What are the relationships between preventive health care and physical examination

In essence, physical examination is the core entrance and decision-making basis for preventive health care, and preventive health care is the extension and implementation carrier of the value of physical examination. The two are linkage links throughout the entire life cycle of health management, and there is neither a subordinate relationship nor a substitution relationship.

Last week, I was sitting at a free clinic for preventive health care at a community health service center and met Aunt Zhang who lives in the neighborhood next door. She goes for a routine physical examination every year with her work unit. All the indicators on the report are within the reference range. However, she has been feeling tired for more than half a year and catches colds at every turn. She complained to an old sister before that "physical examinations are a waste of money and can't detect any problems. They are not as useful as square dancing every day." I looked through the physical examination reports she had brought over for the past three years, and I found at a glance that although her white blood cell count had always been stuck at the lower limit of normal, it had dropped steadily by 0.2 every year, and her fasting blood sugar had been stuck at the critical value of 5.9mmol/L for two consecutive years. However, it did not exceed the reference range in a single look, so there was no abnormality in the physical examination report. Later, I adjusted her diet and asked her to drink less Laohuo soup that had been simmered for two or three hours, and add 15-minute strength training twice a week. I checked again after three months. Both indicators have gone back half a step, and her overall energy level has improved a lot.

Nowadays, there are actually many different opinions about the relationship between the two. Many people think that "doing a full physical examination is just doing preventive care." They spend thousands or even tens of thousands every year to have a full set of high-end physical examinations. If there is no red arrow in the report, everything will be fine. They should stay up late and drink heavily when they should. I met a 28-year-old Internet practitioner before who does tens of thousands of VIP exams every year. All indicators were normal, but he had an acute attack of gout and was in so much pain that he could not walk when he registered. When asked, he found out that he took the normal report completely and ignored it. He drank iced milk tea with barbecue every day, and did not even see the sentence "blood uric acid is close to the critical value" in the physical examination report. This is actually treating the "snapshot" function of the physical examination as all preventive care, but wasting the early warning value of the physical examination. There is another extreme view that "routine physical examinations are useless, eating more health products and soaking your feet is enough." I once had an aunt with a family history of lung cancer. After listening to a health care class, she said that drinking health tea every day can prevent cancer without a physical examination. If she waits until she has a cough with blood, she is already in the late stage. If she had done low-dose spiral CT every two or three years as required by preventive health care, she could have intervened at an early stage.

Speaking of the relationship between the two, it is actually very similar to raising green plants at home. Physical examination means that you squat down every once in a while to see if there are yellow spots on the leaves, whether the soil is dry, and whether there are insects. Preventive care means that you adjust the frequency of watering according to the observed situation, whether to move to the window to bask in the sun, and whether to spray some insect repellent. Just squatting there will not work, and the green plants will die sooner or later. Just watering and fertilizing without checking the status will also easily lead to rotten roots and burned leaves. It will be useful only if you gather them together.

Moreover, current physical examinations are no longer the same package as before. The demand for preventive health care is also pushing back to make physical examinations more personalized. For example, for a woman with a family history of breast cancer, we will recommend that she have a breast ultrasound and mammography every six months, instead of the routine examination once a year. For professional groups who are often exposed to dust, the follow-up requirements for preventive care will also specify that chest CT should be done every year instead of ordinary chest X-rays. This can save a lot of detours and avoid spending money on unnecessary projects.

I have been working in grassroots preventive health care for almost 8 years, and my biggest feeling is not to regard physical examination as an annual "mission", and don't regard preventive health care as an unfounded "blind health regimen". Every time I get the physical examination report, it is much more useful to chat with the health doctor than to stock up on a bunch of health care products.