Experts generally can charge higher rates, clientele seek them out and they rarely have to search for business. Today's society prizes and rewards experts very much because true experts are rare and valuable. Many professionals and other business people are afraid that if they focus in on one specific niche market that they will lose business overall. Niche marketing is effective because people tend to feel more comfortable dealing with someone who has a great deal of experience in their specific area of need.
Perception is everything.
It shouldn't surprise you that this surgeon likely does not look for business very often. Once you are recognized in your community as having a specific expertise, existing clients will refer new clients to you and you will likely acquire additional work from already existing clients who are in need of your specialized services. Let's examine the referral phenomenon surrounding experts from another angle. Obviously, it is easier to handle a specific situation that you have dealt with many times before, regardless of its complexity. It thus makes sense that niche market experts are able to provide better service, charge higher fees and retain larger profit margins.