The Membership

Fishtown Medicine is a Direct Primary Care practice. That means I work for you, not for insurance companies. I designed this membership model to provide a level of access, time, and strategic thinking that is impossible inside the traditional system.

What makes the membership worth it?

The membership is worth it because it replaces a team you would otherwise have to assemble and manage yourself. Most people piece their care together across a primary care office, a hormone clinic, a cardiologist for the borderline numbers, a metabolic or weight program, someone for mental health medication, and a specialist or two, with no one reading the whole story. At Fishtown Medicine, one physician covers those lanes in one place: preventive cardiology, metabolic health, hormone care including testosterone and menopause, mental health, and sexual health, integrated with the tools of functional and longevity medicine, and grounded in evidence for each of them.

The second half of the answer is what happens when something does sit outside my scope. I know where my role ends, and the coordination is part of the membership: I find the right specialist, reach out on your behalf with a briefing so the first visit starts at the deep end, read what comes back, and fold it into your plan. You are never the messenger between your own doctors.

And underneath both halves is time. Your visits have no timer. The records review and the lab review each typically run 60 to 120 minutes, and some run longer, because the visit ends when we are on the same page, not when a schedule says so. Your health story, your family history, and your biomarkers get read together, as one picture. That combination, breadth, coordination, and unhurried time with the same physician year after year, is the product. The price is the smaller part of the decision.

Some members come for the integrative and functional side: a root-cause workup that goes past the standard panel into the systems that have been driving the symptoms. Some come for the preventive and proactive side: long-arc planning for cardiovascular, metabolic, bone, and cognitive trajectory. Everyone stays for the same reason. Personalized, direct care, with the same physician.

What does Fishtown Medicine membership include?

The membership includes four connected layers: unlimited access to me, breadth of care in one physician, deep diagnostics, and active patient advocacy. Each layer is built into a single flat fee with no copays, no surprise bills, and no insurance billing for our care.

1. Unlimited Access

• No Copays: Whether we talk once a year or ten times a month, your membership covers it.
• Direct Communication: Text or video your physician directly. No call centers, no gatekeepers.
• Same-Day or Next-Day Appointments: When you need us, we fit you in.
• Sick Visits Included: We treat acute issues like flu, colds, UTIs, and rashes quickly, usually through messaging or a brief video call.
• Home Visits: Across Greater Philadelphia, when in-person care makes more sense than a screen.

2. Breadth of Care in One Physician

• Cardiovascular Prevention: ApoB-driven risk work, blood pressure, calcium score and CCTA decisions, and the long-arc plan for your heart.
• Metabolic Health: Insulin resistance, prediabetes reversal, weight and GLP-1 care with muscle and bone protection built in.
• Hormones: Testosterone evaluated and treated inside full primary care, thyroid beyond a single TSH, perimenopause and menopause care.
• Mental and Sexual Health: The medication side of anxiety, depression, and ADHD, plus libido and sexual health, handled by the doctor who already knows the rest of your story.
• Functional and Integrative Fluency: Supplements, peptides, and root-cause tools evaluated with evidence, so you get a straight answer instead of a sales pitch or a dismissal.

3. Detailed Diagnostics

• Annual State of the Union Physical: A 90-minute deep dive into your metabolic, cardiovascular, and cognitive health.
• Advanced Blood Work: We track markers like ApoB, fasting insulin, hs-CRP, full thyroid, and Lp(a) to spot trends early.
• Wearable Integration: We review your Oura, Whoop, Apple Watch, or CGM data to optimize sleep and recovery.
• Read Together, With No Timer: Results come back in 7 to 10 days, and we sit down and read them together for as long as it takes.

4. Patient Advocacy

• Care Coordination: If you need a specialist, we find the best one in Philadelphia, reach out on your behalf, and send a clinical briefing so you do not waste the first visit.
• Specialist Curbsides: We draw on a network of world-quality experts in Philadelphia and beyond to get their read on complex cases directly, so for many questions you get subspecialist input without another office, another intake, or another exam.
• Hospital Navigation: If you are hospitalized, we communicate with your hospital team and manage the discharge transition.
• One Quarterback: Every result, note, and opinion routes back to one physician who folds it into your plan.

How much does the membership cost?

The membership uses transparent, flat pricing. There are no surprise bills.

The Standard Membership

Designed for individuals and families who want a proactive medical partner.

• Monthly: $250 per month
• Quarterly: $685 per quarter (1 month free vs. month-to-month over the year)
• Annual: $2,500 per year (2 months free vs. month-to-month)
• Partner or Spouse Add-on: $1,950 per year (2 months free vs. month-to-month)

The annual plan is the best value, 2 months free versus paying month to month, and paying once a year keeps your care continuous without a recurring bill in view. HSA and FSA dollars are eligible thanks to the Primary Care Enhancement Act, which often makes the effective cost 25% to 35% lower depending on your tax bracket.

Scientific References

1. Eskew PM, Klink K. Direct Primary Care: Practice Distribution and Cost Across the Nation. J Am Board Fam Med. 2015;28(6):793-801.
2. Cole ES, et al. Direct Primary Care: Applying Theory to Potential Changes in Delivery and Outcomes. J Am Board Fam Med. 2018;31(4):605-611.
3. Doherty M, et al. Direct Primary Care Outcomes: A Scoping Review. J Am Board Fam Med. 2022;35(2):363-374.