How do visits work in Society Hill?

We get to know you well, and most care happens by message, phone, or video for maximum responsiveness and convenience. When an in-person evaluation is clinically necessary, we come to you for a home visit in 19106 rather than asking you to come to a clinic.

Do you take urgent cases?

We are not an emergency room. For urgent issues like UTIs, sinus infections, rashes, or a flare of an existing condition, we usually evaluate you within hours by text, video, or a same day home visit. That spares you the wait times and impersonal feel of a traditional Urgent Care.

Is there an age limit?

We treat adults 18 and older. Whether you are a young professional in a Society Hill condo or a long-time resident in a historic Federal-style rowhome, our systems based approach adapts to your stage of life. We have a particular focus on healthy aging and complex care for adults in their 60s, 70s, and 80s.

Do you handle Medicare patients in 19106?

Many of our older Society Hill members are on Medicare. The membership runs alongside Medicare. Medicare still covers your hospital, specialist, imaging, and lab costs, while the membership covers your day-to-day primary care, messaging, video visits, and home visits. Some patients use the membership as a bridge to coordinate with their existing Medicare Advantage or Medigap plan.

How private is the practice?

Very. We do not have a waiting room where you might run into a neighbor. Communications happen by secure messaging or video. Records are kept on a HIPAA compliant platform, and we do not share anything outside the care team without your explicit consent.

Can you accommodate frequent travelers?

Yes. We are licensed to provide care across many states, and our virtual model travels with you. Whether you are at a second home in Florida, sailing in Newport, or visiting family in California, you can reach Dr. Ash directly.

Do you do home blood draws and EKGs?

Yes. Phlebotomy and basic EKG can be done at the home visit. For more complex imaging like MRI, CT, or echocardiogram, we coordinate with Pennsylvania Hospital, Jefferson, or Penn and walk you through the process.

What about end of life and advanced care planning?

We treat advanced care planning as a normal part of medicine, not an emergency conversation in an ICU. We help you put together a healthcare proxy, HIPAA release, durable power of attorney, and a living will, and we make sure those documents are accessible to the right people at the right time.

How do you support adult children of Society Hill residents managing aging parents?

We integrate adult children into the care plan with patient consent. That includes secure access to records, joint video visits when complex decisions arise, and a clear line of communication for when something changes. Many of our Society Hill members have adult children in NYC, Boston, or California. We act as the local quarterback, so the family does not have to fly in for every appointment.

How do you screen for cancer in older adults?

We screen based on personalized risk, not blanket guidelines. That means continuing colon cancer screening past 75 if life expectancy supports it, considering low dose CT for current or former smokers, and discussing the value of expanded screens like Galleri or full body MRI on a case by case basis. We do not push tests that will not change the plan.

Do you handle minor procedures at home?

Yes. Suturing of small lacerations, wart freezing, joint injections in select cases, ear lavage, and skin biopsies can be done at home with appropriate setup. Anything more complex gets coordinated through a specialist with whom we have a working relationship.

How does the practice handle anxiety and depression in older adults in 19106?

We treat anxiety and depression with the same seriousness as cardiovascular disease. We use validated tools, we prescribe medication when appropriate, and we refer to therapists with whom we have a long working relationship. We also screen for the medical drivers of mood change in older adults: thyroid dysfunction, B12 deficiency, sleep apnea, polypharmacy, and chronic pain.

What is the Warm Invitation Call and what should I expect?

It is a 20 minute video conversation, free, with no commitment. You tell us what is happening with your health, what you have tried, and what you are looking for. We tell you whether the model is a good fit, what we would do differently, and what realistic expectations should be. If we are not the right fit, we will tell you and often help you find a better option.

How do you handle communication when I am traveling internationally?

Our messaging platform works wherever you have internet. For international travel, we provide a brief medical summary letter, recommend a travel kit (medications, supplies, and instructions for common scenarios), and remain available by message for urgent questions. For specific country issues we coordinate with International SOS or a local physician when appropriate.

How do visits work in Society Hill?

We get to know you well, and most care happens by message, phone, or video for maximum responsiveness and convenience. When an in-person evaluation is clinically necessary, we come to you for a home visit in 19106 rather than asking you to come to a clinic.

Do you take urgent cases?

We are not an emergency room. For urgent issues like UTIs, sinus infections, rashes, or a flare of an existing condition, we usually evaluate you within hours by text, video, or a same day home visit. That spares you the wait times and impersonal feel of a traditional Urgent Care.

Is there an age limit?

We treat adults 18 and older. Whether you are a young professional in a Society Hill condo or a long-time resident in a historic Federal-style rowhome, our systems based approach adapts to your stage of life. We have a particular focus on healthy aging and complex care for adults in their 60s, 70s, and 80s.

Do you handle Medicare patients in 19106?

Many of our older Society Hill members are on Medicare. The membership runs alongside Medicare. Medicare still covers your hospital, specialist, imaging, and lab costs, while the membership covers your day-to-day primary care, messaging, video visits, and home visits. Some patients use the membership as a bridge to coordinate with their existing Medicare Advantage or Medigap plan.

How private is the practice?

Very. We do not have a waiting room where you might run into a neighbor. Communications happen by secure messaging or video. Records are kept on a HIPAA compliant platform, and we do not share anything outside the care team without your explicit consent.

Can you accommodate frequent travelers?

Yes. We are licensed to provide care across many states, and our virtual model travels with you. Whether you are at a second home in Florida, sailing in Newport, or visiting family in California, you can reach Dr. Ash directly.

Do you do home blood draws and EKGs?

Yes. Phlebotomy and basic EKG can be done at the home visit. For more complex imaging like MRI, CT, or echocardiogram, we coordinate with Pennsylvania Hospital, Jefferson, or Penn and walk you through the process.

What about end of life and advanced care planning?

We treat advanced care planning as a normal part of medicine, not an emergency conversation in an ICU. We help you put together a healthcare proxy, HIPAA release, durable power of attorney, and a living will, and we make sure those documents are accessible to the right people at the right time.

How do you support adult children of Society Hill residents managing aging parents?

We integrate adult children into the care plan with patient consent. That includes secure access to records, joint video visits when complex decisions arise, and a clear line of communication for when something changes. Many of our Society Hill members have adult children in NYC, Boston, or California. We act as the local quarterback, so the family does not have to fly in for every appointment.

How do you screen for cancer in older adults?

We screen based on personalized risk, not blanket guidelines. That means continuing colon cancer screening past 75 if life expectancy supports it, considering low dose CT for current or former smokers, and discussing the value of expanded screens like Galleri or full body MRI on a case by case basis. We do not push tests that will not change the plan.

Do you handle minor procedures at home?

Yes. Suturing of small lacerations, wart freezing, joint injections in select cases, ear lavage, and skin biopsies can be done at home with appropriate setup. Anything more complex gets coordinated through a specialist with whom we have a working relationship.

How does the practice handle anxiety and depression in older adults in 19106?

We treat anxiety and depression with the same seriousness as cardiovascular disease. We use validated tools, we prescribe medication when appropriate, and we refer to therapists with whom we have a long working relationship. We also screen for the medical drivers of mood change in older adults: thyroid dysfunction, B12 deficiency, sleep apnea, polypharmacy, and chronic pain.

What is the Warm Invitation Call and what should I expect?

It is a 20 minute video conversation, free, with no commitment. You tell us what is happening with your health, what you have tried, and what you are looking for. We tell you whether the model is a good fit, what we would do differently, and what realistic expectations should be. If we are not the right fit, we will tell you and often help you find a better option.

How do you handle communication when I am traveling internationally?

Our messaging platform works wherever you have internet. For international travel, we provide a brief medical summary letter, recommend a travel kit (medications, supplies, and instructions for common scenarios), and remain available by message for urgent questions. For specific country issues we coordinate with International SOS or a local physician when appropriate.

Concierge Medicine Society Hill | 19106

Name: Fishtown Medicine
Address: 2418 E York St, Philadelphia, PA, 19125, US
Telephone: (267) 360-7927
Price range: $195 - $2,500

TL;DR30-second take

Society Hill (19106) residents get private, longevity focused primary care from Fishtown Medicine. Skip crowded waiting rooms, see Dr. Ash by video from your home, and coordinate with Pennsylvania Hospital and Jefferson when needed. Focus areas include cognitive screening, ApoB, and metabolic resilience for long term healthspan.

Walking through Society Hill, almost everything is preserved, quiet, and intentional. The brick rowhomes off Spruce, the gardens behind Locust, the mornings at Headhouse Square. Residents here protect what they have, in their homes, in their work, and in their relationships. The same instinct should apply to your health.

Standard 12 minute medicine often feels jarring in this neighborhood. You want a relationship with a physician who knows your history, your goals, and your trade offs over decades. That is what we built at Fishtown Medicine.

Clinical care for Society Hill residents

Whether you're in Society Hill or nearby, these are the areas we help with most:

Longevity & Medicine 3.0 - healthspan optimization and advanced diagnostics
Metabolic health & weight - insulin resistance, blood sugar, and GLP-1 medications
Hormone optimization - testosterone, thyroid, perimenopause and menopause
Cardiovascular risk - apoB, Lp(a), and early prevention
Performance & recovery - VO2 max, muscle, and sleep
Our supplement guide - professional-grade picks from Dr. Ash

Book a free intro call to talk through your health goals as a Society Hill patient.

Old City - the historic core, a short ride from Fishtown
Queen Village - south of South Street, between river and Italian Market
Bella Vista - the Italian Market neighborhood
Southwark - the riverfront south-of-Pine neighborhood

Fishtown Medicine | Neighborhoods

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

What anchors your week in Society Hill?

Society Hill runs on a slower, more deliberate rhythm. Most of our 19106 members have lived in the neighborhood for 20 or 30 years, often longer, and care should respect that pace.

The Washington Square morning. The Pine Street gardens. The dog walk from a Spruce or Locust rowhome down to the Square and back. A standing coffee at Talula's Garden or one of the cafes on Pine. A lot of our Society Hill members are 60 and older, and the rhythm of the morning loop is also the rhythm of the slower, more thorough primary care relationship we offer.

The Pennsylvania Hospital and specialist coordination work. Most members are anchored to Penn Hospital at 8th and Spruce, with cardiology, nephrology, ophthalmology, or oncology relationships established over years. The hardest part is not finding the specialist; its synthesizing what they tell you. We read every note. We make sure the medications dont fight each other. We give you the tie-breaker opinion when two specialists land in different places.

The home visit rhythm. A meaningful share of our Society Hill members prefer not to leave the rowhome for a routine check-in. Maybe its the steps, maybe its the schedule, maybe its the simple fact that the cardiologist visit already used the day's energy. We come to you. We bring the equipment for a real exam. We sit at the kitchen table or the study and we work through the chart together.

The Society Hill pattern is preservation, in the same way the neighborhood preserves its buildings. We are here to preserve the function you have built over a lifetime, for another two or three decades.

Why does Society Hill choose private primary care?

In our practice, the most common reason patients in 19106 join is simple: privacy and continuity. Many residents are public figures, attorneys, founders, judges, retired executives, or older adults who have seen good and bad medicine over a lifetime. They want a doctor who reads the chart, remembers the conversation, and answers the phone.

We do not run a busy waiting room. Most consults happen by video from your study or by message during the day. When a hands on exam is needed, we come to you.

What does longevity medicine actually look like in Society Hill?

Preservation is the ethos of the neighborhood. We apply that to biology. The goal is healthspan: keeping your cognitive and physical function strong for the next two or three decades, not just adding years to a chart.

That means a different set of metrics than a standard physical:

Cardiovascular: ApoB, Lp(a), hs-CRP, and a CT calcium score when appropriate. We treat plaque biology, not just cholesterol numbers.
Cognitive: Baseline cognitive testing in your 50s and 60s so we can spot early change rather than discover it after a hospitalization.
Metabolic: Fasting insulin, continuous glucose monitoring, and DEXA for body composition. Muscle mass is the single best predictor of how the next 20 years go.
Hormonal: Full thyroid, sex hormone, and adrenal panels, with bio-identical hormone therapy when indicated.

How do you coordinate with Pennsylvania Hospital, Jefferson, and Penn?

Most Society Hill residents are anchored to Pennsylvania Hospital at 8th and Spruce, Jefferson Health a few blocks north, or Penn Medicine further west. We work alongside your existing specialists rather than replacing them.

Our role is the synthesis:

We review every specialist note and translate it into a coherent plan.
We manage day to day medications and prevent the all too common drug interaction problem in patients on five or more meds.
We handle prior authorizations, imaging scheduling, and records transfers so you do not have to.
We give you a tie breaker opinion when two specialists disagree.

What about home visits in 19106?

Many of the historic rowhomes in Society Hill have steep stoops, narrow stairs, and no elevators. That makes mobility a real factor as residents age. Home visits are part of the membership and are often the most comfortable way to get an exam, draw blood, or have a longer conversation about a complex situation.

We schedule home visits at your convenience. The doctor comes to you, not the other way around.

Actionable Steps for Society Hill Residents

Request your records from every specialist you have seen in the past five years. We help you consolidate them into one usable file.
Establish a cognitive baseline. A 30 minute MoCA or similar assessment in your 50s or 60s is the cheapest and most useful longevity test you can do.
Run an Advanced Lipid Panel. Standard cholesterol panels miss particle count and Lp(a). We re-test ApoB and Lp(a) at least once.
Schedule a Warm Invitation Call. A 20 minute video conversation, free, to see if our model fits.

Scientific References

Sniderman, A. D., et al. (2019). Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review. JAMA Cardiology, 4(12), 1287-1295.
Nasreddine, Z. S., et al. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695-699.
Manson, J. E., et al. (2017). Menopausal hormone therapy and long term all cause and cause specific mortality: The Women's Health Initiative randomized trials. JAMA, 318(10), 927-938.

Meet Your Physician

Ashvin Vijayakumar MD (Dr. Ash) is a Board-Certified Internal Medicine physician. He respects the community roots of Society Hill and provides medical care that honors that legacy.

Frequently Asked Questions

Common Questions

Deep-Dive Questions

We start with a baseline MoCA (Montreal Cognitive Assessment) and a structured history that includes sleep, hearing, vision, mood, and medication review. If there is concern, we add brief neuropsychiatric testing and consider an MRI or specialty referral. The goal is to catch reversible drivers like B12 deficiency, thyroid disease, sleep apnea, or polypharmacy before assuming dementia, and to track change over time so we know what is normal aging versus a pattern that needs attention.

Advanced lipidology looks past LDL cholesterol to ApoB (the actual particle count), Lp(a) (a genetic risk marker), and apolipoprotein ratios. At 65, you have had decades of arterial exposure already, so we focus on stabilizing plaque rather than only treating numbers. Statins, ezetimibe, and PCSK9 inhibitors are the standard tools, and they are far more effective when matched to particle data than to standard cholesterol alone.

We do a full medication reconciliation at every visit. We look at every prescription, supplement, and over the counter medication, including the inactive ingredients. We flag interactions, redundant therapies, and meds that are doing more harm than good. We then negotiate with specialists to simplify the regimen when possible. In our experience, the average Society Hill patient over 70 is on three to four medications they could safely stop.

For some patients, bio-identical hormone therapy (estradiol, progesterone, testosterone) extends the benefits of menopause/andropause management beyond standard age cutoffs. The decision is highly personalized: family history, cardiovascular and breast or prostate risk, symptom burden, and personal preference all matter. We use the lowest effective dose, monitor every six to twelve months, and stop or change course when the evidence says we should.

Ready when you are

Start your intake

Dr. Ash reads every intake himself, and answers questions personally - usually within a few hours.

TL;DR30-second take