The difference between preventive care and physical examination

Many people are used to equating the two, and even think that "having an annual physical examination means doing a good job in preventive care." In fact, this is not the case at all - preventive care is a systematic behavior that covers the entire life cycle and proactively intervenes in health risks, while physical examination is only a standardized tool used to screen risks in stages in the preventive care system. The two are included and included, and the core logic and function boundaries are completely different.

Last week I met Aunt Zhang at the community health service center. Less than a week after getting the all-negative physical examination report, she suffered an acute pancreatitis attack and was hospitalized because she went to the night market with her old sisters for three consecutive days to eat skewers and drink cold beer. She was lying in the hospital bed with a puzzled face: "I just said there was nothing wrong with my physical examination last week. Why did I collapse just like that?" ”

In fact, this is the misunderstanding that many people have about physical examination: it is essentially an "instantaneous health snapshot." Your status during the dozen or so hours during the examination largely determines whether the indicators are good or not. In order to pass the physical examination, Aunt Zhang ate very lightly in the first three days. She didn't even touch her favorite braised pork. She turned around and started eating and drinking after taking the blood. Of course, those indicators could not reflect her true long-term condition. Moreover, the items of the physical examination are all standardized and the reference values ​​are universal standards for most healthy people. They will not specifically add items to someone with a family history. Its function is very clear: at the point when you do the examination, it helps you find indicators that have deviated from the normal range, and reminds you that "there may be a problem here." That's all.

Preventive care is another matter entirely. It is not a “task-based consumption” done once a year, but a dynamic adjustment that permeates every day. Dr. Chen of the Traditional Chinese Medicine Clinic I know has an old patient. Three elders in his family were all diagnosed with gastric cancer when they were around 50 years old. He has been doing preventive health care with Dr. Chen since he was 30 years old. In addition to routine physical examinations, he also undergoes two more painless gastroscopy every year. He strictly controls salt in his meals and never eats pickled products. When the solar terms change, he will drink tea for a few weeks to regulate the spleen and stomach. He is 58 this year and has no stomach problems at all. All the indicators in his physical examination last year were even better than many 30-year-old young people.

The industry now has different logic for the implementation of preventive care: the core of the mainstream Western medicine system is "risk stratification management", which is to classify you into different risk levels based on your age, gender, genetic history, and basic diseases, corresponding to different screening frequencies and intervention plans. For example, women with a family history of breast cancer will be recommended to have mammography every year starting at the age of 30, rather than waiting until the universal screening age of 40.； The preventive health care of traditional Chinese medicine is more focused on "treating the disease before it's too late." Even if all your physical examination indicators are within the normal range, as long as you have "not yet sick" states such as fatigue, cold sensitivity, and irritability, you will make adjustments through diet, moxibustion, and exercises to nip the problem in the bud. There is no difference between the two logics, but the angles of entry are different.

To be honest, in the past two years, I thought that as long as I had a physical examination on time every year, everything would be fine. It was not until I came across a case involving a middle-level person in an Internet company that I discovered that many people had a deep misunderstanding of these two things. The eldest brother spent more than 20,000 yuan every year for high-end VIP physical examinations, and the reports were all normal. However, he suffered a heart attack at the age of 34. After he was rescued, a review revealed that he stayed up until 2 or 3 o'clock all year round and drank more than 3 glasses of ice cream every day. He just took annual leave a week before the physical examination. He went to bed early and got up early every day to go hiking. Of course, the indicators were fine, but his daily living habits had already created almost all the blood vessels, so the "snapshot" of the physical examination was not taken.

To use an inappropriate analogy: a physical examination is like a routine safety inspection you do on your car every month. It checks whether the brakes are working, whether there are cracks in the tires, and whether the engine oil is sufficient. At most, it can tell you "the car can be driven now."； Preventive health care is your usual driving habits. If you know that the car has a low chassis, you will avoid bad roads. If you know that the engine is delicate, add high-grade oil and perform regular maintenance. This is the core of making the car drive longer.

You really have to take your health into your own hands. Don’t take the physical examination as the end point, but as the starting point. When you get the report, don't just look for up and down arrows. Pay more attention to the critical values. If you always feel uncomfortable but the physical examination can't find any problems, don't force yourself to do it. Either ask a general practitioner for a risk assessment, or find a reliable traditional Chinese medicine practitioner to adjust your condition. Match the results of the annual physical examination with your usual lifestyle adjustments. This is how you can truly implement preventive health care.