Recently, I discussed one thing with my colleagues: should a good physical examination be from how?
Accurate examination results, efficient and convenient examination procedures, reasonable and reasonable examination prices… Are these enough?
When thinking about this problem, I think of the scenes I have encountered and get some inspiration from them. I would like to use this article to talk to you about my thoughts on the so-called “quality physical examination”.
Scene 1: Doubts after Physical Examination
As a doctor, friends often come to me with physical examination reports to consult-this B-ultrasound report says I have gallbladder polyps, what should I do? Does it matter if the bilirubin is high? Is there heart disease in ST-T abnormality of electrocardiogram? Is HPV positive, meaning cervical cancer? …… Every time I try to patiently answer one by one.
This phenomenon has convinced me that a complete set of physical examination procedures should not only include the examination itself, but also the interpretation of the items after the examination is equally important.
In fact, based on the examination results, is it not the original intention of the physical examination to know [whether these should be treated or not, and whether those should be paid attention to and intervened in time]?
Point of view 1: A qualified adult physical examination should include a professional explanation of the examination results by medical personnel, and inform the examiner of the response plan for the problems found.
For example, simple increase of bilirubin without basic diseases, do not worry, follow-up observation is enough; Found that urine sugar is increased, give diabetes diet guidance, remind blood sugar monitoring, formulate appropriate hypoglycemic programs, and prevent complications; Inform the examinee that HPV positive is not equivalent to cervical cancer, and make a comprehensive analysis based on the results of cervical smear, instead of letting the examinee take the report but still have doubts and rush to the doctor.
After a good physical examination, the examiner should clearly know what to do next. You need to have enough time to communicate with the doctor, solve doubts, let the doctor know you better, and let you know yourself better.
Scene 2: Do you want to do this examination?
A period of time before the unit physical examination, and colleagues together brush physical examination form, take blood pressure, draw blood, take chest radiograph, do electrocardiogram, everything is smooth, when to leave stool routine specimens, but looked at each other-the test is good, specimens are hard to find. Later, everyone commissioned a comrade [communist] with specimens.
This incident became the most embarrassing and interesting point of the day. But afterwards, we couldn’t help asking, why do we need to check the dung routine? Must stool examination be a routine item?
Point of view 2: A reasonable physical examination should not be used for everyone.
Take this fecal routine event as an example. My colleagues and I believe that the general population should be screened for colorectal cancer at the age of 50-74. The items include fecal occult blood test and colonoscopy. In view of the decrease in the prevalence rate of gastrointestinal parasitic diseases in adults, fecal routine is of little significance in physical examination. Fecal routine can be completely unnecessary.
Before physical examination, if you can carry out medical history inquiry, high-risk factor investigation, living habits understanding and comprehensive analysis for the physical examination, you can formulate a physical examination form that is suitable for individuals, can screen diseases more accurately, and avoids unnecessary items. This is undoubtedly more efficient and targeted for the physical examination.
Scenario 3: Backward Archiving Method of Physical Examination Results
Mom and Dad said they wanted a physical examination. The night before the physical examination, I told them to prepare the previous medical records and some examination lists and take them with me for the doctor’s reference. As a result, the parents had a good time, turning over and turning over, and couldn’t find the examination report of the previous year. Asked me, it doesn’t matter. I can only comfort and say that if I can’t find it, remember to put it away this time.
Wry smile. It is said that it has entered the information age, but the physical examination report still stays in the form of paper. Subsequent filing, consulting and comparison have all become troubles. For the elderly, this is especially true-there are many examination lists and they always don’t remember to put them in what.
This should not be the case.
Viewpoint 3: Physical examination information should be retained through the electronic medical record system to facilitate customer inspection and follow-up by medical personnel, so as to formulate a long-term plan for individualized health, prevention, screening and intervention.
When there are minor problems such as headache and brain fever, you can quickly read the health history and give an appropriate diagnosis and treatment plan. When the belly is enlarged, reasonable diet and exercise suggestions can be given in combination with the living habits and examination indexes recorded. As you get older, you can remind that it is time to do corresponding chronic disease or tumor screening.
This is what medical treatment should look like in the information age. This is what the so-called [online diagnosis and treatment] should do.
In short, in addition to pursuing accurate test results and smooth and convenient test process, [good communication feedback], [efficient and personalized item selection] and [convenient and complete electronic files] should also be the characteristics that a good physical examination should possess.
However, many physical examination services cannot do the above and cannot exchange feedback with doctors. Who should be asked if there are any questions?
You can consult a doctor on Dr. Clove’s App.
What kind of examinations should be done for physical examination, how to interpret the examination report, and ask the doctor the most at ease.