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.
Doctors, pilots and other genuinely essential professions are well covered by a number of other visa categories, such as EB-2.
I don't think the EB-2 process allows the applicant to stay within the US while waiting for the priority date to become current so staying in the US and working during that 3-12 year period won't work without another visa type.