Chestnut Hill is arguably the most beautiful neighborhood in Philadelphia. Germantown Avenue gives you a village feel with sophisticated stores and restaurants. The Wissahickon is your backyard. People here are discerning. They do not settle for "average," and they should not have to settle for average primary care either. Fishtown Medicine is a virtual-first practice that gives 19118 residents direct text access to Dr. Ashvin Vijayakumar MD ("Dr. Ash"), video visits, and home visits when an in-person exam is needed. You keep the village. We remove the commute.

What anchors your week in Chestnut Hill?

Chestnut Hill runs on a different clock than the rest of the city, and our 19118 members appreciate that. The Wissahickon morning. The trails inside the park give Chestnut Hill some of the best trail running and walking inside city limits. Forbidden Drive at 7 am with the dog. The harder loops up the Orange and White trails. Mountain bikers further into the woods. A meaningful share of our members fold a hike or a run into the weekday before the rest of the day starts. We see real performance medicine conversations here, especially among the 50- and 60-year-olds whove kept moving and want to keep moving for the next 20 years. The Germantown Avenue village rhythm. Vineyards Cafe for the morning. Weavers Way Co-op for the weekly grocery run. McNally's Tavern for the standing Tuesday lunch. The Goat's Beard or Mica for dinner. Ali's Wagon for the gift run and Style Camp for the boutique loop. A lot of our Chestnut Hill members have been doing some version of this same walk for 20 or 30 years, with the same friends, on the same block. Care should match that continuity, not interrupt it. The long-game health crowd. Tennis at the Philadelphia Cricket Club. Boutique strength work at Balance. Annual physicals that actually measure what matters for the next two decades, not just whatevers on the insurance template. Most of our 19118 members didnt come to us because something is wrong. They came because they want a primary care relationship that takes the same long view they take with everything else in their life. The Chestnut Hill pattern is quiet, discerning, and built on continuity. We are not here to disrupt your week. We are here to extend the runway by a decade or two.

How do I get to Fishtown Medicine from Chestnut Hill?

Most members never make the trip. We come to your home for in-person exams, and the rest is by text or video. If you ever want to meet at the Fishtown office, your options are:

• SEPTA Chestnut Hill East to Temple, then the Market-Frankford Line to Spring Garden Station (about 50 minutes total).
• SEPTA Chestnut Hill West to Jefferson Station, then a short Lyft (about 45 minutes door to door).
• Driving via Lincoln Drive and I-76 (about 25 minutes off-peak).

Skipping the trip is the point.

Where do members go for labs and imaging?

You have good options on the Hill and in Mt. Airy:

• Quest Diagnostics on Germantown Avenue.
• LabCorp locations in Flourtown and Mt. Airy.
• Mobile phlebotomy to your home so you do not leave the house.

For imaging (MRI, CT, DEXA, ultrasound), we send orders to Chestnut Hill Hospital, Jefferson, or Penn, and we negotiate cash-pay rates if needed.

Is this practice good for active retirees and Wissahickon hikers?

Yes. Many of our 19118 members are 55 to 75, still hiking Forbidden Drive, riding the trails, or working part-time. We focus on cardiovascular endurance, joint health, lipidology, bone density, and cognitive resilience: the things that actually matter for a long, active life.

Deeper Questions for Chestnut Hill Residents

I have a chronic condition (hypertension, prediabetes, hypothyroidism, osteoporosis). How does this work in 19118?

We manage most chronic conditions inside the membership: hypertension, prediabetes and diabetes, lipid disorders, hypothyroidism, osteopenia and osteoporosis, GERD, anxiety, and chronic insomnia. The shift compared to traditional care is more time, more touch points, and continuity with one physician who actually remembers you.

Are there health concerns specific to older Chestnut Hill homes?

The Hill has gorgeous pre-war and Victorian housing stock. That stock can come with:

• Lead paint and lead pipes in pre-1978 construction. We can order a blood lead level if you are concerned, especially if grandkids visit.
• Radon in stone and basement-heavy homes. Radon test kits are inexpensive; we walk you through interpretation.
• Mold and indoor air quality in older basements and slow-leaking roofs. We talk through testing and HEPA filtration.

Walkability and movement on the Hill?

The Wissahickon, Forbidden Drive, Pastorius Park, and the trails off Crefeld are real assets for daily movement. We build movement plans that use them: Zone 2 walks on Forbidden, hill walks on Germantown, easy bike rides on the lower trails.

I am thinking about longevity, not just sick care. What do you offer?

Most 19118 members come for exactly this. The longevity layer includes:

• ApoB and Lp(a) for true cardiovascular risk, not just cholesterol.
• Insulin and HbA1c to catch metabolic dysfunction early.
• DEXA for body composition and bone density, not BMI.
• VO2 max guidance, which is the single best predictor of longevity in the literature.
• Cognitive screening when appropriate.

How does Fishtown Medicine compare to a Chestnut Hill Hospital primary care office?

Chestnut Hill Hospital is a great resource for hospital and specialty care. Their primary care clinics run on insurance economics: short visits, large panels, weeks-long scheduling. We do small panels, long visits, and same-day text access. We refer into Chestnut Hill Hospital, Penn, and Jefferson when you need specialty care.

I want an executive physical without driving to Center City. Can I get one?

Yes. Our annual deep-dive includes advanced lipidology, hormones, insulin, body composition, VO2 max guidance, and a written 12-month plan. The whole thing happens between video, your home, and one lab visit. No 8 a.m. trip to Walnut Street.

Discretion in a small neighborhood?

Chestnut Hill is a village. Everyone runs into each other at Trolley Car Cafe. Virtual care keeps your health private. No bumping into a neighbor in a waiting room.

I am caring for an aging parent on the Hill. Can you help?

We see adults 18 and older, including many in their 70s and 80s. We can be the primary care for a parent who finds traditional offices exhausting, with home visits and direct text access. The relief for adult children is significant.

Cognitive health and memory concerns?

We screen for cognitive change with validated tools, run a focused workup (B12, thyroid, vitamin D, sleep, depression, medication review), and refer to neurology at Penn or Jefferson when needed. We do not dismiss "I am just getting older."

What if I move out of Pennsylvania for retirement?

We are licensed in 42 states and we add new ones as members move. Continuity is the point. If you head to Florida or the Carolinas for the winter, your care goes with you.

I take a long medication list. How does that change things?

We build time into the membership for medication review and deprescribing where appropriate. Many older members come on with 8 to 12 medications and leave with a leaner, more rational list because someone finally took the time to look at the whole picture.

Meet Your Physician

Ashvin Vijayakumar MD (Dr. Ash) is a board-certified internal medicine physician based in Philadelphia. He built Fishtown Medicine so neighborhoods like Chestnut Hill could get high-touch, evidence-based primary care without losing a morning to a Center City commute.