Recently, the Wall Street Journal did a great piece on how mobile technology is being used in medicine. They looked at the major avenues of use, from the hospital to personal to emergency care settings.
They gave an example of how a cardiologist has stopped carrying a stethoscope, and now just uses mobile ultrasound, a modality we have highlighted numerous times in the past.
Eric Topol, MD, [a Fellow of the American College of Physicians] a cardiologist in San Diego, carries with him instead a portable ultrasound device roughly the size of a cellphone. When he puts it to a patient's chest, the device allows him to peer directly into the heart. The patient looks, too; together, they check out the muscle, the valves, the rhythm, the blood flow.
"Why would I listen to 'lub dub' when I can see everything?" Dr. Topol says.
As mentioned in our article on mobile ultrasound, research continues to show how the modality can be used to improve outcomes, such as with central line procedures.
With the continued improvements in ultrasound mobility, will physicians be required to become more proficient in the modality?
I would argue yes. For cardiac sounds, it will replace the stethoscope in the future, and it will eventually become a part of medical school curriculums once pricing goes down. Right now the price point is $8,000. The value added by ultrasound is tremendous. The ability to look at not only cardiac pathology, but abdominal, eye, venous, arterial, and more.
Would a cardiologist be able to use a mobile ultrasound tool better than a primary care physician to look for cardiac abnormalities? Of course, but that's the case with a stethoscope as well. Most physicians today are proficient with a stethoscope--not masters--and the same paradigm could be applied to a mobile ultrasound tool.
Furthermore, since ultrasound uses sound waves, and not radiation, more physicians proficient in ultrasound could lead to less X-rays or CT scans. Recent data on cumulative doses of patient radiation exposure highlights the need for ultrasound use when possible.
Although you can use ultrasound to look at pulmonary pathology, such as for pulmonary embolisms, sound still plays a key role. Hearing the interval improvements in a patient's expiratory or inspiratory wheezing is essential when treating a patient with acute exacerbation of COPD.
While there are cases the stethoscope would be useful, especially in regards to certain pulmonary sounds, it's not outlandish to think mobile ultrasound could be the essential tool physicians carry around, while the stethoscope becomes relegated to PRN use.
We'd love to hear what you think in our comments section, whether you agree or disagree.
[EDITOR'S NOTE: ACP Hospitalist addressed portable ultrasound technology adoption in its May 2011 issue.]
This post by Iltifat Husain appeared at Get Better Health, a network of popular health bloggers brought together by Val Jones, MD. Better Health's mission is to support and promote health care professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the provider point of view on health care reform, science, research and patient care.