depends on the person i think.. i had a cheapo 10$ steth and it was ok. i now have an 100$ littman and it works beautifully. i can hear sooo much more, it is louder and clearer than the cheapo. i can hear in a crowded loud room with no probs outta the littman but the cheapo it had to be absoultely silent. plus the earbuds for the littman are sooo much more comfortable!... so just depends on the person :)