Over the past few years I have introduced pulmonary function tests in several primary hospitals and community health centers, and I have continued to call for attention to pulmonary function tests in several media, but the situation still does not seem optimistic. Today I went to a very large community health service center in the west of Hangzhou, which serves a population of at least 50,000 people and has five service points under its jurisdiction, and there were 40 to 50 medical staff listening to the lecture, but when I asked if they had a lung function meter on their side I learned that there was only a portable simple lung function meter, and the number of cases per year was very limited probably only a few dozen. According to the research of our scholars, the number of cases of airway diseases or lung diseases should be around 4,000 to 5,000 cases, and even if screening is carried out, many early patients can be screened for timely treatment, but unfortunately it is not included as a routine screening item. Pulmonary function tests have made significant progress in this decade in general. In our hospital, for example, the number of cases per year stayed at about 400 to 500 a decade ago, but last year it was close to 10,000. Pulmonary function tests have led to a significant increase in the diagnosis of asthma and COPD, as well as to the diagnosis of many cases of upper airway obstruction and airway stenosis, and to a better understanding of airway function. However, since pulmonary function is a relatively new field of knowledge, compared to electrocardiography, which has a history of hundreds of years, pulmonary function has only been studied and clinically applied for half a century, especially in the last 30 years or so when computers have become popular. There are many similarities and differences between pulmonary function and electrocardiography, including: (1) they are both functional tests that cannot be replaced by morphological tests, for example, electrocardiography cannot be replaced by cardiac ultrasound and chest X-ray, and pulmonary function cannot be replaced by CT; (2) the learning of these functional tests has its own rules, and the common performance can be quickly mastered through short-term training; (3) they are both noninvasive and inexpensive, and are suitable for population screening. (4) Their interpretation must be closely related to the medical history and signs, and requires the attending physician to make a correct judgment with a full understanding of the condition. The differences are: (1) Pulmonary function tests require the cooperation of the person being examined, so they are more time-consuming and often have to be repeated in order to obtain good results, so the number of cases completed per day is small, whereas ECG is usually faster and the number of cases completed per day is large. (2) Pulmonary function tests require strict quality control by the examiner, not only to calibrate the machine daily, but also to identify the quality of the patient’s pulmonary function and be able to discern at least 10 conditions that interfere with the pulmonary function test, because quality control in pulmonary function tests is very important for diagnosis. (3) Since pulmonary function requires patient cooperation, adequate time is needed to tell patients or have a video to demonstrate to patients, but there are many patients such as deaf, elderly, and anxious patients who have difficulty cooperating and may have conflicts with the examiner, which has happened many times in our hospital, so full understanding from patients and families is also especially expected. (4) The interpretation of pulmonary function test results needs to be analyzed by the attending physician himself, and not to rely too much on the technician’s report. I have seen many times when I was in the U.S. that superior physicians led lower-level physicians to study pulmonary function, and once I even heard a superior physician say, “Pulmonary function is a monkey will type the report.” From so many years of clinical practice, there are still many problems with the interpretation of lung function, and many clinicians, including respiratory physicians, often incorrectly analyze lung function, and the quality control situation also seriously affects the accuracy of the results, and a few years ago the popularization of lung function at the grassroots level has been an important project to promote at the national level, but the situation is still not optimistic today. The huge smoking population in China, the deterioration of air quality over the years, and the increasing morbidity and mortality of chronic respiratory diseases are threatening the health of the people. It is hoped that the state and society will pay more attention to this issue, and that the medical profession, especially the respiratory physicians, will be obliged to increase the publicity and train primary care physicians so as to improve the overall diagnosis and treatment of respiratory diseases.