A doctor's most important accessory, the stethoscope, may be heading for the scrap heap after 200 years, it has been claimed.
The development of new, more accurate and compact ultrasound devices could soon consign the Victorian stethoscope to medical history, two US heart experts predicted.
Professor Jagat Narula and Dr Bret Nelson, both from Mount Sinai school of medicine in New York, said several manufacturers already made hand-held ultrasound machines that were slightly larger than a deck of cards. Evidence suggests that, compared with the stethoscope, the devices can reduce complications, assist in emergencies and improve diagnostic accuracy.
Currently even a top-of-the-range stethoscope costs only a fraction of the several thousand dollars needed to buy the cheapest ultrasound device.
But according to the experts, the falling price of new technology and changes in medical training could eventually see the stethoscope supplanted by pocket-sized ultrasound probes.
The simple listening tube for monitoring abnormal heartbeats and wheezing lungs has been a common sight around the necks of doctors since its invention in 1816.
Writing in the journal Global Heart, of which Narula is editor-in-chief, the authors conclude: "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.
"Medical students will train with portable devices during their preclinical years, and witness living anatomy and physiology previously only available through simulation. Their mentors will increasingly use point-of-care ultrasound in clinical environments to diagnose illness and guide procedures.
They say that as young doctors progress and take on leadership roles, "they may realise an even broader potential of a technology we are only beginning to fully utilise. At that point, will the 'modern' stethoscope earn a careful cleaning, tagging and white-glove placement in the vault?"
Despite the advantages of the new technology, the experts suggest there will still be traditionalists who prefer to hang on to the old ways, like music buffs lovingly preserving their vinyl records.
They ask: "As some audiophiles still maintain [that] the phonograph provides the truest sound, will some clinicians yet cling to the analogue acoustics of the stethoscope?"