Whilst money changing hands is always good in an economy, the reality is the money is going from the hands of the rich back into the hands of the rich. Surgeons are already among the upper middle class stratum. Then you have to take into consideration that rich people will use the most experienced and popular surgeons. These surgeons will be of a higher income than the other surgeons (who would still have a hefty salary). The wages paid to cleaners and the other menial workers would pale insignificant to what the surgeons were earning. The surgeon would then keep the money and they would save it, so the money would still be redundant in our failing economy.