What is the relationship between preventive health care and physical examination?

The two are essentially two core links that interlock and verify each other in the health management chain. Physical examination is the "navigator" of preventive health care, and preventive health care is the "amplifier" of the value of physical examination. The approaches of completely separating or replacing each other are going astray.

Last week when I was doing a health follow-up at the community health service center, I met Aunt Zhang who lives in the neighborhood next door. In her annual physical examination report last year, her fasting blood sugar reached 6.2mmol/L, which is the critical state of impaired glucose tolerance. At that time, we combined her usual habit of eating sweets and rarely exercising and gave her a very specific preventive health plan: adding sugar every day The intake does not exceed 25g, and she walks briskly for 40 minutes after dinner, and measures her fingertip blood sugar twice a week. This year she came for a physical examination again, and her fasting blood sugar dropped steadily to 5.4mmol/L. Even her previously high triglycerides were normal. If the physical examination had not pinpointed the problem first, she might still be following the online health prescriptions, which might have delayed the golden window for sugar control.

There are actually two common disagreements about the relationship between the two. I can’t say who is right or wrong, but they are both a bit extreme: one is to equate physical examinations with all preventive care, and feel that if there is nothing wrong with the annual examination, you can do whatever you want. I have met a 28-year-old Internet practitioner before. His physical examinations for three consecutive years were all normal, so he stayed up until two or three o'clock every day, drinking cold beer Barbecuing is the norm. Last year’s physical examination showed that uric acid had soared to 580 μmol/L, and there were already signs of gout. He took the report and asked me, “Why do I still have problems when I have physical examinations every year?” In fact, I just didn’t understand. Physical examinations only take a “snapshot” of your current health status. If you continue to do it after taking a picture, no matter how frequent physical examinations are, it will not stop the health decline.

Another view is just the opposite. I feel that if I pay attention to health, eat health products, and exercise every day, I don’t need to have a physical examination. This is the case for a 62-year-old man I saw last month. He gets up at five o’clock every day to do Tai Chi, and always has wolfberry and astragalus soaked in a thermos cup. He has quit smoking for ten years and feels that he is in great health. I refused to spend money for a physical examination. This time I came because I felt dizzy and unsteady. When I checked, my blood pressure had reached 180/110mmHg, which is grade 3 hypertension. Stable plaques had formed in the carotid arteries. In fact, if I had found that my blood pressure was high during a physical examination a year or two earlier and had slightly adjusted my health care plan, I would not have reached this point.

Speaking of which, the relationship between the two is particularly similar to when you drive to a 4S store for maintenance: the physical examination is a full vehicle inspection when you enter the venue. Everything from tire wear to engine carbon deposits will be clearly checked for you. If you don't do this inspection, you will add detergent and replace parts randomly, which may injure the car.； Preventive care is the follow-up maintenance and adjustment. If you only do inspections and find out that the tires are worn flat but not replaced, and the carbon deposits are thick and unclear, then no matter how precise the inspection is, it will be meaningless.

In fact, the weights of the two are different for people of different age groups. Young people have strong metabolic abilities and may have a routine physical examination once a year. Just stay up less late and exercise more. After the age of 45, special screenings such as gastrointestinal endoscopy and tumor markers must be increased. Corresponding preventive care must also be kept up. For example, if bone density is found to be low, it is necessary to supplement calcium and get more sun, instead of following young people to eat salads and run marathons every day. I have been doing primary health management for almost ten years, and I have seen too many people who separate the two. They either ignore the abnormal prompts in the physical examination report, or they have been practicing inappropriate health care for several years. In fact, in the final analysis, physical examination is to find problems, and preventive health care is to solve problems. When we work together, we can really take health into our own hands.