could have diagnosed a benign Still's or PPS murmur.
As far as being able to record what the attending is listening to (although wouldn't this be more in 3rd and 4th year, at which time it might be a little more reasonable to buy the electronic steth) there have been studies showing that pre-recorded audio of murmurs can substantially increase people's auscultation abilities. There are plenty of inexpensive resourses for this (one newer [read: not studied] resource would be the "iMurmur" app. At $1.99 you'd probably be getting a better educational deal for a noob than a $380 steth).
BTW I've diagnosed plenty of benign murmurs and PDAs, VSDs, ASDs, MVPs, BiAoVs. I've even heard the ejection click of a bicuspid AoV in a 2 day old without a murmur (not that easy). All this with a plain old Littman CIII that I've had since '01. That isn't to speak of my awesomeness but to recommend learning and honing the fundamentals first, and then figure out what technological enhancements are needed or wanted.
And, yes, I read and was unimpressed with the advert...I mean article. And, generally, mistakes with stethoscopes are made not because of lacking in the stethoscope, but lack of the users ability to correctly use it, interpret the sounds from it, and insert the auscultatory data into the clinical scenario.

 

[silas2642]

I doubt ppl have even taken the time to read through this article and the comments about the steth.


This isn't just a typical electronic steth like everyone believes.

All I ask is to please actually read it b4 mocking it! The first thing in an argument is to fully understand both sides. Stop siding with your biases and grow up. Thats all! The source is def credible.

http://www.popsci.com/bown/2009/pro...ope-model-3200-zargis-medical-corp-cardioscan

As a med student about to finish up their 3rd year, I can definitely say that you don't need an electronic stethoscope ever, particularly in your first year. You may be laughed at and made fun of by your superiors and classmates, which as you said, doesn't matter, but more importantly you may not learn how to use one of the good old fashioned stethoscopes properly, which is far more important. You want to learn how to do a good PE with the tools that are standard because in reality, these are the tools that you're going to be using day in and day out (i.e. panoptic ophthalmascope vs. regular ophthalmascope-- I've seen a pan-optic hanging up a whopping 0 times on the wards, necessitating learning how to use a coaxial ophthalmascope).

Electronic gadgets also have cons-- they are more apt to get stolen, they run out of batteries (what are you going to say to your attending when you can't use your stethoscope because the battery died?), etc.

Finally, a little piece of advice from a more senior med student-- be careful in medicine about your attitude. Obviously I don't know you, but from your tone you seem a little entitled and very opinionated. Medicine is very hierarchical, and you always have to remember that nearly everyone on the floor has more experience and more knowledge than you do. Just because you read one study about x that your intern, resident, or attending did doesn't mean that you're right and they're wrong. A little bit of humility and respect to your superiors goes a long way in learning.

 

[silas2642]

Get this - the murmur detection software is optional. You can get it - for another $400:

http://www.allheart.com/zazc0005.html?campaign=csegoogle&CAWELAID=477202166

So you can get the steth and murmur software for about $800.

Yeah, I'd rather pay my mortgage for a month.

If by the end of your third year you can't hear a clinically significant murmur on your own and do at least basic characterizations, then you're in trouble and need to go back to the drawing board.

I guess my school is pretty old fashioned-- we learned that technology is supposed to help us confirm what we already have a high index of suspicion and give us more details on the patients condition rather than replace our PD skills.

 

[Doctor Bob]

Pssh... you are all wrong. The stethoscope is so outdated, as is the electronic stethoscope. Technology is continually evolving and we should all always be on the very furthest cusp of the advancement.

What the OP should do is buy one of these:
http://www.coolest-gadgets.com/20091022/ges-handheld-ultrasound-scanner/

It's a handheld ultrasound scanner the size of an IPOD. GE is releasing them later this year and they're projected to be a measly $250,000

You simply can't detect anything or cure any diseases without this in your labcoat, and anyone who tells you differently is setting you up for a lawsuit.

OP, take out a second loan and buy one of these instead. It will really help you, especially during M1 and M2 years.

 

[AgDoc84]

Ill put in my two cents.....
I am a stethoscope dork, and I really dont mind if anyone knows. I have Master Cardiology,Cardiology STC ,Cardiology 3, Cardiology II, Harvey triple head, and various and assorted others.
I recently ran across the 3100 (I realize its a different model) on ebay for like 50 dollars because the company had totally jacked up the engraving and it was the plum color. I really didnt care at 50 dollars it was worth a try. Its a good scope, and can allow you to hear things in a different way.
However, the noise canceling.... which was supposed to revolutionize the stethoscope world just isnt all that impressive. I suppose that it might block out some of the outside noise, but GREATLY amplifies all of the body sounds. Heaven forbid you need to listen for indistinct heart sounds while the patient is hungry.
I will say my favorite part is the heart rate monitor.
If you are willing to spend too much money on a stethoscope (and clearly I advocate doing so) I would go with the Harvey. Sounds are clear and really well amplified. To me the only drawback is its weight... really heavy on the neck and in the ears.
For everyday use though the Cardiology III (with a non tunable diaphragm replacement) is really the way to go. Versatile, lightweight, not overly expensive. 🙂

 

[cyclohexanol]

Cyclohexanol,
If you ever make a preventable mistake that this steth could have prevented your response would be "Its toolish!" Ok I understand.
And paying 2x to 4x more than what the average is a valid reason? Ensuring mistake free healthcare vs the chance of making a mistake (well none in your case)? Ok I understand. It seems so "super impractical." Right.

...

Key word: INVESTMENT

...

Off to save the world with my steth!

You're right, its a ****ing excellent investment and will save thousands of lives. As I said before, go ****ing buy it if you want it so badly.

I take back what I said about it being toolish, it can't possibly make you anymore of a tool.

 

[Bacchus]

There's no reason for the scope. None at all. We were gifted Cardio III's as first years and I feel that is in excess. I wouldn't have bought a Cardio III on my own. I can't tell the difference between what I hear anyway.

 

[actnow]

Sorry but I am back.

I would just like to refer back to post 21:

Quote by me: "I am 100% for learning the right way and not having to rely on electronics! I plan to.......My point is: WHY NOT HAVE TECHNOLOGY BACK YOU UP"

I don't know if the recent above posters are referring to me or speaking in general but this thread is not arguing about whether you should rely soley on electronic steth so "you can think you are some awesome cardiologist w/o having to do the legwork". This is self evident. What I did take from all of you that it is wise to wait til clincal years, thanks.


Silas2642 and J1515,

I agree 100% that you should respect hierarchy, especially in medicine! I will repeat myself again: When a greater than 50% opinion (I am not naming names, oh I really want to tho) is that a major reason not to buy the steth is "because it is toolish!" I just have to laugh. So thats when their higher status/hierarchy for those ppl breaks down (bc I am just a pre-med). I would have thought higher status would correlate to more maturity and a realization that it is not about looking like a tool but whether the steth will have any benefits, but I am wrong. Some more recent posts are on the level of maturity I was initially looking for, thanks!

And to address a seemingly developing issue of mine,

There is a wise saying that I am sure no one has heard, "If he/she jumped of a bridge would you also?" Just because I am a lowly pre-med does that mean I have to take every single opinion, even when you too know is/are immature? Please.
I hope I don't have a superiority complex when I am practicing and think pre-meds are the scum of the earth kind of stereotype sort of thing!




Oh and tkim (my favorite 😍),

I tried to resist but just couldn't (oh and i can't wait for another "no you are .... no you are ....., no you are immature):


http://www.youtube.com/watch?v=Dw9yEuwohkk

 

[tkim]

If by the end of your third year you can't hear a clinically significant murmur on your own and do at least basic characterizations, then you're in trouble and need to go back to the drawing board.

I guess my school is pretty old fashioned-- we learned that technology is supposed to help us confirm what we already have a high index of suspicion and give us more details on the patients condition rather than replace our PD skills.

I didn't say to get it. I'm pointing out that it will cost $800 to detect the murmurs electronically.