I am a hospitalist. I knew I was not hearing sounds with littman, especially in the ED... Wow! I heard a spleno-hepatic shunt bruit day 1! Sometimes there are some issues with background noise and/or bed. Had to go back because my 1st one developed some electrical interference. It was immediately replaced, customer service is great. 1 gripe, ear pieces fall off easily. Would also be nice if it could warm itself, it is often cold as I am wiping it down with disinfectant constantly due to COVID. I haven't used the blue tooth features much, but they are pretty cool. From being able to graph heart sounds and see 1 lead EKG, to remote auscultation, and at a VERY affordable price.