The weight of expertise

By Herman M. Lagon

It started with a simple social media post shared by my cousin, Dr. Alex Escolastico Lagon Cerrillo, citing an explanatory opinion post: “Pag nagpa-follow up checkup ba sa doctor, may bayad?” The kind of question that feels ordinary—practical, even harmless.

But seemingly naïve questions like this linger longer than expected. Not because they are wrong, but because they open something deeper. There is a quiet assumption there—that when work comes with care, maybe it should not cost as much. And that is not something you dismiss right away.

This is not a story of expensive care—it is a story of misunderstood value. Because this is not really about fees. It is about how we see effort and value. At some point, we began counting time, instead of remembering the years behind it.

And I found myself thinking about Manong Alex—and about my own daughter, now in that same white coat. Becoming a doctor is not a simple path. It is long, demanding, and often quiet in its sacrifices—years of study, lost sleep, missed days with family. And when you finally get there, the responsibility only deepens. It becomes heavier. Because now, people trust you with something they cannot afford to lose.

And to be clear, this reflection is not about doctors who are after money. If anything, people like Manong Alex, a surgical oncologist, have shown the opposite—quietly giving, extending help when needed, and often going beyond what is required. But service, no matter how sincere, still rests on structure. And structure is what keeps that service sustainable.

A doctor does not simply “see” a patient. They carry background data, nuances, context, stories—uncertainty, fear, hope. And that does not end after the first consultation. It does not pause just because the visit is labeled a follow-up.

That is why the idea that a follow-up is just “silip kung gumaling ka” feels incomplete. Inside that room, something more careful is happening. The doctor is checking if the treatment worked, if something has changed, if something subtle is being missed. Sometimes, it is in the follow-up where the real story begins to reveal itself. Research on continuity of care shows that timely follow-ups improve recovery and reduce complications, particularly after initial treatment (Agency for Healthcare Research and Quality, 2019). “Hindi siya ulit.” It is refinement.

My daughter once shared a story that stayed with me. A ship broke down at sea. Engineers tried everything, but nothing worked. Then an old mechanic came in, tapped a single part, and the engine came back to life. When he sent his bill, it was high—not for the tap, but for knowing exactly where to tap.

That story makes sense because we see it everywhere.

Just recently, I called a refrigeration technician when our ref stopped working. I thought it needed freon change. He came in with his assistant, brought his tools and machines, checked a few parts, adjusted something I could not even name, and in less than two hours, everything was running again. The bill was ₱2,500. I paid without hesitation. Because I knew I was not paying for two hours. I was paying for the years that made those two hours possible.

I see the same thing in my own work as a calculus an physics teacher. Students sometimes think a quick solution means something is easy. But what they do not see are the years behind that clarity—the confusion, the repetition, the problem sets, the patience it took to understand it deeply enough to explain it simply. Speed is often just experience made visible.

So when we talk about fairness, it cannot just be about how much or how long. It has to include dignity and years of training. We do not expect lawyers to revisit cases for free. We do not ask architects to revise designs without compensation. We do not assume mechanics will recheck engines out of goodwill alone. Yet somehow, when it comes to doctors and other health practitioners—perhaps because their work involves care—we sometimes expect generosity to take the place of structure.

To be fair, generosity is very much alive in the profession. Many doctors offer free follow-ups within a certain period. Some lower their fees quietly. Others waive them entirely when they know a patient is struggling. These acts do not come from obligation, but from compassion. And that distinction matters.

Because there is also a cost we do not always see—service fatigue. The constant listening, explaining, synthesizing, deciding, caring. Over time, this kind of constant giving wears people down. Studies on burnout in healthcare show how emotional exhaustion builds when boundaries are ignored—and when that happens, everyone feels it, not just the doctor, but also the patient and the quality of care itself.

A friend, Atty. Geobelyn Lopez, shared a quiet reminder: people—whether doctors, teachers, engineers, lawyers, computer technicians, civil servants, or parents—also need proper space to think and serve well. Not every concern can be handled through a quick message or an unexpected call. Some things need time, context, and the discipline of an appointment.

Still, this is not about limiting service. People like Atty. Geobelyn and Dr. Alex don’t hesitate to help when it counts. But even generosity has its limits—it needs space to last. The same goes for priests, pastors, nuns, even parents who quietly carry so much every day. They give deeply—but they also need time to rest and reflect. In the end, it is about balance—plain and simple.

I have also noticed this pattern more widely—the habit of messaging experts and expecting instant answers. A quick “Doc, ask lang…” or “Atty., pa-check naman…” sent anytime, as if expertise is always on standby.  There is often no context, and sometimes, no follow-through. Not always on purpose—but it shows how we have come to think: that knowledge is always within reach, and often, free for the taking.

And to be fair, I am not exempt from this. There have been moments when I, too, have sent a quick message, hoping for a quick answer, forgetting that there is a person on the other side with their own time and boundaries. That is why it also matters to recognize something we often overlook: when people respond despite the timing, the lack of context, or the inconvenience, that is not an obligation—it is grace. It is generosity. And generosity, when received, should not be taken for granted, but met with gratitude—not entitlement or insensitivity.

And perhaps this is where it becomes clearer—this is not just about one profession. It is about how we have come to value work itself. Every job has its own kind of expertise—the driver who knows every shortcut, the household helper who keeps things in order, the vendor who can spot what is fresh, the janitor who prepares everything before anyone notices. Skill is everywhere. We just tend to overlook it.

So when we ask if a follow-up has a cost, maybe the better question is—what does that cost really hold? Not just minutes, but attention, care, and responsibility that continues even after you leave. This is not about justifying a fee. It is about seeing clearly. Some things appear simple only because someone worked hard to make them so. And sometimes, respect begins with understanding.

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Doc H fondly describes himself as a “student of and for life” who, like many others, aspires to a life-giving and why-driven world grounded in social justice and the pursuit of happiness. His views do not necessarily reflect those of the institutions he is employed or connected with.