A deeper kind of primary care
Prevention-focused, integrative care with longer visits, direct physician access, and a plan tailored to the full picture, for a simple monthly fee.
How direct primary care works
A simpler model: you pay a monthly fee directly, and in return you get a real relationship with your doctor.
Join with a monthly membership
One clear price. No copays, no surprise bills, no insurance hassles for your primary care.
Get direct access to your physician
Longer visits, same-week availability, and direct messaging with Dr. Ash for your routine primary care needs.
Use insurance for everything else
Keep your insurance for hospital care, imaging, specialists, and prescriptions. We help coordinate it all.
What you actually get
Not just easier access. More thoughtful, preventive care from a physician who knows your full story.
Same-week or next-day visits
No more waiting weeks for an appointment.
Direct messaging with your physician
Text or message Dr. Ash directly. No phone trees, no waiting on hold.
Longer, unhurried appointments
45 to 90 minute visits so your concerns are actually heard and addressed.
Prevention and longevity focus
Proactive screening, metabolic health, and root-cause thinking. Not just reacting when something breaks.
Clear, upfront pricing
One monthly fee. No copays, no surprise bills, no hidden costs from us.
Labs, specialists, and care coordination
We help coordinate labs, referrals, and specialist visits, and make your insurance work for you.
Simple, transparent pricing
One membership. Everything included. No surprise bills from us.
HealthSpan Partnership
$208/mo equivalent · billed annually
HSA/FSA eligible. 100% of your membership qualifies.
No initiation or cancellation fees. Cancel anytime.
Insurance still recommended for hospital, ER, specialist, and prescription coverage.
Partner/spouse discount: $195/month.
Meet Dr. Ash

Ashvin Vijayakumar MD (Dr. Ash)
Board-Certified Internal Medicine · Philadelphia, PA
Dr. Ash built Fishtown Medicine because he believed primary care should be more than rushed 10-minute visits and fragmented follow-ups. With a background in internal medicine and a focus on preventive and integrative health, he takes the time to understand each patient's full picture: metabolic health, cardiovascular risk, hormones, energy, and the signals that most doctors don't have time to investigate.
The direct primary care model lets him practice the way medicine should work: fewer patients, longer visits, and a genuine partnership focused on keeping you healthy, not just treating you when you're sick.
Is this a good fit for you?
This may be right for you if…
This may not be the best fit if…
Frequently asked questions
Ready to see if this is right for you?
Book a free 20-minute intro call with Dr. Ash. No obligation, no pressure. Just a conversation about your health goals and whether this model fits.
Book Your Free Intro CallHSA/FSA eligible · No initiation fees · Cancel anytime