Can Dr. Ash come see me in the hospital?

Dr. Ash does not round on hospital floors, since hospital care is delivered by inpatient hospitalists who are physically present 24/7. What he does do is coordinate with your hospital team, review your records, and stay in close contact with you and your family throughout the stay.

Should I call you instead of 911 in an emergency?

You should call 911 first for any life-threatening emergency, then text us. We are your continuity quarterback, not your emergency responder. Once you are stable or en route, we step in to coordinate.

Which Philly hospitals do you work with?

We work with all major Philly hospital systems, including the University of Pennsylvania (HUP, Pennsylvania Hospital, Presbyterian), Jefferson Health, Temple Health, Einstein, and Mainline Health. We hold record-access privileges at the major systems so we can see labs and imaging quickly.

What happens to my appointments while I am admitted?

Your appointments are paused or rescheduled by our team while you are admitted. We track your hospital course through the chart and reach out to your specialists as needed. You do not have to handle anything administrative.

Will my insurance still cover the hospital stay?

Your insurance covers the hospital stay according to your plan, since hospital care is billed through traditional insurance. Our membership covers the coordination, communication, and post-discharge follow-up that insurance does not pay for.

What if my family has questions while I am admitted?

Your family can message or call us with questions while you are admitted. With your permission, we keep a designated family contact updated and translate the medical plan into plain language.

How fast can you respond when I text you from the ER?

We typically respond within minutes during business hours and within an hour after hours for urgent issues. We have a coverage system so the messaging line is monitored.

Can you help me decide whether to go to the ER at all?

Yes, we can help you decide whether to go to the ER. For many concerns (mild chest pain, abdominal pain, fever, falls), a quick text or video call clarifies whether the ER is the right place or whether we can manage it directly.

How does record access actually work between Fishtown Medicine and the hospital?

Record access works through a mix of hospital-grade EHR portals (like Epic Care Everywhere), HIPAA-compliant fax for older systems, and direct doctor-to-doctor communication. With your consent, we can pull lab values, imaging reports, and discharge summaries usually within hours.

What is a "clinical brief" and what goes into it?

A clinical brief is a one-page snapshot designed for an ER team. It includes your active diagnoses, medications, allergies, baseline labs (such as creatinine and ApoB), pertinent surgical history, and any advance care preferences. It cuts triage time and reduces medication errors.

How do you reduce 30-day readmission risk after discharge?

We reduce 30-day readmission risk by closing the typical gaps. Within 48 hours, we reconcile medications, confirm follow-up appointments, check vitals, and watch for early warning signs. We also stay accessible for any new symptom that emerges, which avoids a panic ER return for something we can manage.

Can you coordinate care with my specialist while I am hospitalized?

Yes, we can coordinate care with your specialists while you are hospitalized. If you have an existing oncologist, cardiologist, or GI specialist, Dr. Ash will call them, share key notes, and align the post-discharge plan with their recommendations.

What if I am admitted to a hospital outside Philadelphia?

If you are admitted outside Philadelphia, we still coordinate. We can request records, speak with the local hospitalist, and arrange a transition home or to a Philly facility if appropriate. Our license and reach extend across many states.

How do you handle ICU admissions or critical illness?

For ICU admissions, our role expands. Dr. Ash brings prior ICU experience to translate the language of vasopressors, ventilator settings, and goals of care for your family. We help anchor decisions in your values and your long-term plan, not just the moment-to-moment data.

What do you do if a hospital wants to discharge me too quickly?

If a hospital wants to discharge too quickly, we advocate. We can speak directly with the hospitalist or case manager, request additional evaluation if clinically warranted, or arrange enhanced post-discharge support (home nursing, IV services, follow-up visits) so an early discharge does not become a setback.

How do you prevent medication errors during transitions of care?

We prevent medication errors by manually reconciling each prescription before and after admission. We check for duplications, dose changes, and dangerous interactions. Where possible, we use a single pharmacy and update your medication list in Ultralight so you have a clean reference.

What happens if a procedure or surgery is recommended during admission?

If a procedure or surgery is recommended, we help you understand the data and your options. We can request additional information, get a second opinion through a "specialist curbside," or align the recommendation with your goals. We do not replace your surgical team, but we make sure you understand the trade-offs.

How do you support recovery and rehabilitation after discharge?

We support recovery by tracking labs, vitals, sleep, and activity through wearables and follow-up visits. We coordinate physical therapy, home nursing, IV antibiotics, or specialist follow-up where needed. We re-anchor your longevity plan once acute recovery is complete.

Can you help with end-of-life or palliative care decisions?

Yes, we can help with palliative and end-of-life decisions. We help patients and families clarify goals of care, complete advance directives, and coordinate hospice or palliative services when appropriate. These conversations are part of being your physician for the long term.

How do you handle billing and insurance issues from the hospital?

We help interpret billing and insurance issues and can write letters of medical necessity, dispute coding errors, or identify in-network alternatives. We do not negotiate with insurance for you, but we equip you with the clinical information needed to do so successfully.

TL;DR · 30-second take

If you go to the ER or are admitted to a Philadelphia hospital, Fishtown Medicine acts as your digital quarterback. We send your clinical brief to the ER team, coordinate with the hospitalists, and follow up within 48 hours of discharge to prevent medication errors and readmissions.

Hospitalization Support: What Happens If I Go to the ER?

TL;DR: Going to the ER is scary. Navigating the hospital system alone is even scarier. As a Fishtown Medicine member, you do not have to. While we do not treat patients inside the hospital (that is done by hospitalists), we act as your digital quarterback from admission to discharge.

What should I do the moment I head to the ER?
How do you support me during admission?
Why is discharge the most dangerous moment?
Actionable Steps in Philly
Common Questions
Deep Questions

What should I do the moment I head to the ER?

The moment you head to the ER (and it is safe to do so), text Dr. Ash.

We send a clinical brief to the triage team so they know your medications, allergies, and key history before you see the ER physician.
Sharing the brief early prevents medical errors and speeds up your care.
If a family member or partner is bringing you in, they can also text us. We will coordinate either way.

How do you support me during admission?

We support you during admission by playing the quarterback role between the hospital team and you. Hospitals have shift changes every 12 hours. It is easy for details to get lost between handoffs.

Doctor-to-Doctor Calls: Dr. Ash can speak directly with your attending hospitalist to clarify your complex history and ensure key context is not missed.
Translation: Hospital jargon is confusing. We explain what the doctors are actually saying and help you understand the options.
Family Updates: We can update a designated family member or partner if you prefer not to repeat the same story to everyone.

Why is discharge the most dangerous moment?

Discharge is the most dangerous moment because roughly one in five patients are readmitted within 30 days due to confusion, missed follow-up, or medication errors.

Medication Reconciliation: We verify that the medications you go home with do not conflict with what you were taking before admission.
Follow-Up: We typically schedule a video or home visit within 48 hours of discharge to check vitals and ensure you are recovering safely.
Specialist Coordination: If discharge instructions include a cardiology, GI, or surgical follow-up, we book it and prep you for the visit.

Note: We can access records from major Philadelphia health systems (Penn, Jefferson, Temple) so we can see your hospital labs and imaging in real time.

Actionable Steps in Philly

A simple plan for the moment things go sideways.

Save Dr. Ash's Number: Save the practice number on your phone and your partner's phone. Add it to your iPhone Medical ID.
Carry a Med List: Keep an updated list of medications, allergies, and emergency contacts in your wallet or phone.
Pick a Hospital Plan: For routine ER visits in Philly, our preferred systems are Penn, Jefferson, and Temple. Pick the closest emergency department.
Text First, Then Travel: Text us as you head to the ER unless you need to call 911 first. We can often have a brief in their hands before you arrive.
Schedule a Discharge Visit: After admission, book a 48-hour post-discharge visit through Ultralight before you leave the hospital.

Scientific References

Jencks SF, et al. Rehospitalizations among Patients in the Medicare Fee-for-Service Program. N Engl J Med. 2009;360(14):1418-1428.
Forster AJ, et al. The Incidence and Severity of Adverse Events Affecting Patients After Discharge From the Hospital. Ann Intern Med. 2003;138(3):161-167.
Coleman EA, et al. The Care Transitions Intervention: Results of a Randomized Controlled Trial. Arch Intern Med. 2006;166(17):1822-1828.

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 hospital coordination plan must be matched to your unique health needs and goals. Consult Dr. Ash to determine if this approach is right for you, especially if you have chronic health conditions or recent hospitalizations.

Dr. Ash is a board-certified internal medicine physician specializing in preventive medicine and healthspan optimization at Fishtown Medicine in Philadelphia.

Fishtown Medicine | About

2418 E York St, Philadelphia, PA 19125(267) 360-7927 hello@fishtownmedicine.comHSA/FSA Eligible

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