The relationship between preventive care and physical examination is

Physical examination is the most operable pre-screening entrance in the preventive health care system. The two are not subordinate hierarchies, but two core links that support and correct each other in the closed loop of health risk prevention and control.

Many people either equate the two and think that "if I have a physical examination every year, I have done a good job in preventive care", or they completely separate them and think that "I usually soak my feet and work out and take supplements. It doesn't matter whether I do a physical examination or not." I have come across these two misunderstandings too many times during health follow-up visits in the community over the years.

Last year, I met 62-year-old Aunt Zhang. She failed to pass the annual routine physical examination at the workplace. All indicators were stuck within the reference values. As a result, she became dizzy for three months in a row. Every time she came to the community to have her blood pressure measured, it reached the critical line of 140/90. After doing 24-hour ambulatory blood pressure monitoring, it was discovered that she had typical "hidden hypertension." During the day, her blood pressure happened to be at a low point when she was measured at the workplace, and the routine physical examination could not catch it at all. She used to think that since she took antihypertensive supplements every day and her physical examination was normal, there would definitely be no problems. To put it bluntly, she didn't understand the relationship between the two.

After working on the front line of health management for these years, I found that the academic community actually has different tendencies in prioritizing the two. Most scholars with a background in evidence-based medicine prefer "physical examination first". After all, all preventive interventions must be based on accurate physical data. You don't even know whether you have Helicobacter pylori infection. Taking stomach health supplements every day may not prevent gastric ulcers. On the contrary, blind supplementation of probiotics may disrupt the intestinal flora. Researchers in the fields of public health and traditional Chinese medicine "treat diseases before they happen" prefer "preventive care throughout the entire cycle" and believe that a physical examination is just a "body snapshot" at a certain point in time. If you stayed up late or drank alcohol the day before, your blood sugar and transaminase indicators will fluctuate. Determining a health plan based on the results of a physical examination alone can easily miss the diagnosis of transient risks and fail to cover daily health maintenance needs.

To be honest, the views of both groups are actually correct, but the scenarios are different. I met a 28-year-old Internet programmer before. He went to the gym four times a week and ate a lot of protein powder, liver protection tablets, and fish oil. He felt that he was doing better preventive care than anyone else. However, the physical examination after his employment showed that his transaminase level soared to 120, which is three times higher than the normal value. After careful questioning, I found out that he had stayed up late for more than 20 days in a row to prepare for the project, and his daily protein intake was more than twice the recommended amount, which had long put a burden on his liver. His so-called "health care" was completely based on the online guide, without any targeted screening based on his own physical condition. If his liver function had been checked three months earlier, it would not have been high enough to require medication.

Of course, the most discussed controversy over "excessive physical examination" is essentially caused by the decoupling of the two. Many people think that the more expensive and comprehensive the physical examination items, the better. They do a full set of tumor marker screenings and chest CT every year, but instead they receive unnecessary radiation, or are scared to death by false positive results. The core of this matter is actually whether the physical examination is tied to follow-up preventive care: if you are a young person who does not smoke and has no family history of lung cancer, annual chest X-rays are enough, and there is no need for low-dose spiral CT. ； But if you have been smoking for more than 10 years and smoke one pack a day, a low-dose spiral CT scan that year is the most cost-effective preventive measure for lung cancer, and it is not excessive at all.

To put it bluntly, the relationship between the two is actually no different from your car maintenance: a physical examination is an annual car inspection, and preventive care is daily maintenance, filling up with compliant gasoline, and not driving violently. You can't say that I don't need to change the engine oil after I've had a car inspection, and you can't say that if I usually add 98-proof oil, I don't need to check the brakes last year to see if they have aged, right?

My own experience in doing health management for so many years is that there is really no need to worry about which one is more important. Spend time every year to choose a physical examination package that suits your past medical history and living habits. Don’t just look at the “little arrows up and down” when you get the report. Go to the doctor to ask which abnormalities need to be adjusted in your living habits and which ones need regular review. Don’t just buy Internet celebrity health products and follow health exercises. Only by combining the two can you really take your health into your own hands.