Family Doctor Discusses
The stethoscope — an integral tool to a doctor. With so many options out there from super expensive to super cheap, which is the best?
Like any professional, having the right set of tools helps get the job done. Afterall, you wouldn’t want a plumber turning up to fix your leaking pipe with a broken wrench. It is no different for a doctor. Choosing a stethoscope that ticks all the boxes is vital when it comes to examining patients and making the correct diagnoses.
What are those boxes I hear you ask? Well, in my use case as a family doctor, I have some very specific requirements. These are requirements that I’ve developed over the last 15 or so years, helping me to get my job done efficiently and effectively.
A stethoscope that hears well
This is obviously a no brainer, but you’d be surprised. As a medical student, if I forgot my stethoscope (something that I grew out of very quickly), I’d often have to resort to using the ward stethoscope. An un-named, unusually long, light and brightly coloured stethoscope. As soon as I would pick it up I knew it was going to be trouble. The ear pieces were uncomfortable and hard and the acoustics were quite possibly the worst. I was probably better off using my bare ears. So my piece of advice if you are on the hunt for a stethoscope, know that the cheapest isn’t always the best. I was always wondered (and still wonder) what the use of those ward stethoscopes were.
A stethoscope that feels good
As mentioned before, when you spend a good part of your day with something in your ears, it needs to feel good. Hard ear pieces, in my opinion, are a no-no. Soft and flexible ear pieces are important and easy cleaning options are also on my top list.
Not only does the stethoscope need to feel good inside your ears but the tubing should also feel sturdy. As a medical student my first stethoscope was a Littmann Classic II. It was the all black edition and I felt really cool wearing it.
However, over a period of 4–5 years the tubing failed me. After proudly wearing the stethoscope around my neck, I entered a respiratory ward round and was asked by the consultant to listen to the patient’s chest. I placed my ultra cool stethoscope on the back and as the patient was breathing in and out I heard nothing. Confused, I tried again. My face was slowly going red. What were the signs on the chest and what would I report back to my consultant in front of my peers? In a matter of moments I took a breath and looked at my stethoscope and realised the tubing had snapped in half in two different locations. I took the stethoscope out of my ears and with a small voice told my consultant what had happened. From that point onwards I knew I never wanted to be in that situation again and choosing a stethoscope that felt strong and durable was vital in my criteria.
The weight of the stethoscope
I carry my stethoscope in my handbag when I go to work. With other medical gadgets in my bag I really can’t afford to have shoulder problems due to lugging around heavy tools. So, the weight of my stethoscope is very important.
I got excited one afternoon and decided to buy a Littmann Bluetooth 3200 Electronic Stethoscope. The specifications were appealing, a stethoscope that could amplify sounds up to 24 times and record up to 12 tracks. It had one face only (rather than a traditional bell and diaphragm) and relied on battery power to turn on and off. So with the click of a button I purchased a swanky stethoscope with black tubing and a chrome finish.
I had big hopes of recording murmurs and other interesting findings so I took it to work one day. Unfortunately as luck would have it, I didn’t hear anything out of the ordinary. Now this stethoscope was heavy and moreover it didn’t come with a carry case. Meaning I had to lug the box around with me. Being on the expensive side I was almost too afraid to use it and so the next day resorted back to my go-to stethoscope — which ticks all my boxes as you will shortly see.
In saying that, the electronic stethoscope, although not for me and sits on my shelf, would be perfect for a cardiologist in training or a medical student wishing to learn about different pathologies first hand.
The appearance of the stethoscope
This may seem quite superficial, but there’s something about having a colourful stethoscope in general practice. I choose to have pink stethoscopes which almost always gets a comment from children. This then helps to relax the child so that if I am listening to their chest they are not crying and are more cooperative. In fact, after learning this very early on, I purchased a lot of colourful gadgets which make examining children much easier.
Suitability of the stethoscope
In addition to how good the stethoscope sounds, it’s also really important that it caters for all ages and sizes. In general practice in one day, I may see babies as young as 7 days old to 80 year old patients. So having a stethoscope that caters for all of these ages is really important. Generally, having the presence of both a diaphragm and bell (the two sides of the stethoscope) helps with this, however some stethoscopes are aimed at just children or just adults.
The longevity of the stethoscope
As mentioned before, having a stethoscope that lasts a while and is durable is probably one of the most important criteria. Stethoscopes are not the cheapest and if you have to replace them every few years, it can be a costly process. With my current stethoscope, one of the issues that I had was that the diaphragm cover had come off — this may have been due to the glue getting loose after repeated over-zealous cleaning. I contacted the manufacturer who informed me that I could purchase replacement covers — which I did and was much cheaper than buying a new stethoscope.
So which stethoscope do I have?
Littmann Classic III. This stethoscope has been with me for the longest duration of time — approximately 10 years. I still have the same one, which I keep in a carry case. I would highly recommend getting a carry case as I believe its longevity is thanks to this. Even though this stethoscope has served me for the longest time without any major issues and ticks all of my boxes, I purchased a second one as back up.
All in all, this stethoscope, for me is perfect, it’s light, it’s colourful, it does a great job with all ages, feels good and most importantly auscultates well.
If your considering a stethoscope yourself, be sure to have your own criteria so that you can make the right choice.
I hope that you have found this article helpful.
Take care and stay healthy,
Dr Nora x
Please note that the contents of this article are not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or medical condition.
