Square One

Domhnall MacAuley reports on a recent respiratory medicine master class, from which he comes off thinking about the stethoscope:

Do you still use a stethoscope…? So, last century. Traditionally trained clinicians might have come away from the masterclass a little disillusioned: The stethoscope, our traditional garland of honour, may be of little value in respiratory medicine and, possibly in general practice; its sensitivity and specificity is poor.

…and Anthony Papagiannis, a respiratory physician in response to the post says:

As to the stethoscope, one of my mentors used to say that the modern chest physician can be deaf but cannot be blind as radiology is a key instrument in our diagnosis. However, the stethoscope is to the clinician the equivalent of the stole to the cleric: a mark of authority, a symbol of Hippocratic (or Laennecian) acumen, a powerful placebo that we can only ignore at our peril.

So frankly, it does bear some thinking about, doesn’t it? How do you really use the stethoscope? As stole or as placebo, or in the traditional twentieth century fashion?