You're correct that handoffs are a common point-of-failure, and also that residency programs are already near the tipping point of financial non-viability for the non-wealthy.
However, to your last point:
> (btw, w/r/t/ shortages, it is probably due to the doctors themselves -- specialty boards such as the Board of Radiology essentially throttle the number of available training positions (residencies) per year creating artificial scarcity and keeping up their own pay.)
The actual bottleneck on residency positions is not artificially imposed by any external group - the bottleneck is the funding for residency positions themselves. Residency programs run at a loss, which is why Medicare has had to step in to fund GME. There are a very small number of non-Medicare funded residency slots, but they're also funded through external means.
However, to your last point:
> (btw, w/r/t/ shortages, it is probably due to the doctors themselves -- specialty boards such as the Board of Radiology essentially throttle the number of available training positions (residencies) per year creating artificial scarcity and keeping up their own pay.)
The actual bottleneck on residency positions is not artificially imposed by any external group - the bottleneck is the funding for residency positions themselves. Residency programs run at a loss, which is why Medicare has had to step in to fund GME. There are a very small number of non-Medicare funded residency slots, but they're also funded through external means.