Stethoscope Disease

For years the dangling stethoscope has been the symbol of the physician. But just how reliable a piece of equipment is it? Cardiologist Dale Groom at the Medical College of South Carolina has long suspected that many a faulty diagnosis comes from faulty equipment. To prove it, he ran a check on the 33 stethoscopes used by his Charleston colleagues at Medical College Hospital, found his suspicions confirmed. Two-thirds of the stethoscopes were defective. The doctors using them would be almost as well off with a rolled-up sheet of paper--which is just what the stethoscope was when first conceived by French Physician Rene Laennec in 1816. Among the most common failings that Dr. Groom found:

P: Though the instruments have a right and a left earpiece, designed to match the forward slant of the doctor's ear canal, some fit so badly that a piece of ear completely shuts off the hole in the end.

P: Most are too long (the shorter the better, but 20 in. is a practical maximum), too large (internal diameter should be no more than 3/16 in.), and made of thin-skinned rubber.

P: Leaks that let out too much wanted sound and let in too much unwanted noise are common, may be found almost anywhere in the tubing, valve or chest-piece junction.

The effects of all these defects are amplified, Dr. Groom points out, by the high noise level in the average hospital, even in its examining rooms, so a doctor can hear only the louder heart murmurs. For $500 worth of soundproofing, the noise level in a typical examining room can be dropped enough to increase a doctor's sensitivity to heart murmurs about twelvefold. Provided, of course, he uses a healthy stethoscope.

This file is automatically generated by a robot program, so reader's discretion is required.