Everything on this stethoscope seems to have had maximum performance in mind when they designed it. I went with the slightly longer 27" tubing and I have no regrets. I think that the 22" tubing would have been exceedingly difficult to keep in place around my neck. It would probably have flopped onto the floor every time I walked into greet the patient--making me look like an idiot! The acoustics of the chest piece are awesome, but I feel that the extra thick diameter tubing may also assist in providing the optimum listening experience. I bought the "Smoke-finish" and it really looks impressively high-tech. I call it my "stealth-stethoscope"!