What is the difference between preventive care and physical examination?

Physical examination is to take "static snapshots" of the body regularly to find abnormal indicators that have surfaced or even been hidden deep down. Preventive health care is to "dynamically protect" the body throughout the entire process and try to prevent risks before they arise.

Last year I met a 30-year-old programmer. The annual physical examination package organized by his work unit was quite comprehensive. For two consecutive years, he only had a small problem with critical uric acid. The doctor also mentioned that he should drink less milk tea and stay up late, but he didn't take it seriously. As a result, he had an acute gout attack three months before the next physical examination. His feet were so swollen that he couldn't even put on shoes. Are you saying he didn't have a physical examination? I did it, but the physical examination can only reflect your physical condition during the few hours when blood was drawn and CT was taken. After that, you stayed up late every day and drank tons of fruit tea for more than half a year without anyone intervening. If you accumulate enough risks, problems will naturally arise.

This does not mean that physical examination is not important, but accurate physical examination is a very core reference in preventive health care. Nowadays, people's understanding of these two is actually quite polarized. Some people think that spending thousands every year for a high-end physical examination will make everything fine. They think that people should stay up late and drink heavily when they should. Some people think that physical examinations are over-medical and can detect diseases even if they are not sick. Drinking some wolfberry berries and drinking health tea is considered a preventive measure. These two views actually go to extremes.

Take people with a family history of lung cancer as an example. Serious preventive health care should be followed starting from the age of 40: the first thing is to quit smoking, and to prevent kitchen fumes. Special screening with low-dose spiral CT is added every year. The low-dose spiral CT examination here is part of the physical examination. But you must first have a sense of prevention, know what to check, and how to adjust if there are minor problems after the check, instead of waiting for the unit to give you a general package and just do whatever you want. After you finish the report, you can see that there are no major problems and then throw it away in the drawer. Even if you have a physical examination every year, it will not prevent disease.

In fact, it is the same as maintaining a car. A physical examination is a semi-annual vehicle inspection to check if the brakes are not working and the exhaust gas is not passing the test. Preventive care means adding regular oil at ordinary times, doing minor maintenance on a regular basis, and not slamming on the accelerator and rebuilding the engine. You can't just wait for the car to detect problems before repairing them. At that time, small scratches can turn into major faults. Repairs are not only expensive but also damage the car, and the same goes for people.

There is also a lot of controversy now. Some people say that many preventive health care projects on the market are IQ taxes. Moxibustion and meridian dredging are all charged with IQ taxes. It is better to spend money on high-end physical examinations. Some people say that many physical examination items are unnecessary and a waste of money. It is better to exercise more. In fact, formal preventive health care originally includes physical examination items approved by evidence-based medicine, as well as practical actions such as vaccination and lifestyle intervention. A qualified physical examination will not randomly prescribe items. They are all matched based on your age, family history, and living habits. The two are inherently complementary and not antagonistic at all.

I usually tell the residents who come for consultation, don’t separate the two. Physical examination is the “positioning coordinate” of your health status, and preventive care is every step you take in the direction of health along the coordinates. Without either, you will be unstable.