What is the relationship between preventive care and physical examination?

Simply put, physical examination is the most advanced screening entrance in the preventive health care system and the prerequisite for accurate preventive health care, but it is far from the entirety of preventive health care.

To use a very common analogy, preventive health care is like providing full-cycle safety protection for your old house, while a physical examination is to first scan the walls, circuits, water pipes, and waterproofing with a professional detector to see where there are cracks, aging lines, and potential leaks. Finding problems is only the first step. Follow-up repairs, daily use precautions, and regular targeted inspections are the core of making the house stable. If you only scan without repairs, no matter how detailed you scan, it will be meaningless.

I have been working in a community public health post for almost five years, and I have encountered many people who misunderstood the relationship between the two. I met an old man last month. Every year, my work unit arranges a high-end physical examination worth several thousand yuan, including tumor marker screening and genetic testing. Every time the report comes out and no major abnormality is found, I sigh with relief. I turn around and stay up until two or three o'clock, drink cold beer and eat barbecue. He says that the physical examination is normal anyway, and there must be no problem with my body. As a result, this year's physical examination revealed that the coronary arteries had been blocked by 40%. When I received the report, I was completely confused. Why did I still have such a big problem during my annual physical examination? In fact, he regarded the physical examination as the end point of preventive care. He ignored the warnings of high blood lipids and critical blood pressure that were repeatedly mentioned in the reports in the past few years. He did not do any follow-up dietary adjustments and work and rest intervention, which meant that the previous screenings were all wasted.

There is another common perception nowadays. Many people who pay attention to health care feel that they soak their feet every day, eat organic vegetables, and do aerobics and running. They do enough preventive health care and there is no need to spend money on physical examinations. Previously, when our community organized free physical examinations for the elderly, there was an Aunt Zhang who always refused, saying that she was very healthy and had no disease, so why should we check? Last month, she felt dizzy after dancing and came to the community to have her blood pressure checked. Her systolic blood pressure had soared to 180, and there was slight bleeding under her eyes. She didn't feel any discomfort at all. If the abnormal blood pressure had been detected during the physical examination half a year earlier, it would not have been so dangerous.

In fact, from the professional classification of public health, physical examination is a core method of secondary prevention. Its core function is to identify hidden dangers before the disease has obvious clinical symptoms and avoid it from becoming severe. The coverage of the entire preventive health care system is much wider, including childhood vaccination, health science popularization, and lifestyle guidance at the front end, physical examination and screening at the middle end, and chronic disease management and postoperative rehabilitation follow-up at the back end. The two actually depend on each other: without a physical examination, many people are blind to preventive health care and follow the online health posts. Maybe they are cold and drink cool chrysanthemum tea every day, but the more they take care of themselves, the worse they get. ； If only physical examinations are performed without follow-up intervention and adjustments, preventive care will only cover the first 10%, and will not be able to prevent serious diseases at all.

Seriously speaking, when you get the physical examination report, don't just stare at the red letters of "major abnormalities". Those minor problems that require review and adjustment of living habits are the most critical nodes for connecting physical examinations to preventive health care.