Altruistic Healing
We are well aware that it is a great mitzvah to treat patients. It is said that the only subject the Vilna Gaon did not learn was medicine, because if he had, he would have been obligated to apply his knowledge to practice, impeding his ability to focus on Talmud Torah (which is equal to all mitzvos). Accordingly, one would presume that it is commendable for a physician to deny payment for his services and choose to do the mitzvah of refuah for free. This is certainly true based on the Gemara in Bechoros (29A) that rules one may not take payment for a mitzvah. The Shulchan Aruch (Y.D. 336) rules
“The Torah granted permission to a doctor to heal, and it is a Mitzva, and included in [the obligation to attend to matters of] Pikuach Nefesh. If he withholds [treatment], he is spilling blood… A doctor may not take payment for his wisdom or the insight he provides, but it is permitted to charge Schar Tircha and Batala.”
It seems that only through a legal “loophole” can a physician take compensation. However, the Gemara in Bava Kamma (85A) seems to take a different position. In discussing an assaulter’s obligation to pay for the medical bills of the assailant, the Gemara says that “a doctor who heals for nothing is worth nothing.” This Gemara allows the assailant to force the attacker to pay for a doctor even when someone offers complimentary medical services because the free medical service is inferior. How can the Torah forbid a physician from taking payment while also allowing one to coerce a damager to pay a physician?
Rabbi Yitzchak Zilberstein reconciles this seeming contradiction with the following idea. A patient (or the one paying medical bills) must seek to compensate a physician for their care. The care and assistance of an expert physician must be recognized and valued appropriately. However, a physician may deny payment, opting to perform his duty for the novel purpose of serving G-d. As such, while barring the technicalities of Schar bitul, a physician may not charge for their work, not from a lack of value applied to their work, but rather the recognition of the ultimate compensation that awaits them.