What is the relationship between preventive health care and physical examination?

Physical examination is the front-end risk screening entrance of the preventive health care system and is the core basis for all subsequent preventive intervention measures. The personalized needs of preventive care will in turn optimize the selection of physical examination items. The two are not a disconnected "physical examination first, then health care" sequence relationship, but a closed loop of health management that supports each other.

Last week, I met a 38-year-old Internet programmer while working at the community consultation desk. For three consecutive years, the uric acid level in the workplace physical examination has been hovering around the critical value of 420 μmol/L. The report was marked with "low purine diet, regular review." You see, this is a typical example of completely separating physical examinations from preventive care. Having physical examinations but not following up on follow-up interventions is equivalent to doing most of the work in vain.

Nowadays, there are indeed two completely opposite opinions on the relationship between the two. One is the "physical examination is omnipotent" theory. They believe that as long as they spend thousands of dollars a year on a full physical examination, they are equivalent to doing preventive health care and can avoid any serious illness. They turn around and stay up late and drink heavily without paying attention to daily maintenance.； The other is the theory that physical examination is useless. It says that many cancers will be in the advanced stage once diagnosed, and physical examination is useless. It is better to brew wolfberry and drink health tea at home to maintain health. In fact, both of these ideas are wrong.

To put it bluntly, the relationship between the two is a bit like the maintenance you do for your family car: a physical examination is a full vehicle inspection that you take to a repair shop every six months. Everything from the glass water margin and the degree of brake pad wear to the engine carbon deposits and gearbox failure hidden dangers are clearly listed for you.； Preventive care includes follow-up glass filling, brake pad replacement, and carbon deposit removal, as well as daily operations such as not slamming on the brakes, washing and waxing the car regularly. You can't just do inspections without repairing the car, nor can you never go for inspections and rely on yourself to feel that there is nothing wrong with the car, right?

There used to be a 42-year-old sister Zhang in our community. Her mother and two aunts had breast cancer. She only had routine breast B-ultrasounds every year. When she came to set up preventive health records last year, we suggested that she adjust the physical examination to an annual breast B-ultrasound combined with breast MRI screening. This year, a 1cm early-stage breast cancer in situ was detected. After minimally invasive surgery, she was fine, and she didn’t even need chemotherapy. This is a typical example of the personalized needs of preventive care in turn optimizing the physical examination plan.

In fact, for ordinary people, there is really no need to think about these two things too complicated, nor do they need to be separated. When you get the physical examination report, don’t just focus on the “abnormal” red stamp. Those critical indicators marked with “follow-up”, “observation” and “recommendation to adjust your lifestyle” are all there to point you in the direction of follow-up preventive care. ； If you have any discomfort or family history, remember to mention it to the doctor before your next physical examination and adjust the corresponding screening items. This set of procedures is much more reliable than buying a bunch of sky-high-priced health products that cost thousands of dollars.