What is the difference between preventive care and physical examination?

The most essential difference is that the goals are different - physical examination is to "check for existing health abnormalities" at a fixed point, while preventive care is to "reduce the probability of health risks" throughout the cycle.

I have been working as a community health worker for almost 8 years, and I have met too many residents who confuse the two. Last month, I just met a 42-year-old middle-level employee of a company. He failed to pass the routine physical examination organized by the company every year. All indicators were either normal or only at the critical value. Not even a nodule was found in the report. As a result, he was taken to the emergency department last week for acute myocardial infarction and a stent was inserted. It wasn't that the physical examination was inaccurate, but that he stayed up late all the time, socialized and drank, and his triglycerides were always stuck at the critical value. The doctor wrote on the physical examination report "low-fat diet, regular work and rest, and follow-up consultation."

Nowadays, there is a lot of controversy on the Internet about the two. Some people think that physical examinations are "free money, and it is too late to find out, so it is better to do more preventive health care." Others think that all preventive health care without clear indicators is an IQ tax, and as long as a physical examination is done on time every year, it is enough. In fact, both opinions are a bit extreme.

To use a very popular analogy, your body is like a family car that has been driven for several years. The physical examination is the annual vehicle inspection. Only when the parts are worn to a certain extent, the fault light comes on, and the indicators no longer meet the prevailing standards, will an abnormality be flagged for you. Preventive care is your daily maintenance. Change the engine oil after running thousands of kilometers, clean the air-conditioning filter after the season changes, and check the tire pressure regularly to check for wear. These operations will not be done until the fault light comes on. The purpose is to nip problems in the bud and prevent major breakdowns.

It’s no wonder that everyone can’t tell the difference. The services of many formal medical institutions are overlapping. If you go for a physical examination and it is found that your bone density is low, the doctor will not only write it on the report for you, but also tell you how much calcium to supplement every day, how long to stay in the sun, and how to adjust your exercise patterns. This part of the follow-up intervention guidance actually belongs to the category of preventive health care. On the other hand, formal preventive health care will not blindly prescribe all kinds of expensive conditioning programs for you. The first step must be to read your physical examination reports over the years for reference. If your own uric acid is approaching the critical value, you can't still drink thick soup every day to supplement it, right?

When I do science popularization for community residents, I always say that there is no need to antagonize the two. Don’t be lazy when it comes to age-appropriate screenings and routine physical examinations every year. Don’t just focus on the word “abnormal” when you get the report. Those indicators with critical values ​​and the “follow-up” that doctors lightly mention are actually signals that targeted preventive care should be initiated. Once the problems have accumulated to the extent that they can be detected by physical examination, intervention will often take several times the energy.