Mac,
I'm definitely not a surgeon, but I use headlamps quite a bit. Overall brightness isn't my first concern, usually. I generally use lights which feature longevity for battery life.
While many camping/hiking lights put out only about 35 lumens, some like the Petzl MYO XP E83P2 or Petzl MYO RXP E87P put out up to 150 lumens. These are in the hundred dollar range.
In the four hundred dollar range you can get the Petzl Ultra E52 or E53. These put out thee hundred fifty lumens (and to my thinking probably require sunglasses...).
The Fennix HP10 is one of the brightest lights you can get on AA batteries, with a two and a half hour runtime, and 225 lumens. It also costs half of the others, at about fifty dollars.