Frequently Asked Questions

    At the moment we accept all insurances except for UPMC. To be absolutely sure, you're welcome to call and ask.

      I get asked this not infrequently; and especially in rural America, physicians are generally seen as thinking that medication is the answer to everything. If someone is thirsty, do they not drink, and if hungry, eat? How is this different from replenish a vitamin when it is proven someone is deficient in it. Likewise, why take a supplement when someone isn't deficient in it (most vitamins get flushed out in the urine when there is excess, so there isn't a harm either, other than the time and effort it takes to take something you don't need).

    I am extremely cautious about adding on new meds and go to great lengths to review and consider the necessity of every single medication my patients are on.  

     Lifestyle modification and other non-medication treatment options will always be advised first, and I make sure to confirm a diagnosis as well as exhausting every non-medication option before I would consider a medication.

     Yes, I do, though it would need to be deemed medically necessary, i.e. getting to the clinic would not be feasible for you due to a medical reason.

      We are NO LONGER at 10 Timberview Ln in Russell PA.  Our current address is 1585 Market Street, Warren PA 16365. This is across from Big Joe's.

      The parking lot for our current location is tricky for first timers. Turning from Market Street into Follett Run, there will be an almost immediate left turn into a parking lot.

You have a few options:     

1.)   Give the office a call at (814) 757 6505, and specify to his staff you are considering establishing care with Dr Le and would like to speak to him to get a better sense of how well you interact with him.

2.) If you happen to be nearby, drop in and visit. He'll make the time to speak to you.

^ If you are wondering if I speak English (fluently), both of the above mentioned methods should answer that.

3.) Check out past patients' testimony that is publicly available online  Dr. Dien Le, MD - Internal Medicine Specialist in Kane, PA | Healthgrades  

     I would never want you to go with a physician you have qualms about and fully support and respect your desire to get to know me a bit before making a decision. Whether it's making a phone call or dropping in the clinic, that's entirely up to you.

    It's important that you find a physician who can adequately manage your medical problems, but it's even more important that are treated by someone you trust fully, because that is the core of complying with treatments in which the benefit is not apparent in the short run, but in the long run, would add years to your life and/or for the remaining years, giving you the best quality of life possible.

RECORDS ACQUISITION

   If you happen to have hardcopies of your records, you should drop this off at your earliest convenient, allowing for me to review it as well as for my staff to scan the records in. Whether you want the records back is entirely up to you (we would otherwise shred it or keep it in a locked cabinet, as it is highly confidential information that should not be left hanging around)  

    In the event you need records sent to my clinic, a wet signature is needed. This can be accomplished in one of several ways.

1.)  Drop by the office to sign a release of information form. Depending on which office it's coming from, it may take up to 2 wks for the records to be received. Nowadays, records tend to be faxed, which in our experience, can happen as promptly as later the same day, but generally not more than 2 to 3 business days.

2.) Go  to your current PCP's clinic to sign the release. 

3.) A form can be mailed to you, you can sign it, and mail it to whoever is/was taking care of you.

ACCURATE MED LIST

    Bringing a written up list of your medications would be helpful. An alternative to this is putting all your current meds in a zip lock bag and bring it to your first appointment. 

    You can also call your pharmacy and ask them for a complete list of your medications (please also ask for dosage and directions). Write this list down and bring with you to appointment.

Step 1: Take a deep breath.

Step 2: Call (814) 757 6505, you should be able to get a message to me at ANY time; rain or shine, day or night, weekends and holidays.

  I care deeply about the well-being of my patients… if it’s a simple call to address a time sensitive matter, such as requesting a medication refill, or informing you tested positive for COVID, or expressing a concern over a worrisome symptom, please do NOT feel bad about calling.

    One caveat is if you are feeling extremely sick, going to urgent care or the ER would be prudent, as I would likely advise to do just this. There, important labs and imaging can be done and you can be started on IV antibiotics.

     Sometimes it may be more on the fence whether it needs a visit to the ER or not. If in doubt, give my office a call.

    I am not aware of there currently being another internist in Warren county, especially if we're referring to ones who are taking on new patients.

     If you're not all that sure what is the difference between a family doctor and an internist, please refer to a thorough response of this below. 

     The biggest take-home is...

-If you're young and healthy, it generally doesn't matter who manages your care, and it becomes more of a function of who do you get along with.

-If you're middle age and feel that you may have developed some problems, an internist (wherever you happen to find one) is likely going to do the most appropriate evaluation and investigate with the right labs and imaging.

-If you're medically complex, is of adult age, you should definitely be managed by an internist, as some of your problems either already needs nuanced management, or you will eventually develop an issue that should be managed by an internist.

    That's a great question and one I can only pose a conjecture: family doctors offer the most flexibility, which is more ideal in an area not as well resourced. 

     While a community is better managed by a pediatrician, OBGYN, and an internist, (arguably even a geriatrician if they can afford one), there arises the issue of non-overlap should one of these  doctors take a sick day or is out of town for a week or even a month. Whereas an internist and geriatrician overlaps heavily and can cover for each other, if a Ped or OBGYN takes time off, we would be hard pressed to find someone who can manage patients they were not trained to see. 

    On the plus side, family doctors receive some training in of all group: "from cradle to the grave", so in a town that can only afford to have ONE doctor, this is ideal. On the down side, they are also reputed as "jack of all trades, master of none," so per answer for above question, as a patient gets older and is more prone to cardiovascular disease, being managed by an internist would be more ideal. However, there is always that exception of a 90-something years old patient who is super healthy and is not on any medication and it wouldn't make or break such a patient which type of doctor he or she establishes with.

    In the scenario of 3 family doctors, if one of these doctors took a month off, the other two would be sufficient to cover the patients of the doctor on leave.

    Well, if you have great rapport with your current family doctor, and are relatively healthy, management by either would be the same, so it would be in your best interest to stay with a family doctor. If you have young kids, and want your whole family to have the same doctor, it must be with a family doctor.

    On the other hand, if you have a complex medical condition, or many conditions such that it is difficult to keep on top of ALL of them (this becomes especially challenging when the treatment of one condition worsens another), a switch to an internist would be more strategic. If you want all your family to have the same doctor and they are all age 18+, an internist OR a family doctor can be the doctor for your entire family.

    If you are aged 65 or order, it would be ideal to be managed by a geriatrician (who started out as internist and then did an additional 2 yrs of fellow in geriatrics training), but unfortunately this specialty is a dying breed and you would have to drive to a major city to find one, and hope they accept new patients.

   How are they the same: Both do 4 yrs of undergrad, and 4 yrs of med school. Up until the end of their 3rd year of medical school, their education and training would be identical. There may be some divergence come 4th year. Usually someone knowing they would go into say... internal medicine... would do as many IM-related rotations as possible, respectively if they know they want to go into family medicine... in this sense, 4th year of medical school would be very different... though some might be undecided and instead do a mix of rotations.

    Residency is really there is a major fork in the road.  The major difference in the training of an internist is that our residency training consist 100% of managing adults. A family doctor's training is split up to cover pediatrics, adults, and OBGYN (not necessarily in a 33% of each specialty... it all depends on the practitioner on how they want to split up their training).      

    Our board certification exams are different and forces us to keep a bare minimum knowledge of our respective field. Family Medicine (FM) would include knowledge of peds and OBGYN, whereas this is not tested on at all in Internal Medicine (IM). Instead, in IM, we are required to know the bare basics of all the sub-specialties of IM (e.g. Rheumatology, Cardiology, Endocrinology, Nephrology, GI, Heme/Onc), IN ADDITION TO chronic management of common adult disorders - diabetes, high blood pressure, heart disease, etc... By virtue of having to prepare for these certifications, our fund of knowledge is different.  

   Vitamin repletion, when proven a patient is deficiency, is as harmless of a treatment as it gets, and at times, can lead to drastic improvement of symptoms (eg B12 or iron), or prevent very bad events from happening (eg calcium and Vit D strengths bone and prevents fracture of pelvis or leg). 

    Vitamin is something your body naturally get sufficient amount of when you have a well balanced diet. Poor absorption can also lead to vitamin deficiency despite eating a well balanced diet (this would then prompt physicians to introduce the vitamin via a different method than orally).

    It is most prudent to take vitamin supplement AFTER confirming you are deficient. Taking vitamins without proof of a deficiency has multiple issues: you may not need it. Furthermore, when we check your level while you are taking a supplement, and it comes back in the normal level, we don't know if it's normal because you're taking the supplement, or because it was never deficient in the first place. What's scarier is we check the level and it shows deficiency! (How is this possible if I am taking a supplement?! The amount in multivitamin are intentionally dosed to be rather small , as inadvertently overdosing on certain vitamins can lead to terrible outcomes and said company would be fighting a class action lawsuit). More likely, taking vitamins when you are not deficient won't help you (other than providing a placebo effect), nor harm you, as most vitamins are water-soluble, meaning they would just overflow into your urine and excreted. 

     This is a complex subject that warrants a whole book to do justice, and even at that, the literature is controversial, leaving the world divided as to what guidelines they set, especially when it comes to should cholesterol meds ever be stopped and if so, at what age?

    Different doctors will have different approach to this, hence a guideline, developed from a conglomeration of data on hundreds and thousands of patients on how they were affected by being on a cholesterol medication vs not being on it (the biggest and longest-running of its kind, the Framingham Heart Study, which spans multiple generations), helps to standardize the advice doctors would give.   Fun fact: Dr Le worked as a medical assistant for several years in Framingham, MA , under an outpatient internist, and while there, ran into actual study participants of the study, who told Dr Le that not only are they are part of the study, but also their fathers, and their grandfathers)

    f you already have CAD (coronary arterial disease), then the answer is a definite yes, up until you turn 85 (if you have ever had a heart attack, you should probably stay on a statin for life, though this should be a shared decision, made in conjunction with your cardiologist).

    If the goal is instead to prevent you from having CAD or prevent a 1st heart attack, then the following is the current guideline of whether you should be on cholesterol medications. Listed from what is most compelling reasons.

1) Your chance of having a heart attack or stroke over, referred to ASCVD over the next 10 years is 10% or more. ASCVD is derived from the Framingham Heart Study,

2) Your bad cholesterol (aka LDL) is 190 or higher.

3) You have diabetes and is between age of 40 to 65; even if your cholesterol is within goal in the absence of a statin, it would still be advised to be on the lowest dose of a statin because of its other property - inhibiting cholesterol from aggregating and forming a plaque