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

To put it bluntly, physical examination is the most practical screening port in the preventive health care system. The two are neither subordinate nor substitutes. They are a coordinated "health gatekeeper" combination. I have been working as a public health worker in the community for almost 8 years, and I have met too many people who antagonize the two. In the past two years, Aunt Zhang in the community danced square dances for two hours every day, ate organic vegetables grown by herself, and told everyone she met that she did a good job in health care. There was no need to waste money on physical examinations. As a result, the community screened for free pyloric screws last year. Bacteria, she went to check it out with the mentality of joining in the fun, and the result was positive, and there was already slight atrophy of the gastric mucosa. Fortunately, it was discovered early. After taking the quadruple therapy for half a month, it turned negative. After that, she herself said that if she really waited for her stomach to hurt before checking, it might develop in a worse direction, and all her usual health care efforts would be in vain.

There are a lot of debates about these two on the Internet. One group thinks that regular health care is enough, and physical examinations are a gimmick for hospitals to make money. The other group thinks that as long as they do a full physical examination every year, it doesn’t matter how they build their bodies. Both views are actually extreme. I often tell the residents who come for consultation that you treat your body like a car that has been driven for more than ten years. You usually drive smoothly, fill up with regular oil, wipe dust regularly and do interior maintenance. This is daily preventive health care, which can reduce vehicle wear and tear and extend its service life. But you can't just not go for annual inspection just because you have maintained it well, right? Brake pad wear, internal pipeline aging, and hidden engine faults that need to be checked during the annual inspection are things you don't even feel when you are driving. But when something goes wrong on the road, it is a serious matter that can be fatal. A physical examination is equivalent to this regular annual inspection.

Last month, a 28-year-old man came to see a doctor. His feet were so swollen due to a gout attack that he couldn't wear shoes. He was particularly aggrieved. He said that his physical examination indicators at work every year were normal, so why did he suddenly suffer from gout? After careful questioning, he found out that he usually stayed up late playing games every day and had barbecue and cold beer for his late-night snacks. The physical examination was indeed He does it every year, but the metabolic problems caused by his bad living habits are accumulating little by little. By the time the physical examination can detect excessive uric acid, it is often close to the critical point of attack. If he can stay up less late and eat less high-purine foods, even if he doesn't need to take medicine, he won't be in so much pain that he can't walk.

In fact, most people who think that physical examinations are useless have fallen into the pitfalls of "ineffective physical examinations." For example, people who smoke all year round only have chest X-rays to screen for lung cancer, and women with a family history of breast cancer only have breast B-ultrasounds without mammography. If no problems are found, they naturally think of physical examinations. People who do it in vain, and think that physical examinations are omnipotent, essentially want to "buy insurance" for their health, ignoring that preventive health care is the basis for maintaining health. If you smoke and drink alcohol every day, and have a reverse day and night, no matter how frequent physical examinations are, it will not stop diseases from coming to your door. To put it bluntly, the relationship between the two is never an either-or relationship. Only by doing small things such as eating, sleeping, and exercising well, and then choosing the right physical examination items based on your age, family history, and living habits can you really take your health into your own hands.