What is the difference between preventive care and physical examination?

To put it simply, a physical examination is a single-point health snapshot with the core goal of "detecting existing problems", while preventive care is a full-cycle health maintenance system that covers all scenarios of clothing, food, housing, transportation, medical care, and support. The core goal is to "prevent problems from appearing and small problems from turning into big problems." The former is a very important component of the latter, but the two are completely different from the underlying logic to the implementation actions.

Take the 32-year-old Internet operator I met last year as an example. He had a standard physical examination every year with his company. His blood sugar and uric acid were stuck at critical values ​​for two consecutive years. To be honest, this is a typical example of only doing a physical examination without preventive care - the physical examination is only responsible for taking a frozen picture of your current physical condition and telling you which indicators deviate from the normal range. However, how to adjust your diet in the future, how to arrange exercise according to your own work rhythm, how often critical indicators should be reviewed, and what pitfalls in life should be avoided, these are all covered by preventive care.

To use an inappropriate analogy, the difference between the two is like maintaining a car: a physical examination is equivalent to driving to a 4S shop every six months to do a full body inspection to check tire wear, whether there is enough engine oil, and whether there are any fault codes in the engine.； On the other hand, you said that I usually put a car jacket on my car, fill up the fuel tank regularly, and never do a test. Maybe the engine is blocked by carbon deposits and I don't know it yet. There are two extreme views in the health circle today. One thinks that as long as you have a physical examination on time every year, everything will be fine. Those who advise you to adjust your work, rest and diet are just trying to cut leeks. The other thinks that physical examinations are over-medical. If you usually eat more health products and soak your feet, you don't need to go to the hospital. In fact, these two ideas separate the functions of the two and go to extremes.

I have been doing community health management for almost 7 years, and I have seen too many similar examples. For example, for a resident with allergic rhinitis, the physical examination report will only say "pale and edema of the nasal mucosa, indicating allergic rhinitis." However, our preventive care staff will help him find out whether the allergen is dust mites or pollen in spring and autumn. We will teach him how long to wear a mask in advance, how to get rid of mites at home, and what kind of medicine to use before the attack can avoid suffering. Even small details such as using a soft tissue to wipe the nose will be easily abraded to the nasal mucosa and induce infection.； There are also elderly people with high blood pressure at home. Physical examinations include measuring blood pressure once every six months, checking liver and kidney function, and checking whether long-term antihypertensive drugs have any side effects. However, preventive health care should focus on how to measure blood pressure at home in a standardized manner, how much salt intake should be controlled every day, how to avoid a sudden rise in blood pressure when the temperature drops in winter, and what kind of exercise is suitable for elderly people with high blood pressure and will not cause cardiovascular and cerebrovascular accidents. These are all things that cannot be covered by a simple physical examination.

Don’t think that the two are contradictory. No one can completely replace the other. If you only do daily health care and never do physical examinations, you are likely to miss early asymptomatic lesions, such as early stage lung cancer and early gastric cancer. You usually don’t feel anything at all. You can’t solve problems by relying on health care. Only targeted physical examinations such as low-dose spiral CT and gastroscopy can detect them early.； But if you only do a physical examination and stuff the report into a drawer to make whatever you want, then the physical examination can only "detect the disease early" but cannot "prevent the disease early". This is also the core reason why many people complain that "the physical examination is useless, and it can't be cured even if it is detected" - the original function of the physical examination is to find hidden dangers for you, but if you don't intervene if you find them, it will be in vain.