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Executive Physicals: Strategy vs. Checkboxes
Fishtown Medicine•5 min read
4.96 (124)

Executive Physicals: Strategy vs. Checkboxes

Ashvin Vijayakumar MD

Medically Reviewed

Ashvin Vijayakumar MD•Updated February 6, 2026
On This Page
  • The bottom line, up front
  • What is the "binder problem" with executive physicals?
  • How does the Fishtown Medicine model work?
  • Comparison: hospital executive physical vs. Fishtown Medicine
  • "What if my company already pays for the Penn physical?"
  • Common Questions
  • Do you offer a one-day executive physical at Fishtown Medicine?
  • Is the Metabolic Audit covered by insurance?
  • Can I use HSA or FSA funds for an executive physical?
  • Why is a hospital executive physical $3,000 to $5,000?
  • What labs are usually included in an executive physical?
  • How often should an executive get a physical?
  • Are executive physicals worth it for people under 40?
  • What is the difference between a stress test and a CTA Coronary?
  • Deep Questions
  • How do I get the most out of a Penn or Jefferson executive physical?
  • What if my hospital physical found something abnormal?
  • Can a Center City executive realistically use a Fishtown-based doctor?
  • What about home visits for busy executives?
  • How does an executive physical compare to a "Function Health" lab subscription?
  • What advanced cardiac tests should I ask about?
  • How is metabolic health measured beyond HbA1c?
  • Can my partner or spouse also join the practice?
  • What if I travel often for work?
  • How does Philadelphia weather affect executive health?
  • How long does it take to see results from a Fishtown plan?
  • Will my regular cardiologist or endocrinologist still be involved?
  • What is a "Metabolic Audit" exactly?
  • Scientific References
  • Related at Fishtown Medicine

Get a preventive doctor that knows you.

Consult Dr. Ash
TL;DR30-second take

An executive physical in Philadelphia is a one-day, $3,000 to $5,000 head-to-toe screening at a hospital like Penn or Jefferson. It is good at collecting data, but most patients leave with a binder and no real plan. A membership-based primary care doctor can take that data and turn it into a year-round strategy.

The bottom line, up front

Hospital-based executive physicals, like the ones at Penn or Jefferson, are excellent at data collection. They are not as strong on follow-through. They charge between $3,000 and $5,000 for a single day of testing. They hand you a binder of results, and then you are usually on your own.

At Fishtown Medicine, we believe execution beats information. We do not sell a "day." We sell a relationship.

What is the "binder problem" with executive physicals?

The traditional executive physical is built around corporate contracts, not patients.

  • The workflow: Arrive at 7 AM. Cycle through standard specialists (cardiology, dermatology, eye exam). Eat a fancy lunch. Leave at 3 PM.
  • The result: A 50-page binder of data.
  • The gap: If your cholesterol is high, the report says, "Follow up with your primary care doctor."

Most busy executives never follow up. The binder sits on a shelf. The risk stays the same.

How does the Fishtown Medicine model work?

We replace the one-day event with a year-round strategy. Instead of charging $5,000 for a single day, we charge a monthly membership to be your health quarterback.

Comparison: hospital executive physical vs. Fishtown Medicine

FeatureHospital Executive PhysicalFishtown Medicine (Membership)
Cost$3,000 to $5,000, one-timeMonthly or annual membership
ModelTransactional, see you next yearRelational, text or call any time
Action"Here is your problem.""Here is your plan."
Follow-upNone, you are referred outWe treat it. We prescribe, manage, and re-test.
CardiacStress test (older method)CTA Coronary plus ApoB (advanced)
MetabolicHbA1c (a lagging average of blood sugar)Fasting insulin plus continuous glucose monitor (real-time)

"What if my company already pays for the Penn physical?"

Fishtown Medicine

A 90-minute conversation with Dr. Ash. A written plan you can actually follow.

Start your intake

Take it. If your employer covers a $5,000 exam at Penn or Jefferson, use it. It is free data.

Just do not rely on it for your care. Bring that binder to us, and we will:

  1. Read every line: We review the entire report, not just the summary.
  2. Filter the noise: We tell you what truly matters and what is just a defensive finding.
  3. Build the plan: We prescribe the medications, set the lifestyle changes, and track your progress.

Use the hospital for the hardware (scans). Use us for the software (strategy).

Scientific References

  1. Sniderman AD, et al. Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review. JAMA Cardiology. 2019. Evidence supporting ApoB as a sharper cardiovascular risk marker than LDL alone.
  2. SCOT-HEART Investigators. Coronary CT Angiography and 5-Year Risk of Myocardial Infarction. New England Journal of Medicine. 2018. Long-term outcomes data on CTA-guided coronary care.
  3. Mozaffarian D, et al. Health Effects of Trans-Fatty Acids: Experimental and Observational Evidence. European Journal of Clinical Nutrition. 2009. Background on cardiometabolic risk modification.
  4. American College of Physicians. High Value Care for Adults: Avoiding Unnecessary Annual Exams. Annals of Internal Medicine. 2015. Critique of low-yield annual exams and call for personalized risk-based care.

Related at Fishtown Medicine

  • Executive Physical - the service page for executive physicals at Fishtown Medicine
  • Preventive Care - the broader preventive medicine framework
  • Longevity Medicine - Medicine 3.0 applied to executive health
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.
Ashvin Vijayakumar MD (Dr. Ash)

Fishtown Medicine | Articles

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

Frequently Asked Questions

Common Questions

We do not offer a one-day executive physical, because we do not believe you can fix your health in one day. Instead, we offer a Metabolic Audit (around $499) for deep diagnostics and pair it with an ongoing membership for follow-through.
The Metabolic Audit is not covered by insurance. It is much cheaper than a hospital executive physical, and we use the time to explain why each number matters, not just hand over a value.
Yes, you can use HSA or FSA funds for an executive physical or a Metabolic Audit. All of our services count as qualified medical expenses, so they are usually eligible.
A hospital executive physical is $3,000 to $5,000 because it bundles many specialists, advanced imaging, and a same-day report. The price reflects the labor and the corporate contracts these programs are built around, not necessarily the long-term value to you.
A typical executive physical includes a complete blood count, a basic metabolic panel, a standard lipid panel, HbA1c, thyroid screening, and sometimes ApoB or coronary calcium scoring. The exact list depends on the program, so always ask for the full menu in writing.
Most executives benefit from a deep diagnostic visit once a year, plus a shorter check-in mid-year. With a membership-based practice, that ongoing rhythm is built in, so you do not have to schedule a separate annual event.
Executive physicals can be worth it for people under 40 if they include advanced lipids, metabolic markers, and fitness testing. A standard hospital exam is often overkill for a healthy 35-year-old, while a focused Metabolic Audit is usually a better fit.
A stress test looks for blockages by stressing the heart, usually on a treadmill, while a CTA Coronary uses a CT scan to image the coronary arteries directly. A CTA is more sensitive for early plaque, which is why we lean on it for proactive risk assessment.

Deep-Dive Questions

Bring all prior records, ask for the raw data and not just the summary, and request advanced markers like ApoB, Lp(a), and fasting insulin. After the visit, share the full binder with a primary care doctor who has time to actually read it.
If your hospital physical flagged an abnormal result, the next step is to bring the full report to a primary care doctor who can prioritize, repeat, and treat. Many "abnormal" findings are minor, but a few need fast follow-up. The right doctor will sort that with you.
Yes, a Center City executive can realistically use a Fishtown-based doctor. Fishtown is a short trip on the Market-Frankford Line or by rideshare, and most visits can also happen by video. Lab work runs through Quest or LabCorp, which have multiple Center City locations.
Home visits are part of the Fishtown Medicine model when an in-person exam makes sense. We can come to your office or home for an exam, blood draw, or focused consultation, which often saves more time than a hospital visit.
An executive physical includes a physical exam, imaging, and clinician interpretation, while a Function Health subscription is mostly self-ordered labs through a dashboard. Both produce data. Only the physical adds a doctor who can interpret and treat.
Ask about ApoB, Lp(a), a Coronary Artery Calcium (CAC) score, and, if appropriate, a CTA Coronary. These give a much sharper picture of heart risk than a standard cholesterol panel and a stress test alone.
Metabolic health is best measured with fasting insulin, fasting glucose, triglycerides, HDL, and waist-to-height ratio. A 2-week continuous glucose monitor adds real-time data on how your body responds to specific meals and stress.
Yes, partners and spouses can join the practice. Many of our members enroll as a couple or family, which keeps health planning aligned across the household and makes coordination simpler when one person needs more attention.
If you travel often for work, a relationship-based practice is usually a better fit than a hospital event. We are licensed across many states for virtual visits, and we can coordinate labs near wherever you are working that month.
Philadelphia winters are long and dim, which drives vitamin D deficiency and lower step counts. A good annual plan adjusts for that with seasonal vitamin D testing, indoor strength training, and structured outdoor cardio in shoulder seasons.
Most members see early lab changes within 8 to 12 weeks of starting a plan, particularly in cholesterol, blood sugar, and inflammation markers. Larger changes in body composition, fitness, and long-term risk take 6 to 12 months of steady work.
Yes, your existing cardiologist or endocrinologist can still be involved. We coordinate notes, labs, and imaging with your specialists so the plan stays consistent. Many of our members keep long-term specialist relationships and use us to quarterback the bigger picture.
A Metabolic Audit at Fishtown Medicine is a focused deep dive into your metabolic, cardiovascular, and hormonal health. It includes advanced labs, a longer visit, and a written plan. It is designed to give you the strategic value of an executive physical without the inflated price tag.

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