Joseph Markenson, MD at the Hospital for Special Surgery is supposed to be one of the finest rheumatologists in New York City according to a colleague in the New York City Health Department, where I have worked for the past 4 years as the World Trade Center Health Coordinator. I've scheduled this appointment even though he doesn't accept GHI because the meloxicam hasn't helped much and I've begun to limp during my regular lunchtime walks across the Brooklyn Bridge and back. I've also been told that orthopedic surgeons always recommend surgery so I'm seeking a second opinion.
Dr. Markenson does a very thorough examination and requests extensive bloodwork. He notices the ridges on my fingernails and asks me if I suffer from psoriasis. Apparently, there is a connection between arthritis and psoriasis. He also suspects my hip is the greater problem because when he asks me to raise my right leg against the force of his hand, the resistance is much weaker than it was with my left leg.
I ask for more meloxicam because I've run out and I will be vacationing in the Pines for the next week. Our house is located far from the harbor where the ferry docks, and I've begun to experience pain during the commute even while wearing sneakers. I'll double my dose before going to the Ascension Party on Sunday.
Dr. Markenson's consultation fee is $600, most of which I will pay from my own pocket. My housemates are divided, with one insisting I'm nuts to "go out of network" and another agreeing that if I can afford high quality health care, I should seek it. Something tells me to go the more expensive route. This totally goes against my frugal nature and a long held belief that one physician is a good as another, based on the experience of my sickly mother, who constantly sought medical care for a variety of ailments to no avail before succumbing to non-Hodgkin's lymphoma at 59 more 35 years ago.
