What is the relationship between preventive health care and physical examination

Essentially speaking, physical examination is the front-end quantitative entrance of the preventive health care system, while preventive health care is the subsequent extension carrier of the value of physical examination. The two have never been a subordinate relationship of "who includes whom", but a complementary combination of dynamic linkages. Many people either equate physical examination with preventive health care in its entirety, or think that the two are completely unrelated, and in fact they have gone astray.

When I was doing public health management in the community two years ago, I met a 42-year-old programmer from an Internet company. He attended the regular physical examinations organized by his unit every year. Every report except for high blood uric acid and a body mass index slightly above the critical value were marked "no obvious abnormality." Every time he glanced at it, he stuffed it in the drawer and never took it seriously. Last winter One day, my feet were so swollen that I couldn't wear shoes due to an acute attack of gout. When I came to us to set up my profile, I muttered, "I have physical examinations every year, how could I suddenly become so seriously ill?" This is a typical separation of physical examinations and preventive care - just doing an examination, but not taking the abnormal signals in the examination as the entry point for preventive care, is equivalent to blinding the previous physical examination data.

This does not mean that physical examination is just a tool to "find faults." It is precisely the continuous data accumulated from each physical examination that prevents preventive health care from turning into a meaningless "metaphysical health regimen." There was an aunt in her 60s who heard a health lecture in the community saying that taking Coenzyme Q10 and deep-sea fish oil can protect the heart and blood vessels. She bought a bunch of them and ate them for half a year. Later, a routine physical examination and an electrocardiogram revealed that she had first-degree atrioventricular block and the triglycerides in her blood lipids were higher than before. We pulled her through the first three pages. The physical examination report in 2016 found that her basal heart rate was slow and she had no family history of hyperlipidemia. She did not need to take these supplements in large doses. She adjusted the plan and stopped the excess supplements. She was asked to walk for half an hour more after meals every day and eat less braised pork. After half a year, she was reexamined and the indicators returned to the normal range.

There are two extreme views on the market now. One is that "physical examination is an IQ tax. If you find a problem, it cannot be cured, so it is better not to have it checked at all." The other is that "the more expensive the physical examination, the better. A complete set of high-end physical examinations is considered preventive." I have encountered corresponding examples. Last year, there was a cross-border e-commerce boss who spent more than 100,000 yuan on a full physical examination every year. He wanted to have a full set of PET-CT and tumor markers checked every quarter, but he smoked two packs of cigarettes a day, socialized and drank, and stayed up late. He said, "Anyway, I have regular physical examinations, and I can detect any problems as soon as possible." "Come", it turned out that at the end of last year, it was found that the blood pressure had reached the standard of grade 2 hypertension, and early carotid plaques had also appeared. This means that the physical examination was regarded as a "healthy and death-free gold medal", and there was no thought of using the results of the physical examination to guide one to adjust his living habits. No matter how expensive the physical examination is, it cannot play a preventive role.

Now the family doctor files in our community will store the physical examination data of the residents in the past five years. Every time they come for a follow-up visit or when the residents come to prescribe chronic disease medicine, they will compare the previous indicators. For example, someone's blood pressure has been at the critical value of 130/85 for three consecutive years. They will remind you to put less salt and don't stay up late all the time. If your weight has increased by more than 5 pounds in two consecutive years, you will also be reminded to walk more and drink less milk tea. These suggestions are much more reliable than the "universal health prescriptions" found online. This is actually a state where physical examination and preventive health care are truly integrated.

To put it bluntly, the relationship between the two is a bit like wearing glasses. The physical examination is the process of optometry. Whether you have accurate power, whether you have detected phoria and astigmatism during the optometry will directly determine whether the glasses you wear later are suitable, and preventive care is the next step. The whole process of selecting frames, adjusting temples, and adjusting the power according to eye habits is missing the step of optometry, and the glasses you wear will either be blurry or dizzy. Without the subsequent fitting steps, even if the optometry data is accurate, you will not be comfortable wearing them, and it will not be able to correct your vision at all.