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NPCs and Medical Treatment
Should NPCs not pay player characters for IC services?

After talking with a few players and puppets to try to solve this issue IC, I've found that NPC gangers never pay player characters for medical treatment. As these are the primary patients IG, it really disadvantages medics both monetarily and RP-wise, and leaves a lack of incentive to treat NPCs. The IG explanation is that the issue is handled between NPC characters - somewhat of a let down gameplay-wise.

A few solutions could solve this issue. The first, encouraging more RP, is that pledges can run payment from their gang leader to the medics, who would then be encouraged to keep track through notes of who they treat and what is owed. Secondly, medics can do the same noting practice, and reach out to a certain gang NPC at the end of the week to sort out payment.

If anyone has any thoughts on other solutions, or support for something like this, please share! Just trying to gauge whether this is a personal issue of something the community notices as well. Could provoke some interesting RP and improve NPC interactions/ambience.

This is by design. If a ganger PC isn't paying for his NPC cohort's medical treatment and stocking them with items - they're at a serious disadvantage in a fight. Maintaining your gang via healthcare, gear, and even NPC placement is the barebones mechanics of the ganger archetype.

The real magic is in all the RP surrounding that though. It sounds like you're 100% on the right-track with your ideas and should take your theory's into practice.