The idea of requiring a high salary is reasonable, but I'd make it rather e.g. 120% of the median salary in a particular industry.
If you can't find somebody skilled enough here to work for 200k or less, then you should probably be paying 200k or more since you're looking for a role that is niche and low supply.
This fee is a great way to ensure that there's very little medical services available to rural populations and to help kill science in the US among other things.
Part of the shortage is also because very few people can afford to become doctors.
In many cases, the rebalancing that is needed is from subspecialties to community based primary care in rural and other underserved areas. Some new medical schools appeared in the 1970’s to address the need for more family medicine docs. What happened was completely predictable… more subspecialists. Graduates follow the money trail when choosing residencies and fellowships.