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The Practice
Fishtown Medicine•3 min read

The Practice

Restoring the doctor-patient relationship through transparency and trust.

On This Page
  • Leadership & Vision
  • Services & Pricing
  • Practice Policies & Legal
  • Practice Guides & Insights
  • Common Questions
  • What is Fishtown Medicine?
  • Where is Fishtown Medicine located?
  • What kind of doctor is Dr. Ash?
  • Do you take insurance?
  • What is the GER·O·SPAN framework?
  • Do you offer virtual visits?
  • What is the difference between concierge and DPC?
  • Can I use my HSA or FSA for membership?
  • Scientific References

Get a preventive doctor that knows you.

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TL;DR30-second take

Fishtown Medicine is a modern internal medicine practice in Philadelphia focused on healthspan, prevention, and a real doctor-patient relationship. This page connects you to Dr. Ash's bio, our clinical framework, services, pricing, and our practice policies.

Fishtown Medicine is a modern internal medicine practice dedicated to optimizing healthspan and restoring the doctor-patient relationship. Healthspan means the years of your life spent healthy, mobile, and clear-headed, not just total years lived. We are fully transparent about who we are, what we believe, and how we operate.

This page is the front door to the rest of the practice. From here you can learn about Dr. Ash, our clinical framework, our services and pricing, and our practice policies. Each link below opens a focused page with more detail.

Leadership & Vision

  • Meet Dr. Ash Learn about Ashvin Vijayakumar MD's background, credentials, and vision for neighborhood-based precision medicine.

  • GER·O·SPAN Understand our clinical framework for optimizing healthspan and performance.

  • Home Visits
    Learn about our doorside care across Greater Philadelphia, included with your membership.

Services & Pricing

  • The Membership Detailed breakdown of our annual membership plans and what they include.

  • Care Packages One-time strategic audits and consults for non-members.

Practice Policies & Legal

We believe in transparency in all aspects of our practice, including our business model and data handling.

  • Disclosures Important information about our practice model, limitations, and financial relationships.

  • Privacy Policy How we protect your data and personal health information.

  • Terms of Service The rules governing the use of our website and services.

Practice Guides & Insights

  • Concierge vs. Direct Primary Care Understanding the difference and why we chose the DPC model.

  • HSA/FSA Guide for DPC How to use your health savings account for your membership.

  • The Future of Medicine 3.0 How we are evolving healthcare for the next generation.

  • Affirming Care Standards Our guiding principles for LGBTQ+ clinical excellence and support.

Scientific References

  1. Eskew PM, Klink K. "Direct Primary Care: Practice Distribution and Cost Across the Nation." Journal of the American Board of Family Medicine. 2015.
  2. Phillips RL, et al. "The Effects of Training Institution Practice Costs, Quality, and Other Characteristics on Future Practice." Annals of Family Medicine. 2017.
  3. Attia P. "Outlive: The Science and Art of Longevity." Harmony Books. 2023.
Medical Disclaimer: This resource provides clinical context for educational purposes. In the world of Precision Medicine, there is no "one size fits all"; the right plan must be matched to your unique lab work, physiology, and goals. Consult Dr. Ash to determine if this approach is right for you, particularly if you have chronic health conditions or are taking prescription medications.

Frequently Asked Questions

Common Questions

Fishtown Medicine is a modern internal medicine practice in Philadelphia focused on results, prevention, and a real doctor-patient relationship. Dr. Ash works closely with each patient on healthspan, metabolic health, hormones, cardiovascular risk, and the everyday concerns most doctors don't have time to investigate. The relationship is the product; everything else is in service of it.
Fishtown Medicine is a mobile-first practice based in the Fishtown neighborhood of Philadelphia, Pennsylvania. We do not run a traditional office. Care happens through doorstep home visits across the Greater Philadelphia area and through secure messaging, phone, and video visits for members who travel or live in any of our 42 licensed states.
Dr. Ash is Ashvin Vijayakumar MD, a board-certified internal medicine physician focused on prevention, healthspan, and getting real results for the patient in front of him. Internal medicine covers adult primary care, chronic disease management, and complex problem-solving, but Dr. Ash works one layer further upstream: catching early signals, designing a proactive plan around your baselines, and partnering with you over time to keep the small things from becoming serious problems.
Fishtown Medicine does not bill insurance for membership care, and that is the whole point. The Direct Primary Care model means a flat monthly fee paid directly to the practice, which is what makes 60 to 90 minute visits, same-day messaging, and a real relationship possible (instead of the 7 to 12 minute, prior-auth-driven appointments insurance billing forces). For everything outside the membership, Fishtown Medicine puts your insurance to work: labs run through Quest or LabCorp on your plan, imaging at hospital-grade facilities on your plan, specialist referrals coordinated through your network, and prescriptions filled at your in-network pharmacy. Most members keep a high-deductible insurance plan for hospital and specialist coverage and pay the membership separately, which together costs less than a traditional plan with copays for many patients. The result: more time, better diagnostics, and care that is actually proactive.
GER·O·SPAN is the Fishtown Medicine clinical framework for healthspan, captured by the mnemonic GER·O·SPAN. On one side sit three Fundamentals you control day to day: Sleep, Physical Activity, and Nutrition (the SPAN). On the other side sit three Modulators that shape how those Fundamentals land on you: Genetics, Environment, and Relationships (the GER). In the middle sits Our work as your physician (the O of GERO): turning your data into a coherent picture and the right next action. The full framework lives on the GER·O·SPAN page.
Yes. Fishtown Medicine offers virtual visits for members across 42 licensed states. Video and secure messaging cover routine care, follow-ups, and quick clinical questions; doorstep home visits across Greater Philadelphia handle anything that benefits from in-person evaluation. There is no traditional office.
Concierge medicine usually keeps insurance billing and adds an extra annual fee, often for access alone. Direct Primary Care (DPC) is a flat monthly fee that replaces insurance billing for primary care entirely. Fishtown Medicine chose DPC because it is more transparent, removes the 15-minute appointment pressure, and centers the relationship on actual results, not just access.
Yes. As of the 2025 federal ruling, HSA and FSA dollars can be used to pay for Direct Primary Care memberships. Fishtown Medicine has a dedicated HSA/FSA Guide for DPC that walks through the current rules and what to tell your plan administrator.

Ready when you are

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FishtownFish wrapped around the rod of AsclepiusMedicine
Philadelphia Primary Care
2418 E York St, Philadelphia, PA 19125Primary care in PhiladelphiaHome visits in Greater PhiladelphiaPricing & MembershipGER·O·SPAN: our clinical frameworkDigital Health Literacy

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