For some people, the stethoscope is as much a symbol for a medical professional as a poofy hat is for a chef or eyeglasses are for a psychiatrist. But this device is more than an identification badge, proponents insist. There are a number of times each day that a doctor or nurse may use a stethoscope, and in many ways, it is an alternative to high-priced and rather cumbersome diagnostic equipment.
On the other side, some scoff at the stethoscope as an outdated piece of medical equipment that’s more commonly associated with TV doctors than with actual medical professionals. Furthermore, given the advances in technology, it will not be too much longer before an echocardiogram and other tests are available as palm-held devices, obviating the need for stethoscopes even further.
This debate, however, is really not about what goes around the doctor’s neck. Instead, this discussion goes to the heart of how patients expect doctors to behave, and what services these professionals should perform.
Poor bedside manner is one of the leading complaints that patients have about their physicians. This grievance is almost as common as its two closest competitors — poor customer service and inadequate medical skills — combined. The “physical exam” is a key part of this bedside manner. Many people expect to be gently probed and prodded when they are on the examining table. And, in a competitive environment, if patients don’t find what they are looking for at one office, they will go somewhere else. Furthermore, in the social media environment, they will go online and air their complaints in front of thousands of existing and potential patients.
Stethoscopes are also useful technical devices. While they do not have the accuracy or “wow” factor associated with high-tech diagnostic tests, if used properly, stethoscopic diagnoses are surprisingly accurate. This method serves other purposes as well. In addition to a physical connection with the patient (bedside manner), a quick stethoscopic examination saves time and also eliminates the need for an expensive test (customer service).
Many argue that it’s possible to have a good bedside manner without using a stethoscope. Most often, the underlying issue is that the doctor makes little or no effort to connect with a patient. Indeed, many patients want that experience. They feel that a trip to the doctor is rather like a trip to the auto mechanic, and the technician (doctor) simply fixes the machine (body) with little or no input from the driver (person).
Even if the patient wants a connection, there are more ways to do that than listening to a chest. Doctor and patient can look at the same screen at the same time while the doctor walks the patient through the diagnosis. Arguably, that interaction builds more of a bond than listening to a pair of headphones and then commenting on the music which the other person did not hear.
Furthermore, as mentioned earlier, the stethoscope is about as relevant as artificial leeches or hernia tools, according to some. Patients expect the highest quality of care possible, and that means the most sophisticated tests possible.
Doctors should try to anticipate their patients’ needs. At the risk of sounding overly broad, older patients might expect a Marcus Welby throwback, and younger ones might expect a tech-savvy doctor. The beauty of stethoscopes is that they are just as easy to store in out-of-the-way cases that protect stethoscopes from damage as it is to wear them scarf-like around the neck, so it’s quite possible to have the best of both worlds.
That may be the bottom line. To please patients, and give the highest caliber care, have a stethoscope handy, but do not rely on it.