The EKO is hands down the best amplified stethoscope I have ever used though it does have some room for improvement. I have previously used the Littman 4200 and 3200. The first was a poorly constructed piece of technology that did amplify well enough but fell apart within a year, was poorly repaired under warranty and lasted another year at best. The 3200 looked better, did not seem to have the same structural weaknesses but was otherwise unchanged in terms of accessibility and short tubing - a true face-to-face patient-provider experience. The Eko's length is appropriate, though it does make it a bit head-heavy and tends to slip of your neck unless you tuck it in somewhere. EKO's stethoscope is of superb quality and comparable to mid and end range Littman pieces. The amplification is by far the best I've encountered - however, it only works well when you are in a quiet office. If there is any external noise, talking, machines beeping, forget about it. The amplification unit is just badly insulated for external sound. The bluetooth connection between the unit and your phone is seamless on android and, I assume, would be on iOS, too. I like the app, though would prefer the option of storing the data locally on my device, as well and being able to handle it outside the actual app instead of working through the cloud. Overall, I think that this device is excellent for a primary care office or similar, it works great as a regular stethoscope and is mostly limited in very noisy environments. Personally, I am very happy with my purchase and would recommend it.