Reps need to let their customers know there’s a lot more to a stethoscope than an earpiece and tubing

Choosing the right stethoscope can be a personal experience for veterinarians and their staff, who invariably use the same scope for 20 years, if not longer. In that time, they grow to depend on their scope as a lifeline to their patients. And, they depend on their sales reps to help them make the right selection.

How they work
Stethoscopes can be used to listen to any body sound, including respiratory, cardiac, bowel and circulatory. Traditional mechanical scopes are comprised of a metallic (brass or stainless steel) chest piece or head (typically brass or stainless steel), PVC or rubber tubing and metal binaurals or earpieces. A lumen, or channel in the tubing, permits sound to pass between the chest piece and the earpieces.

While stethoscopes are not specific to humans or animal applications, there are many different grades of scopes. For instance, there is a direct correlation between the sound quality and the mass of the head (chest piece) and the tubing wall thickness, such that thicker, more solid tubing walls help prevent outside sound from penetrating the tubes and interfering with the veterinarian’s ability to listen. So, an inexpensive, lightweight stethoscope produces a different sound than a more solid one. Whereas an inexpensive scope can be used for taking a patient’s blood pressure or listening to general auscultation, an expensive, cardiac-grade scope is more appropriate for a specialist trained to listen for more definition in sounds.

Typically, a veterinarian relies on a cardiology-grade stethoscope with both an adult and pediatric attachment. In comparison, a vet technician or assistant generally uses a more general-purpose scope.

The size of the stethoscope is also a factor. In smaller animals, where the heart and lungs are located in close proximity, the veterinarian requires a smaller scope, such as a pediatric scope, with a smaller diameter chest piece to narrow down sounds. Because vets see so many animals every day, it is important for them to purchase a stethoscope with interchangeable pieces, permitting them to examine both larger and smaller patients. Different manufacturers offer different solutions. However, one stethoscope with both adult and pediatric chest pieces should work well, according to experts.

Wear, tear and cost
Typically, veterinarians and their staff use the same stethoscope for as long as 20 to 30 years, and they tend not to share or swap instruments with others in the practice. The design of a stethoscope affects the way sound travels from the patient to the user’s ears. Each individual learns to hear sounds in a certain way and hence becomes very attached to his or her scope.

Although vets and their staff replace their stethoscope infrequently, distributor reps should remind them to replace certain parts of the scope before they wear out. For instance, tubing should be replaced every three to four years, as continual cleaning with alcohol dries out the rubber. Ear tips, the diaphragm piece and the anti-chill rubber ring that encircles the diaphragm also must be changed every couple of years for hygienic reasons.

Low-end, general-purpose scopes start at $25, while high-end models usually cost close to $100. Cardiac-grade scopes range between $140 and $230.

Not your grandfather’s scope
Stethoscope technology has improved in recent years. Manufacturers are experimenting with new materials to replace conventional metal and rubber. For instance, one brand has traded stainless steel for trumpet brass, which reportedly accentuates subtle sounds that can be difficult to hear.

Perhaps the biggest change in the technology, however, is the emergence of electronic stethoscopes. Unlike traditional scopes, which employ air or vibration to carry sound, electronic stethoscopes convert acoustic sound into an electronic signal. The sound is filtered and amplified, and then reproduced for the ear to hear. Many higher-end models permit filtering of heart and lung sounds. Although the technology varies from one manufacturer to the next, the fundamental amplification process is the same. So, while some scopes provide more or less filtering capability, all electronic stethoscopes amplify and reproduce sound.

Lower-end electronic stethoscopes that provide less filtering start at about $200, and, depending on the quality, the price increases. Electronic stethoscopes with filtering capability cost approximately $350. In fact, some electronic stethoscopes can be combined with computer software systems, which permit the user to collect additional information, such as phonocardiograms or reference ECGs. Add-ons such as this can bring the total cost to as much as $1,000.

An investment such as this, however, can bring great value to a veterinarian clinic. For example, by plugging an electronic stethoscope into a distributor box, and providing the client with a set of headphones, the veterinarian and client can listen to the same sounds together. Or, by connecting the electronic stethoscope to a laptop, the vet can record a heart sound and produce a reference ECG. Tools such as these enable the veterinarian to better explain his or her diagnosis to the client, and the client, in turn, can better appreciate the importance of certain treatments. As veterinarians strive to market themselves to new clients, advanced technology becomes increasingly important.

How to sell
When sales reps approach their customers, they should try to determine whether they are looking for a replacement stethoscope, or whether they own one in need of repair. Possibly something has changed with regard to the vet’s ability to hear sounds using a conventional stethoscope, and it may be time to upgrade to an electronic one. Some probing questions might include:

• “Doctor, is everyone in your practice set with their current stethoscope? Does anyone need parts for their existing products, or is anyone looking to upgrade?”
• “Doctor, are you finding it increasingly difficult to convince pet owners to go with your treatment recommendation? Are you looking to upgrade your practice and improve client communication?”
• “Would the ability to generate a phonocardiogram and/or ECG be helpful?”
• “Are any of your assistants looking to upgrade their stethoscopes from a general purpose stethoscope to a cardiology scope?”
• “If you have an electronic record keeping system, would it be nice to be able to save aucultatory sounds and an ECG waveform for future reference?”

Some practices may benefit from upgrading to electronic stethoscopes, while others may not. It is up to the distributor rep to evaluate the clinic’s needs and make the most appropriate recommendations. By providing a variety of stethoscopes for the veterinarian and staff to test, reps can help them weigh their options. And, when customers object to the cost of a higher-end scope, reps should remind them of the old adage: you get what you pay for. In the end, it may be a small price for better patient care and greater client trust.