BP measurements and Stethoscope use

Dr Wil dr.will at FUSE.NET
Mon Sep 16 02:38:45 UTC 2013


It was like that here for many of us 30 years ago. And still could be if not so distracted by extra "needless" work expected by the clinician in today's delivery system.
Will Sawyer, MD

Sent from my iPad

On Sep 15, 2013, at 11:48 AM, "David Gordon, M.D." <davidc.gordon at DUKE.EDU> wrote:

> So here is a twist to this discussion -- is it the stethoscope that is inaccurate or have we become less accurate in using it?  Here in the States, we can quickly move from "I hear something" to obtaining some form of imaging study whether it be an x-ray or echo.  We are also challenged by the growing body habitus of our population.
>  
> On the other hand, when I spend time watching our students in Singapore, I am very impressed with their use of the physical exam and stethoscope. They are very in tune with their findings and rely on them to make clinical decisions. This reliance on the stethoscope has preserved its utility and necessity.
>  
> -David
>  
>  
>  
> David Gordon, MD
> Assistant Clinical Professor
> Undergraduate Education Director
> Division of Emergency Medicine
> Duke University
>  
> The information in this electronic mail is sensitive, protected information intended only for the addressee(s). Any other person, including anyone who believes he/she might have received it due to an addressing error, is requested to notify the sender immediately by return electronic mail, and to delete it without further reading or retention. The information is not to be forwarded to or shared unless in compliance with Duke Medicine policies on confidentiality and/or with the approval of the sender.
> From: robert bell [rmsbell at ESEDONA.NET]
> Sent: Saturday, September 14, 2013 6:06 PM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> Subject: Re: [IMPROVEDX] BP measurements and Stethoscope use
> 
> Agree.
> 
> So across the spectrum of age, experience, hearing loss, etc. how inaccurate is the stethoscope?
> 
> Sounds like an Institute of Medicine project! 
> 
> Rob Bell
> 
> 
> On Sep 14, 2013, at 2:43 PM, Peggy Zuckerman wrote:
> 
>>> Rob,
>>> If someone invented the stethoscope yesterday, and tried to introduce it to the medical world, advising that one could just "listen" to the varying sounds, and from there, diagnosis with certainty a wide range of diseases and problems, he would be laughed off the block.  When there are more objective ways to measure hearts, which permit comparisons between professionals and institutions, listening with a stethoscope sounds like the equivalent of my touching the child's head with the back of my hand.  Tells me something, but not much, and not verifiable.
>>> Peggy Z
>> www.peggyRCC.wordpress.com 
>>> 
>>> 
>>> On Fri, Sep 13, 2013 at 1:17 PM, robert bell <rmsbell at esedona.net> wrote:
>>>> Dear Bill,
>>>> 
>>>> I have often thought that taking blood pressure in the office is one of the worst things that the medical profession does
> 
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