What is the relationship between preventive care and physical examination?

The two are by no means subordinate or substitutable, but a linked closed loop of "accurate diagnosis and dynamic intervention". Physical examination is the core entry-level tool for preventive health care and the core reference basis for the formulation of all health care plans.

Two cognitive biases are actually quite common at present. One is that one thinks that doing a physical examination once a year is equivalent to completing preventive care. When you get the report, you just throw it aside if you don’t see any abnormal arrows. The habit of eating, drinking and staying up late does not change at all.； Another person feels that physical examination can only detect organic problems that have already occurred, and is of little use in prevention. It is not as effective as taking supplements and exercising more.

I have been doing preventive health care work in a community health service center for almost 7 years, and I have seen too many such examples. Last month, I met a 34-year-old programmer. His physical examination showed that his fasting blood sugar was stuck at the critical value of 6.1mmol/L for two consecutive years. He did not take the diet and exercise suggestions attached to the report seriously. This year, he was found to be pre-diabetic, so he rushed to our department in a panic to ask for help. Later, the sugar control plan we formulated for him was all based on his blood sugar fluctuations, weight changes, and dietary preferences over the past two years. It took more than three months of follow-up to bring the indicators back to the safe range. You said that without the support of continuous physical examination data, we can't find a precise entry point for health care intervention. On the other hand, if there is only physical examination without follow-up adjustments, then the annual physical examination is nothing more than a piece of waste paper with numbers printed on it.

To use a crude metaphor, the relationship between the two is like the smoke alarm installed in your home and the daily fire prevention measures. The physical examination is the alarm. It usually does not sound. If there is a hidden danger, it will notify you as soon as possible. You can’t say that after installing the alarm, you don’t have to turn off the gas and check the aging circuit regularly. You can’t say that if you pay attention to fire prevention, you don’t need to install the alarm. If you wait until the smoke hits your face, you will be unable to recover.

In fact, we who work in public health often say that the first step in this move is physical examination, especially for high-risk chronic diseases such as high blood pressure and diabetes. In the early stage, there is no physical sensation at all. It depends on physical examination and screening to intervene as soon as possible. If you wait until symptoms such as dizziness and fatigue appear before dealing with them, you will often have to rely on drugs to maintain them, and it is difficult to reverse them. I usually do popular science for residents and always say, don’t split these two things into two parts. Don’t just look at the up and down arrows when you get the physical examination report. Even if it fluctuates within the normal range, you can also talk to a health care doctor about whether you need to adjust your living habits. Spending 10 minutes to ask clearly is much more useful than buying a bunch of health care products blindly.