What are the contents and methods of the relationship between preventive health care and physical examination

From the practical level of public health implementation, physical examination is the core entrance to the general population in the preventive health care system. The two are strongly bound to each other as "goal guidance" and "implementation gripper". It is wrong to completely separate or equate them.

Many people are confused about the relationship between the two. They either think that getting cancer every year through physical examination is in vain, or they think that buying the most expensive physical examination package is equivalent to insuring their health. In fact, there is no way to link the two misunderstandings. When I was following up on chronic diseases at the street public health station, I met Aunt Zhang, who is 62 years old and lives in an old community. She always thought that she could eat and sleep without any problem. She was urged by the community to do a free elderly physical examination. It was found that her fasting blood sugar was 6.8, which is the critical value of abnormal glucose tolerance. If she had taken the report before, she would have stuffed it. Drawer, at most she should pay attention to eating less sugar. This time, the doctor from our public health team followed her up for three months. They reminded her to test her blood sugar every week, adjusted her staple food ratio, and taught her to walk for 40 minutes after meals. When she had another physical examination this year, her fasting blood sugar had returned to the normal range of 5.4, and even her previously high triglycerides had dropped.

Think about it, if there is only a physical examination without follow-up preventive health care intervention, Aunt Zhang's borderline abnormal indicator may develop into real diabetes in a year or two. If you only think about health care and eat various health products every day, but don't even know that your blood sugar is high, then it will be useless to eat more health products, but may lead to a trap. In fact, to put it bluntly, preventive care is like a long-term maintenance plan for your house. There are clear rhythms for when to replenish waterproofing and when to open pipes. Physical examination is a monthly house inspection. If you don’t inspect the house, you won’t know where the leaks are. If you don’t repair the leaks after the inspection, the floor will still have to be soaked next time it rains.

There are now different views on the compatibility of the two in the industry. Some scholars in the field of public health believe that many people now blindly pursue high-end physical examinations. Healthy people undergo PET-CT every year and check a lot of unnecessary tumor markers. On the contrary, there are additional radiation risks and the possibility of excessive medical treatment. This completely violates the original intention of preventive health care; some front-line clinical doctors believe that for high-risk groups such as those with family histories of cancer, long-term smoking and drinking, appropriately increasing the frequency of targeted physical examinations can nip early lesions in the bud, which is essentially the most efficient prevention at the lowest cost. The two views have been arguing for several years. In fact, the essential consensus is that physical examination must follow the goal of preventive health care and cannot be performed for the sake of physical examination.

When it comes to ordinary people, there is no need to get entangled in these academic disputes. The core thing is not to separate physical examination and health care into two separate things. Many families I have met who have done good health management will not buy random "family bucket" physical examination packages that cost tens of thousands. Instead, they will first find a family doctor who is familiar with their family's situation and list everyone's preventive care priorities. For example, if there is a family history of lung cancer, annual low-dose spiral CT is a must, and it is more reliable than checking ten tumor markers; for those with a family history of hypertension, in addition to blood pressure measurement, each physical examination will also include items such as homocysteine ​​and carotid artery ultrasound to detect the risk of stroke in advance. After the physical examination, you don't just throw the report aside and everything will be fine. For example, if you are found to be positive for Helicobacter pylori, in addition to taking medicine to eradicate it according to the doctor's instructions, you must also keep up with daily health care activities such as dividing meals at home and regularly disinfecting tableware. Otherwise, if you re-examine positive after six months, the previous physical examination and treatment will be in vain.

Last week, a 28-year-old programmer came to our site to get a physical examination report. It was found that the uric acid level had reached 580. He also said that he always felt that he was young and did not need to do any health care before. Only now did he realize that physical examination is never the end of health assessment, but the starting point of adjusting daily health care methods. Isn't this the most practical connection between the two.