Imagine you just entered the medical field twenty years ago and you think you have the staples of the profession down pat. Then you meet a patient in the ER who tells you the most ridiculous thing you have ever heard. In a few short years the stethoscope and to an extent, EKG’s will be chased away by the new upstart, the ultrasound machine. It is my opinion that we are here.

Every technology becomes smaller and faster. Just look around: TV’s, radios, ovens, projectors and phones have all gotten smaller. The need for medicine to run faster with better and immediate information is critical. Decreasing reimbursement drives the need for better and cheaper technology to provide fast and accurate results. Ultrasound machines started off with a huge console, a foot pedal and an articulated arm that was the probe. Annular probes seemed to require two hands and weighed at least a pound. Now ultrasound is the size of a cell phone and the probes are the size of a carrot.

The decrease in size, price and ease of use provides a democratization of ultrasound. Many medical schools are handing them out to their students. Our friends at Rojo Cruz Ambulance Services in Uruguay have them on all their EMS trucks. They are being used in the mission fields and battle fields as well. Ultrasound is the one portable imaging tool that is essential in diagnosis and treatment.

Ultrasound is easier to perform than ever before. New machines do not have focal zones and in some cases TGC curves. This does not mean that it will take the pictures and do the diagnosis for you. Ultrasound machines are not Polaroid cameras. The user must invest significant time and effort to learn the craft. Ultrasound is a separate and unique specialty. We just bought a brand new car and an applications specialist went through all the new features and how to use them. It would be dangerous for me to think I could drive the car without the proper training. Likewise it would be foolish to think you would be a competent provider with only sixteen hours of training in ultrasound.

What about AI use in ultrasound? AI has made huge strides and there are new applications in ultrasound coming out monthly. AI depends on great images taken with the proper angles to work properly. Bad images lead to bad diagnoses. While it makes interpretation and clinical decision making easier, the images still have to be formed correctly. That takes skill and proper training. There is no shortcut for proper training. When you combine AI and all the new nanotechnology you will have a small wearable chip that can image the heart during exercise or image the organs for forty eight hours continuously. That opens up many horizons and potential subspecialties in ultrasound. While the wearables will be a few years off before they are widely available it will make the application of ultrasound even more immediate.

Do I think that the stethoscope will become obsolete? Yes I do. Will ultrasound be the technology to chase it: most likely yes? There is no substitute for actually seeing the organs in real time. With well trained providers ultrasound will be unstoppable.