I've never really thought about it, but I guess I'm a little uncomfortable with noncommercial anesthesiologists and I would prefer that they are supervised.
In general I wouldn't dispute the point that a large country can't make all that much of its income from tourism.
The logic is a bit flawed though as GDP based on just about any single industry is going to look disappointing by this logic. I think money from an export or something that functions similar to an export like tourism is actually represented over and over in an economy as it flows through the economy and becomes savings that finance things, etc. I don't think rich country incomes can make any sense in terms of goods and services exported unless considered from the lens that most people spend or invest the majority of their salary every month in a way that is already moving into the explanation for many other salaries.