What are the routine physical examinations

The essence of routine physical examination is a basic preliminary screening project for ordinary healthy people. The core includes physical examination, basic laboratory examination, and basic imaging examination. The price of basic routine package in public institutions is mostly in the range of 300-800 yuan, which is enough to cover the early warning needs of more than 80% of common diseases.

I have been working as a counselor in a public physical examination center for almost 7 years. I have seen too many people choose luxury packages worth tens of thousands of dollars. In fact, 90% of the items are redundant for ordinary healthy people. When you enter a physical examination center, the first thing you do is usually a physical examination from the Department of Internal Medicine, Surgery, Ophthalmology, and Otolaryngology. Don’t think that the doctor uses a stethoscope to listen to the heart and lungs twice, and feels the neck and stomach. Just last week, a 29-year-old Internet operator found a thyroid nodule with unclear boundaries and poor mobility during surgical palpation. Subsequently, a puncture was performed to diagnose micro-papillary cancer. It was discovered early and did not even require surgery. It was done with ablation, which is more accurate than many expensive primary imaging examinations.

The 2-3 tubes of blood drawn are the core items of laboratory examination in the routine physical examination. They are nothing more than routine blood test, liver and kidney function, fasting blood sugar, and blood lipids, plus urine routine and stool routine. It is nothing fancy, but it can uncover a lot of problems. Last year, there was a little boy who had just graduated. He always felt tired and did not take it seriously. However, a routine blood test showed that his white blood cells were abnormally elevated. He was subsequently diagnosed with chronic myelogenous leukemia. Now he is taking targeted drugs to control his condition like normal people. There has been a lot of quarrel online recently about whether to add tumor markers to routine physical examinations. Our center also has different opinions. Some doctors think that healthy people under 40 years old and without a family history of cancer do not need to add tumor markers. If a single increase in a certain item is mostly caused by inflammation and staying up late, it will only increase anxiety. Some doctors also suggest that people with family history should take it. The dynamic changes of the indicators are more informative than the results of a single image. You don't need to listen to people saying that it is completely useless or must be done. You can choose based on your own situation.

After drawing blood and collecting urine and stool samples, the next step is to the imaging room. The routine items are usually chest X-ray and abdominal ultrasound. For women, breast and gynecological ultrasound will be added, and for men, prostate ultrasound. In the past two years, more and more institutions have replaced chest X-rays with low-dose chest CT. Many people have questioned whether the radiation is unnecessary. In fact, for people who smoke more than 20 packs a year or have a family history of lung cancer, the benefits of low-dose CT are far greater than the negligible radiation. For ordinary young people who do not smoke, a chest X-ray is enough and there is no need to blindly upgrade.

Many people complain that routine physical examination is an "IQ tax", saying that no problem can be found. In fact, this should be discussed separately. The positioning of routine physical examination is originally a "preliminary screening". For high-incidence cancers such as lung cancer, thyroid cancer, liver cancer, and breast cancer, routine items can be clearly stated. warning signs, but cancers with hidden locations and low incidence rates, such as pancreatic cancer and small bowel cancer, are indeed not within the scope of routine screening. If you really have abnormal symptoms such as abdominal pain and sudden weight loss, go directly to a specialist to register for a targeted examination. Don’t expect routine physical examinations to cover the whole world.

If you are having a routine physical examination for the first time and don’t know what to choose, you are right to just choose the “basic package” posted by the public physical examination center. If you have a family history of high blood pressure and diabetes, or you always feel uncomfortable in a certain part, just tell the guide in advance to add the corresponding items. Don’t buy a luxury package worth thousands of dollars just for a gimmick. Not to mention spending money in vain, you may also cause unnecessary anxiety due to excessive examinations.