What is the difference and connection between preventive care and physical examination?

To put it simply, physical examination is a very important part of the preventive health care system, but it is far from the whole of preventive care. The two are related to the part and the whole. The core difference is like the difference between "regular annual vehicle inspections to troubleshoot problems" and "usual maintenance according to the manual + timely repair of minor problems + daily development of good driving habits".

Our community health service center also encountered a typical example last week. All the indicators of the 62-year-old Aunt Zhang's physical examination organized by her work unit last year were normal. However, she felt dizzy when she took her blood pressure test at the beginning of this spring. She found that her blood pressure had reached level 2. She was also very confused, saying that she had just checked last year and had nothing wrong? After careful questioning, I found out that she had been helping her son take care of his one-year-old baby every day for the past six months, often staying up until one or two o'clock, eating every meal. It was common to eat pickles with porridge, and she had never taken the initiative to measure her blood pressure. If she could follow our preventive health care plan, take 5 minutes to check her blood pressure once a week, and control her intake of high-salt foods, she would not be diagnosed with high blood pressure until she reaches grade 2.

Many people always think that doing a physical examination means doing preventive care. In fact, it is really a misunderstanding. Physical examination is essentially a staged health screening. Whether it is a blood test, a CT scan, or an ultrasound, the essence is to take a "health snapshot" of your body at a certain point in time. It can only reflect your physical condition during the days of the examination. The purpose is to uncover hidden early health problems before obvious symptoms appear.

Preventive health care is full-cycle health management that runs through your entire life. Its scope is much broader: when you are not sick, you will be given guidance on how to adjust your work and rest, diet, and exercise, and how to vaccinate you to avoid infectious diseases.； When a physical examination reveals minor problems such as high fasting blood sugar or critical uric acid, we will provide you with a customized intervention plan to help you reverse it and avoid developing a real chronic disease. ； After you really get chronic diseases such as high blood pressure and diabetes, you will also be instructed on how to use medicine, how to monitor indicators, avoid complications, and even training guidance during the recovery period of sudden diseases. These are all preventive health care contents.

But don’t think that the two are completely separated. A good preventive health plan must be dynamically adjusted based on the results of each physical examination. I used to provide health guidance to a 28-year-old man who works in Internet operations. His uric acid level in the physical examination the year before last was 420 μmol/L, which was just at the critical level. I asked him to drink less fruit tea and milk tea, play basketball for half an hour two nights a week, and try not to go to bed after 12 o'clock. Last year, his uric acid dropped to 380 μmol/L during the physical examination. This year, it has completely stabilized in the normal range. Without the accurate indicators of physical examination as a reference, I would not be able to give him such a targeted intervention plan. He would not be able to see the effect of the adjustment himself, and he might not be able to persist long ago.

At present, the industry does have different views on the weight of the two. Many clinicians feel that physical examination should be given a higher priority. After all, many early-stage cancers and hidden chronic diseases can only be discovered through professional instrument examinations, and cannot be discovered through daily body sensing and routine monitoring.； Some scholars in the field of public health feel that the public now relies too much on physical examinations and neglects daily health maintenance. There are many cases of sudden heart attacks after normal physical examinations every year. The essence is that the usual preventive health care has not kept up. Both views are actually reasonable. It is necessary to combine the two to achieve the greatest effect.

When we chat with community residents, we often say, don’t think that spending thousands every year on high-end physical examinations will make everything fine, and don’t think that you don’t need physical examinations because of your regular schedule. Only by combining the two can you really take your health into your own hands.