When did doctors start wearing their stethoscopes around their necks. Doctors used to have the two earphones wrapped around their necks with the listening end dangling in front. Also, when did nurses stop wearing white uniforms and why did that stop?
We were told during child-bearing lessons that you could hear just as well by putting your ear up to the patient, but the stethoscope was used because this would be considered “undignified”. So if any physicians could confirm or debunk that one I would also be interested.
Well, I started wearing it around my neck as a med student, when I noticed the diaphragm and bell would hit me in the crotch if I let it dangle. The stethoscope that is.
Not true. The stethoscope is priceless in it’s ability to amplify and transmit otherwise muffled noises.
“Not true. The stethoscope is priceless in it’s ability to amplify and transmit otherwise muffled noises.”
I agree with the priceless part but the stethoscope doesn’t amplify anything and although it transmits sound well enough you do get transmission losses that you would not get if you put your ear in contact with the patient’s skin.
You can, in fact hear some sounds of medical interest quite well by pressing your ear against the skin. For example, a fetal heart beat in the later stages of pregnancy. But what makes the stethoscope so useful is that you can put the bell or diaphragm nearly anywhere on the skin and get a good seal allowing you to listen to sounds emanating from the body while excluding ambient nose. You can do that with your ear pressed against a protruding abdomen of a women in the third trimester of pregnancy because you can get a good seal. You can also listen to the lungs fairly well by pressing your ear to someone’s lower back. But listening to heart sounds is problematic, especially in women, and listening for the sound made by blood rushing through a narrowed artery would be tricky in anatomical locations (e.g., the groin).
You’ll have to excuse the blind cite, but I don’t have the book with me. I’ll be able to elaborate on it more when I get home.
I’m reading several books for my history of modern medicine class. Aparently a gentleman (okay, so I need to study more…) realised that if he placed the opening of a small diameter wooden tube on the patients skin, he could hear things much more clearly than his bare ear alone, and he could also hear some sounds that were not audable to his bare ear on the pt’s skin.
I’m not so sure if a regular scope amplifies sound, or just collects more than the naked ear, but how about the electronic scopes. One nurse I know claims that he could hear perfectly through his on a helicopted. Now thats a priceless scope…
Nurse’s whites began to disappear (in the Great Lakes region of the U.S.–don’t want to get caught over-generalizing) in the early 1980s. First OR (operating room) nurses shed them in favor of lighter weight, easier to clean scrubs in the 1970s. After 1980, the logic for scrubs moved into the Intensive Care Units, and were then extended to the floor nurses.
I can remember my wife having a fit when her cap got lost in a move because she’d have been gigged at work for not having it. I haven’t seen her wear a cap in over 15 years.
I drape my stethoscope over my neck because it’s more comfortable that way. The spring tension of the earpieces hooked around the neck is even worse than wearing a tie. I have to put up with the tie, but I’ll be damned if I’ll add to the discomfort with the stethoscope.
The 19th Century French physician, Lennaec, is credited with the invention of the stethoscope, which he claimed to have discovered by rolling up a stiff paper into a tube to place against the chests of his clinic patients. He felt it afforded a better auscultation of the heart and lungs, especially in obese patients, and was less embarassing to him and his patients, especially women, than the older technique of pressing his ear against the chest. I could make some snide remarks here, but I will leave that to other dopers…
The monaural stethoscope is still used by some in OB-GYN. That instrument has a trumpet shape. I have a couple of nice wooden ones in my collection. The binaural stethoscope appeared in the late 19th Century, and used rubber tubing. The binaural device is useful because it directs the sound to both ears and occludes extraneous environmental noises.
While no purely acoustical stethoscopes amplify sound energy, they do provide high and low frequency selective mechanical filtering, by use of the bell and the diaphragm, that is impossible to obtain reliably by the unaided examiner using his ear pressed to the body of a patient.
There are electronic stethoscopes that DO amplify sounds and employ electronic frequency filters. These are expensive. I have tried them, but find them not worth the cost.
You may find this “study” of some interest.
I have assumed that the popularity of carrying stethoscopes slung behind the neck was associated with the rise in popularity of the Rappaport-Sprague stethoscope which is relatively short and heavy and tends to fall off when only the spring tension of the ear pieces is used to hold it onto the neck. I think the more traditional-looking stethoscopes are better carried with the ear pieces around the neck because they tend to be lighter and don’t fall off. They also tend to be longer which means than when they are slung behind the neck the ear pieces are over one pocket and the diaphrgm is over the other.
Of course, it could just be fashion.
Great study, Karlgauss.
Note that not all specialties wear the stethoscope around the neck. Internists, family practitioners, and the like wear them in the “cool” manner described in the study.
Surgeons keep their stethoscopes in their pockets if they have one at all, and tend to give hell to those who do. They refer to the neck-draped stethoscope as a “dog collar”, and they consider it a sign of the internist, so they want no part of it.
Psychiatrists on an inpatient ward (where they might need one) keep their scopes in their pockets, because otherwise it becomes a handy choking mechanism for the acutely disturbed.
Dr. J (a neck-draper)