University of Minnesota Medical School graduate Spencer T. Hoostal, MD joined the Hillcrest Internal Medicine team in July 2024 after completing internal medicine residency at Scripps Mercy Hospital San Diego. The lifestyle medicine focus of his residency training routes cardiovascular risk patients toward concurrent cardiology consults with providers like Shahin Keramati, MD at San Diego Heart and Vascular Associates for coronary risk stratification. Hillcrest Internal Medicine operates out of Suite 505 at 4060 Fourth Avenue as part of the Scripps Affiliated Medical Groups network, sharing the building with San Diego Medical Group downstairs. The practice connects to Scripps Mercy Physician Partners billing and referral infrastructure, with same-block hospital admitting privileges at Scripps Mercy on Fifth and Washington. Patients with exertional dyspnea or chronic cough entering the standard primary care work-up can be referred to the UCSD Hillcrest Pulmonary and Sleep Research Laboratory for polysomnography and pulmonary function testing. The highest-value work in this panel is lifestyle-driven reversal of metabolic syndrome through coordinated changes to diet, sleep architecture, and activity, a focus Dr. Hoostal studied during residency as a mechanism to reduce pharmacologic burden in early type 2 diabetes and prediabetes.