The relationship between preventive care and physical examination is

Physical examination is the most practical pre-identification tool in the preventive health care system. It is the core bridge connecting health risk early warning and proactive intervention. The two are neither mutually substitutable subordinate relationships nor completely separated parallel behaviors. They are essentially a collaborative partner of "demining" and "defending fortresses."

I met 56-year-old Aunt Zhang at a community chronic disease free clinic a while ago. Her physical examination indicators at the workplace have been hovering above and below the qualified line every year. She has never stopped taking propolis and fish oil, and she also dances frequently. She always feels that she has done better preventive care than anyone else. However, she suddenly felt dizzy last winter and couldn't stand. When she was sent to the hospital, her triglyceride level was three times higher and soft plaques had developed in her carotid arteries. She was so confused when she took the report sheet and said that my annual physical examination was fine, so why did I say it was blocked? Looking through her reports for the past three years, she saw that her blood lipids were stuck at the critical value every time. The remarks column clearly stated "low-fat diet recommended, review in 3 months." She turned around and forgot about it. She felt that she was not "sick" anyway, and she had to eat all the braised pork. She also bought health care products according to the recommendations of Internet celebrities. This meant that the risk warnings given by the physical examination were not connected to the follow-up health care actions. She spent a lot of money and was all in vain.

I've also seen people go to the other extreme. I once met an Internet operator who was born in 1994. He goes to the gym every day, takes anti-sugar, supplements, and mindfulness meditation. He even washes the oil three times when eating takeout. He feels that he has "preventive health care" engraved into his DNA. He skipped the free physical examination at his workplace for three consecutive years, saying, "I don't know what my body is like?" Physical examinations are all designed to trick people into buying projects.” As a result, I had a cough for half a month at the end of last year and it didn't get better. I went to the hospital for a CT scan and found an 8mm ground-glass nodule on my lung. Fortunately, it was carcinoma in situ. You see, if you only do preventive health care that you think is right, without a physical examination to accurately locate risks, you will not know if you step on a trap.

In fact, whether it is modern preventive medicine or the treatment and prevention system of traditional Chinese medicine, the positioning of the two is essentially the same. Preventive medicine in Western medicine divides health protection into three levels. What we usually call regular work and rest, vaccination, salt and oil control, etc., all belong to the first level of "preventing diseases before they become ill", while the core of the second level of "early detection and early intervention" is regular physical examinations. Even the third level prevention after illness requires physical examinations to monitor recovery, which means that physical examinations are the thread that connects the entire third level prevention chain. In the logic of TCM treatment of pre-disease, whether it is to prevent a disease before it is discovered, to prevent an existing disease from becoming worse, or to prevent a disease from relapsing, the first step is to "identify the body." In addition to the traditional visual inspection, many TCM clinics now also include indicators such as blood lipids, blood sugar, and bone density from routine physical examinations as the basis for identification, and then provide targeted nutrition, moxibustion, and exercise intervention plans. To put it bluntly, "physical examination" is used to first understand the basics of the body, so that subsequent health care actions will not be blind.

Of course, many people now say that "excessive physical examinations can harm the body." For example, indiscriminate CT scans and radiation exposure, and checking for a bunch of unnecessary tumor markers can only increase anxiety. This is not unreasonable. I met a 30-year-old girl before who had no family history of cancer and had never smoked. She paid for a chest CT scan and a full set of tumor markers every year. Last year, one of her carbohydrate antigen levels was slightly higher, which scared her so much that she cried for three days and even thought about her will. However, nothing happened during the re-examination, which made her anxious for more than half a month. But this is not actually a problem with the physical examination itself. It is whether you combine the physical examination with your daily health care and choose items. If you smoke every day and have a family history of lung cancer, low-dose CT examinations are necessary every year. If you have a regular work and rest schedule and have no high-risk factors, once every two or three years is enough. ； If you usually drink a lot and like to eat hot pot and barbecue, it is necessary to have a gastrointestinal endoscopy and blood uric acid examination for physical examination. If you usually eat a light diet and seldom eat out, there is no need to suffer the pain of gastrointestinal endoscopy under general anesthesia every year.

To put it bluntly, you think of your health as a private car that has been driven for many years. The usual preventive care is to wash the car every week, fill up the oil regularly, and be careful not to slam on the accelerator and brake when driving. And the physical examination is to go to the 4S shop once every six months to do a full car inspection to see if there are bulges in the tires, whether there is carbon deposits in the engine, and whether the brake pads are thick enough. You can't say that because I wash my car frequently, I don't need to check the engine for hidden dangers, right? You can't say that I just checked the condition of the car and it's fine, so I just drive it on potholes every day and build the car casually, right?

I have been working in health management for almost 8 years, and I have seen too many people who separate these two things. They either think that after the physical examination, everything will be fine, or they think that they do not need to have a physical examination because they have done enough in daily health. In fact, the two things are basically tied together: the physical examination can help you point out where there are pitfalls, and preventive health care can help you fill in the pitfalls. If you cooperate well, you will go to the hospital less often and suffer less. As for how to do it specifically, there is really no standard answer. Whatever suits your own physical condition is best.