New-patient primary care wait times at Penn Medicine and Jefferson Health often run 3 to 6 months, and annual physicals average 12 to 15 minutes because insurance-based doctors carry panels of 1,800 to 2,500 patients. You do not have to leave Penn or Jefferson to fix this. Most Fishtown Medicine members keep their existing PPO insurance for Penn and Jefferson specialists, imaging, and Quest or LabCorp blood draws while paying a flat $500 a month ($750 or $975 for one-time Clarity and Blueprint packages) for unhurried 60-to-90-minute primary care, home visits, and direct text access to Dr. Ash.
TL;DR: The Plain-Language Version
- The bottom line: You can keep your Penn Medicine and Jefferson Health specialists while stepping out of the 6-month wait for hospital primary care.
- Why hospital primary care takes so long: A typical Philadelphia primary care doctor cares for
1,800 to 2,500patients. Even great doctors only get12 to 15minutes with you before the next chart opens. - How the hybrid setup works: Your PPO or high-deductible plan pays for Quest or LabCorp bloodwork, scans, prescriptions, and specialist visits at Penn or Jefferson. Fishtown Medicine (
$500/monthmembership, or one-time$750 / $975packages) handles your 60-to-90-minute visits, direct texts with Dr. Ash, and preventive plan. - How records travel: Hospital charts connect across Philly through Epic. Dr. Ash sends a one-page summary ahead of your specialist visit and reviews their notes with you after.
- What to do Monday morning: Check your insurance card for the letters "PPO", pull your last MyChart lab PDF, and tell us what's going on if you want one doctor steering your whole plan.
Why Does It Take 6 Months to See a Primary Care Doctor at Penn or Jefferson?
Hospital primary care wait times in Philly stretch to 3 to 6 months because insurance billing forces each full-time doctor to carry roughly 2,000 patients.
Philadelphia has some of the best hospital care in the country. If you need heart surgery at Penn or spine care at Jefferson, you are in great hands.
Primary care inside a giant hospital system is a different story. Over the last five years, private offices like Ninth Street Internal Medicine closed or merged. Large groups like Advocare Stoll Medical Group absorbed thousands of Center City and South Philly patients at the same time.
When a hospital clinic bills insurance per visit, the math looks like this:
| Practice Metric | Penn / Jefferson Insurance Primary Care | Fishtown Medicine (Direct Primary Care) |
|---|---|---|
| Patients per doctor | 1,800 to 2,500 patients | Capped at 200 patients |
| New-patient wait time | 3 to 6 months (often with a rotating NP or PA) | Days to 2 weeks directly with Dr. Ash |
| Annual visit length | 12 to 15 minutes | 60 to 90 minutes |
| Between-visit access | MyChart portal message -> triage nurse -> 48-hour reply | Direct text or call to Dr. Ash's cell |
| Preventive lab targets | Standard lab cutoffs (LDL < 100, A1c < 5.7%, ferritin > 15) | Preventive targets (ApoB < 60-70 mg/dL, fasting insulin < 6-8 uIU/mL, ferritin 50-75 ng/mL) |
The doctors inside Penn and Jefferson are smart, caring people. They are trapped in a schedule that gives them 15 minutes to check your blood pressure, click 20 insurance boxes, and rush to the next room.
Do I Lose My Penn or Jefferson Specialists If I Join Direct Primary Care?
You keep every Penn, Jefferson, Main Line Health, or Temple specialist you already see, and your PPO insurance still pays for their visits, scans, and blood draws.
A common myth in Philly is that leaving a Penn or Jefferson primary care clinic locks you out of their specialists. It does not.
Specialists at Penn and Jefferson take referrals from any licensed doctor. Better yet, if you have a PPO plan (such as Independence Blue Cross Personal Choice, Aetna PPO, Cigna Open Access, or UnitedHealthcare Choice Plus), you do not need an insurance referral gatekeeper at all.
When you pair direct primary care in Philadelphia with your PPO plan, each side does what it was built to do:
- Your insurance pays for the heavy testing and hospital care: Quest and LabCorp blood draws, calcium scans, MRIs, colonoscopies, pharmacy prescriptions, and visits with Penn or Jefferson specialists.
- Dr. Ash handles the thinking, access, and follow-through: Unhurried 60-to-90-minute visits, home visits for members across Philly, direct text access, and a long-term strategic health roadmap across all five pillars of preventive health.
- Your records stay in sync: When Dr. Ash orders bloodwork at Quest or LabCorp or a scan at Penn or Jefferson, the results flow into your chart and your MyChart app. Before you see a specialist, Dr. Ash sends a short doctor-to-doctor note so you do not spend your 15-minute slot repeating your story.
How Does the Cost Compare to Hospital Executive Physicals and Concierge Retainers?
Pairing a PPO plan with Fishtown Medicine gives you year-round care for less than a one-day hospital executive physical, and without the double-billing of old-school concierge offices.
Philly patients who get tired of 6-month wait times usually compare three options:
- Hospital Executive Physicals (
$3,500 to $6,500for one day): Programs at Penn and Jefferson run a full day of tests. As we explain in our Philadelphia executive physical guide, the problem starts on day two. You walk out with a thick binder and nobody steering the plan for the next 364 days. - Traditional Concierge Retainers (
$2,500 to $5,000/yearplus insurance billing): Traditional concierge offices charge an annual fee just to stay on the roster. They still bill your insurance for every visit and collect copays along the way. We break down those fees in our Philadelphia concierge medicine cost guide. - Fishtown Medicine (
$500/monthmembership, or$750 / $975one-time packages): With our membership and diagnostic packages, there are zero copays and zero insurance bills for our time. If you want an ongoing personal doctor, the membership covers every visit, text, and home visit. If you already have a Penn or Jefferson PCP you like and just want a deep checkup or help reading a Function Health 100-biomarker panel, our$750Health Clarity Package or$975Health Blueprint Package builds the whole plan and hands it back to you.
Actionable Steps: Your Monday-Morning Decision Checklist
Use these four If -> Then triggers to set up your Philadelphia care team:
- If your MyChart app says the next physical is 4+ months out -> check your insurance card for "PPO" or "Open Access": With a PPO plan, your insurance still pays for Quest, LabCorp, Penn Radiology, and Jefferson specialists while you use an independent DPC doctor for primary care.
- If your hospital portal says your labs are "normal" -> compare them against preventive targets: Standard hospital ranges only flag late disease. Check your ApoB (we target
< 60 to 70 mg/dLvs. standard< 100), Lp(a) (we target< 75 nmol/L), fasting insulin (we target< 6 to 8 uIU/mLvs. standard< 25), and ferritin (we target50 to 75 ng/mLvs. standard> 15). - If you already love your Penn or Jefferson PCP but want a 90-minute preventive deep dive -> start with a one-time package: You do not have to switch primary care doctors to work with us. Book the
$750Health Clarity Package or$975Health Blueprint Package, get your full testing and written plan, and share the summary with your hospital PCP. - If you are tired of repeating your story to rotating providers -> tell Dr. Ash what's going on: Upload your last MyChart PDF, and we will read your chart before your first visit.
Fishtown Medicine
A 90-minute conversation with Dr. Ash. A written plan you can follow.
Frequently Asked Questions
Common Questions
Ready when you are
The chat is our AI assistant, answering from our published guides. To talk it through with Dr. Ash himself, start with the intake.
