The difference between preventive care and physical examination

Physical examination is a single-point testing link used to collect health data in the preventive health care system, while preventive health care is a complete health management logic that covers the full cycle of daily life and includes a series of actions such as life intervention, disease prevention and control, and risk intervention. The two are the relationship between inclusion and being included, basis and action.

Let me tell you a real story I encountered in the community last week. Aunt Zhang, 62, had just received her annual physical examination report, which was completely normal. Then she went to the hospital for acute gastroenteritis because she stayed up late for a week to dance square dancing + iced watermelon with cold white porridge. She was lying in the hospital bed and wondered: "I just finished the physical examination. There is nothing wrong with me. How can I say I am sick?" ”This is a typical misunderstanding of confusing the two.

If you think about it, a physical examination is essentially an "instant snapshot" of your physical condition. The blood drawn, the films taken, and the blood pressure measured are all the instantaneous state during the few hours you went for the physical examination. If you drank half a bottle of liquor the day before, the transaminase may be twice as high as the normal value. After a week's rest, the test will return to normal.； Routine urine tests for women during menstruation are likely to result in false positives for occult blood. These are the natural limitations of physical examinations. There has been controversy in the academic circles over the cost-effectiveness of routine physical examinations. The USPSTF (Preventive Services Task Force) does not recommend a full set of routine physical examinations every year for healthy people under 40 years old without underlying diseases, and believes that many items are over-screening. ； However, many scholars in the field of domestic public health believe that the living habits and disease spectrum of the domestic population are different from those in Europe and the United States, and annual basic screening is still necessary. However, the consensus between the two groups is very unified: the physical examination itself does not produce health benefits. Only by adjusting health behaviors based on the physical examination results can the risk of disease be truly reduced.

I have been doing grassroots health education for almost 8 years, and I have met too many people who confuse the two things. In the past two years, there was a 32-year-old Internet programmer who spent tens of thousands of yuan on high-end private physical examinations every year. All indicators were green. However, last winter he suffered a heart attack after working overtime for a week. He was almost in shock when he was sent to the hospital. After reviewing the report, I found out that he usually stayed up until three o'clock every day, ate takeaways that were heavy in oil and salt, smoked constantly, and took the physical examination report home without even removing the cover. He thought, "I have a physical examination every year, so there must be nothing wrong with my health." It's like checking your bank card balance every month, but after checking it, you still buy luxury goods and go out to restaurants. No matter how many times you check it, you still can't save money. This is the same reason - checking the balance itself will not make you rich, and the physical examination itself will not make you healthy.

Preventive care is something that permeates daily life and cannot be done by taking two hours a year to go to the hospital. You usually add half a spoonful of salt when cooking, walk 6,000 steps three days a week, add a coat in time when the season changes, set an alarm clock every day if you have high blood pressure and take antihypertensive medicine, stand up and move for ten minutes when your cervical spine is sore and don’t carry it, and get free vaccines for your children on time. These inconspicuous little things are all the core content of preventive health care. The role of a physical examination is more like a compass. For example, if your uric acid is high during this physical examination, you should drink less beer, eat less seafood, drink more water and exercise more in the next six months. These subsequent adjustments are part of preventive health care. If you get the report and then turn around and eat a seafood feast, then the physical examination will be in vain.

Speaking of this, some people may ask, is it okay if I don’t have a physical examination and just eat and sleep well? It’s not absolutely impossible, but some early-stage diseases have no symptoms at all, such as early-stage lung cancer and early-stage diabetes. You can’t detect it with your own body senses. Low-dose spiral CT and fasting blood glucose screening for physical examinations can identify these risks in advance. At this time, physical examinations are a tool to point the way for preventive health care, but you can’t use a compass as your guide, right?

To be honest, it is a good thing that people are now more health-conscious, but don’t spend all your time on “finding the most expensive physical examination institution” and “doing the most comprehensive screening items”. Holding a stack of perfectly normal reports and staying up late eating and drinking every day is really not as useful as drinking two more glasses of warm water and smoking two less cigarettes every day. Don’t treat tools as ends, this is how you truly understand health.