What is the difference between preventive care and physical examination

The core difference is actually that one does "phased screening" and the other does "full-cycle health operation and maintenance." To put it simply, physical examination is to find problems that have already arisen in your body, while preventive care is to help you nip problems that have not yet arisen in the bud, and even help you adjust your physical condition to a better state and avoid getting sick less.

I met a 42-year-old salesman named Zhang when I was rotating in the preventive care department of a community health service center. His routine physical examination reports for three consecutive years were all normal, but he always felt bloated and easily tired. His blood pressure sometimes reached the critical value when he measured it at home, but then it was normal again. I went to the physical examination center and added more than 2,000 items, but no clear abnormalities were found, so he came to our department to ask. We reviewed his physical examination data for three years and asked questions about his parents, both of whom have been suffering from high blood pressure for many years. He runs a business and eats heavy oil and salt every day. He has at least three or four drinking parties a week and often doesn't go home until one or two o'clock. Without prescribing any medicine for him, they set up an ambulatory blood pressure monitoring plan for two consecutive weeks. They calculated that his daily salt intake should be reduced to the level of a beer bottle cap. He was asked to have at least two drinking sessions a week and replace it with 40 minutes of brisk walking. He also reminded him that he didn’t need to have ridiculously expensive high-end items for the next year’s physical examination, and just focused on testing homocysteine ​​and carotid artery ultrasound. He persisted with it for two months, and when he came back he said that the bloating in his head had basically disappeared, and his blood pressure had stabilized within the normal range when measured recently.

There are quite a lot of controversies between these two on the Internet. Some people say that "spending several thousand to do a full-body physical examination can detect all problems, and preventive health care is an IQ tax." Others say that "physical examinations are only afterthoughts, and there is no need for physical examinations at all for normal prevention." In fact, both opinions are extreme. For example, a physical examination is like the annual inspection you do for your car every six months. It can only detect existing problems such as whether the brakes are worn and whether the exhaust gas is up to standard. However, if you are careful not to slam on the accelerator when driving, add the appropriate engine oil regularly, and perform minor maintenance on time, these are the keys to making your car less likely to break down and drive longer. This is the role of preventive health care. You can’t just do the annual review without doing daily maintenance, right? The same goes for the opposite. No matter how careful you are when driving, you still have to rely on annual inspections to troubleshoot hidden problems that you can't detect on a daily basis. Otherwise, small problems will turn into big faults, and you will have to spend a lot of money to repair the car if it breaks down halfway.

In fact, many people’s impression of preventive health care is still that of selling health care products. This is not true. Formal preventive health care is based on your past medical history, family genetic history, daily living habits, and even your environment to provide customized guidance. It ranges from whether to supplement vitamins during the change of seasons, how to adjust cardiopulmonary function after recovering from COVID-19, and how to do targeted early screening if you have a family history of cancer. These are all things that cannot be covered by a single physical examination. Don’t separate these two things in daily life. You still need to have regular physical examinations every year. Don’t stuff it in a drawer to gather dust as soon as you see the arrows that are not rising or falling when you get the report. Find a preventive health care professional to help you identify potential risks and make adjustments on a daily basis. This will save you more trouble and money than waiting for the problem to be diagnosed before going for treatment.