The fragmentation impact of having your customers looking for your services in dozens of different ways vs opening the phone book is costly and complex to overcome.
Once you pay a designer, hosting provider, and then pour the rest into Adwords it is very hard to get the same 8-12 calls per day with $20k of annual spend.
Thumbtack are helping solve that problem and syphoning all the money these businesses used to spend on YellowPages or are wasting on poor Adwords bidding strategies. Paying per lead is not that much different from paying $20k to YellowPages who give you no guarantee you will ever get a phone call.