Old City is a contradiction in the best way. Cobblestone streets and Independence Hall on one block, the heart of Philadelphia's tech scene (Philly Tech Week, N3rd Street, the design agencies along 3rd) on the next. Living here means you value aesthetics and innovation. Fishtown Medicine aligns with that. We bring 21st-century efficiency to the 19106. Ashvin Vijayakumar MD ("Dr. Ash") is a board-certified internal medicine physician you can text directly. Most visits happen by video. When you need an in-person exam, we come to your loft.

What anchors your week in Old City?

Old City runs on overlapping rhythms that most of you can walk between in five minutes. Our 19106 members move through the historic, the creative, and the tech corridors without leaving the neighborhood. The N3rd Street tech corridor. Design agencies, startups, freelancers working from a loft conversion on 3rd or Arch. Old City Coffee for the morning. The Bourse food hall for the working lunch. Sassafras or Wedge + Fig for the quick dinner before the late session. Most of our Old City tech members text us between meetings; the 12-minute window is where care actually fits. First Friday and the gallery weekend. The 3rd Street art walks, dinner at Royal Boucherie or Spasso, drinks at Eulogy after. A meaningful share of our Old City members work in or around design, gallery, or publishing, and they recognize a relationship-based practice when they see one. Were not selling a service; were extending a long conversation. The Race and Cherry Street Pier mornings. Race Street Pier for the river views and the dog walk. Cherry Street Pier for the creative coworking on the way back. The 6 am Delaware Ave runners with the Ben Franklin Bridge as the backdrop. Old City has one of the best waterfront pockets in Center City, and we see a lot of "I finally have time to take this seriously" conversations happen out there. The Old City pattern is creative, design-conscious, and built for people who notice details. Care should match that, quietly.

How do I get to Fishtown Medicine from Old City?

Most members never need to. Care happens by text, video, and home visit. If you ever want to meet at the Fishtown office, your options:

• SEPTA Market-Frankford Line from 2nd Street Station to Spring Garden Station (about 8 minutes plus a 5-minute walk).
• Driving via Delaware Ave/Columbus Boulevard (about 10 minutes off-peak).
• Bike via the Delaware River Trail (about 15 minutes).
• Walk via the waterfront (about 35 minutes if it is a nice day).

Where do members go for labs and imaging?

Old City is well covered:

• Quest Diagnostics in Center City and on Aramingo.
• LabCorp locations on Walnut and at 30th Street Station.
• Mobile phlebotomy to your loft.

For imaging, we send orders to Jefferson, Penn, or independent imaging centers.

I work in tech, design, or hospitality in Old City. Does this fit?

Yes. The N3rd Street tech and design crowd appreciate a digitally native medical practice. The hospitality and restaurant industry crowd (Zahav, Amada, Royal Boucherie) appreciate flexible access for non 9-to-5 schedules. We handle both.

Deeper Questions for Old City Residents

I have a chronic condition (anxiety, hypertension, GERD). How does this work in 19106?

We manage most chronic conditions inside the membership: hypertension, anxiety, depression, ADHD evaluation, GERD, prediabetes, lipids, hypothyroidism, IBS, and chronic insomnia. The shift compared to traditional primary care is more time, more access, and continuity.

Are there health concerns specific to historic Old City buildings?

Yes:

• Lead paint and lead pipes in pre-1978 buildings. Most of Old City qualifies. We can order a blood lead level if you are renovating or planning to conceive.
• Asbestos in older basements and pipe wrap; renovation timing matters.
• Mold in old foundations and slow-leaking roofs.
• Indoor air quality in tightly sealed warehouse conversions and gas-stove kitchens.

What about air quality near I-95 and the waterfront?

I-95 runs along the eastern edge of Old City. Particulate exposure on the waterfront blocks is real. We screen for asthma, allergies, and unexplained chronic cough, and we talk through HEPA filtration and route choice for runs and bike commutes.

Is Old City walkable enough for daily movement?

Walk Score in the 90s. The Delaware River Trail, Penn's Landing, the cobblestones, and the connectors to Society Hill and NoLibs give you real options. We build movement plans around them.

I work in restaurants in Old City. Sleep is wrecked.

Common Old City pattern. We run a sleep workup that does not just say "go to bed earlier." Chronotype, light exposure, alcohol timing, late-night eating, and a sleep apnea screen. We use wearable data when you have it.

I am a freelancer or consultant without traditional benefits. Does this work?

Yes. This is a modal Old City member. Membership replaces the "I just need a real doctor" piece. You still carry catastrophic insurance for ER, hospital, and specialist costs. The math usually works in your favor.

I want longevity care, not just sick care. What do you offer?

Most Old City members come for exactly this. The longevity layer:

• ApoB and Lp(a) for cardiovascular risk.
• Insulin sensitivity to catch metabolic dysfunction early.
• Hormones (testosterone, thyroid, cortisol).
• DEXA for body composition and bone density.
• VO2 max guidance.

How does Fishtown Medicine compare to Jefferson primary care?

Jefferson is great for hospital and specialty care. Their primary care runs on insurance economics: 12-15 minute visits, large panels, weeks-long scheduling. We are direct primary care: long first visits, same-day text access, no rotating residents. We refer into Jefferson for specialty care.

I want an executive physical without leaving Old 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. Most of it happens between video, your loft, and one lab visit.

Discretion and privacy?

Virtual visits are private. No bumping into colleagues or clients in a Center City lobby. Standard HIPAA, secure tools.

I am opening or running a restaurant in Old City. Can you handle the stress and erratic hours?

Yes. Many of our hospitality members are owners and chefs. We are pragmatic about industry life and we work with what you have, not what you wish you had.

Meet Your Physician

Ashvin Vijayakumar MD (Dr. Ash) is a board-certified internal medicine physician based in Philadelphia. He built Fishtown Medicine to give Old City's tech founders, hospitality professionals, and creatives a real doctor who actually fits their schedules.