This article explores the socio-economic aspects of medical care in Late Antiquity with a particular emphasis on how payments and medical costs shaped perceptions of physicians as fee-charging individuals. As it illustrates, criticisms of physicians for greed, hucksterism, and chilly indifference to the poor spanned the gamut of ancient literature, and the limited evidence for physicians’ incomes and fees under the Roman Empire does suggest that medical careers were quite profitable. For ethical and philanthropic purposes, though, many ancient physicians chose to forego payment or adjust their fees for patients of lesser means. This essay concludes with a challenge to a common scholarly assertion that the Christianization of Roman society placed greater pressure on physicians to assume more charitable practices. Christians did not differ appreciably from pagans in their criticisms of avaricious physicians; instead, I suggest, Christian leaders who inherited a tradition of censuring physicians for predatory behavior leveraged established Classical discourses about the greedy physicians and the exclusion of the poor from healthcare to persuade parishioners to support almsgiving, particularly the funding of hospitals. Clerics in this way erected a parallel healthcare economy that was explicitly outside of marketplace norms: volunteers, clerics, and paid physicians were to serve the ailing poor at hospitals, while the rich were to fund these operations by treating their diseased souls through the purgative act of almsgiving.