Worth reiterating - because I've seen this conversation here before - that 1,000 patients @ $38/ month != "earns $38,000/ month".

There are still salaries (well, singular in this example - the receptionist) plus overheads, training, insurance etc. Sure, the margins are much better in medicine, but buying a $10 book off Amazon != $10 income to Jeff Bezos, and the same principle applies.