Truth is, roughly 80% of erotic games are mediocre, or just bad. It seems that, as you say, devs are amateurs looking for some quick money. But the fact that, even by making mediocre videogames they can get that fast money, proves that there is hungry in the market for erotic videogames. The level is so low that, when there is a product that excels in quality terms and profesional approach, it success.
There are a few erotic videogames made from a more profesional perspective that are making big money: "Good Girl Gone Bad", by Evakiss, "Summertime Saga", by Darkcookie, "Dating my Daughter" and "Melodie" by MrDots, Lessons of Passion, Vdategames... Those games and devs are not perfect, at all, but I think that they are making a name for themselves as developers of erotic videogames, a market niche that, until a few years ago, was exclusively ocupied by japanese hentai games.
Darkcookie is making +30.000 dollars every single month for several years now. He can even hire people and create a small company. For a product that is a semi-profesional erotic videogame! Most of the patreons are paying for this game the equivalent of the cost of three, four or more AAA videogames like "The Witcher III" or "God of War"! There is a big market for quality erotic videogames, that´s for sure.
My case about this game: I find really interesting to interact with the patients as characters: to try to gain their confidence, to find things about their lives (especially the spicy ones, as if they have the fetish of exhibitionism, as Kiko
), to flirt with them, etc. I would give more importance to this in the final game.
The part of trying to diagnose an illness is not as appealing for me. I don´t have the knowledge to do that and I´m not interested in reading a codex of more than a hundred of technical articles just to know the medical jargon. I´m not so interested in the medical science, I´m affraid. I would have preferred a more casual approach, without losing the scientific rigor.
In brief, I prefer the part of visual novel and interacting with the characters over the part of pure medical simulator, that I see as kind of a minigame too difficult to gain without cheating. The part of managing a clinic seems interesting, though, also as kind of a minigame, not as the main part of a game.
Just my opinion, of course. I hope you find it useful as feedback.
Anyway, best of the lucks with your project.