What is the difference between preventive care and physical examination?

In fact, the most essential difference between the two is that the directions of action are completely opposite. Physical examination is to look backward for health abnormalities that have already occurred and reached clinical judgment standards. To put it bluntly, it is "clearing mines", while preventive health care is to move forward to block health risks that have not yet arisen, which is a kind of "building a wall."

Don’t think this is a word game. I just met a 42-year-old middle-level person in a company a while ago. He gets a thousand-yuan physical examination package for his company every year. Every report shows nothing abnormal except for slightly high blood lipids and an excessive body mass index. He didn’t take it seriously. It wasn’t until last year’s physical examination that he found plaque in his carotid arteries that he panicked and came to us for health intervention. This is the characteristic of physical examination. Only if your indicators have crossed the line of clinical diagnosis, it will mark you as "abnormal", and it will ignore the "gray area" in the middle.

It is precisely this gray area that preventive health care should focus on. We reviewed his physical examination reports for five consecutive years and found that his low-density lipoprotein increased by 0.18mmol/L every year, and his waist circumference increased from 82 to 94. These trend changes have long been a yellow light. If he had adjusted his diet and increased exercise two or three years earlier, he would not have developed plaques at all.

Of course, many people now think that preventive health care is an IQ tax. A friend around me said, "I do a full physical examination every year, and there is nothing wrong with me. I don't need to spend time and energy on diet management and work and rest adjustments." This idea is not entirely wrong. If you have a regular schedule, a light diet, and no family genetic history of diabetes or cancer, annual routine physical examinations can indeed cover most risk screening needs. But if you already have indicators that are stuck at the critical value, or you stay up late, drink, or eat takeout all year round, and you only rely on the once-a-year physical examination to be safe, it's a bit like just waiting to see if you fail the final exam, and not reading at all to review. If you get a difficult question one day, you will fail the exam directly.

I have been doing health management in a community health service center for almost 7 years. I have seen too many patients whose physical examinations have been normal every year, but who have been found to be in the middle and late stages of malignant tumors. I have also seen many elderly people who have followed us for preventive care for four or five years. To be honest, the two have never been antagonistic. Nowadays, many high-end physical examination packages also include chronic disease risk assessment and lifestyle guidance. In fact, they integrate the logic of preventive care into the physical examination. If you really want to care about your health, don't just look at the word "abnormal" on the physical examination report. Look more at the changes in your indicators in the past few years. Take action when you need to and stay up less late at night, which is better than anything else.