With combined Family Medicine and Psychiatry residency training at UC San Diego (1997-2002) and dual board certification in Psychiatry and Addiction Medicine, Dr. Kaimana S. Macdonald, MD runs a concierge psychiatry practice at 3368 Second Ave on the Mission Hills edge of Hillcrest. Primary care coordination for concierge patients — annual physicals, lab follow-up, vaccinations — ties back to Scripps Coastal Medical Center Hillcrest when a generalist visit is needed outside the psychiatric scope. The practice uses ketamine infusion protocols for treatment-resistant depression alongside traditional psychopharmacology, psychotherapy, and lifestyle interventions within a first-name, single-treater model informed by a University of Minnesota Medical School MD (class of 1997). Same-day urgent medical triage for concierge patients routes to Perlman Clinic San Diego when in-person evaluation beats a virtual check-in. Teaching appointments as Assistant Clinical Professor of both Family Medicine and Psychiatry at UCSD feed into supervision of combined-residency trainees, and the highest-complexity work handles dual-diagnosis patients where severe mood disorders, active opioid or alcohol addiction, and buprenorphine maintenance run in parallel under a single treating physician.