Thank you for posting this and thank you to the authors, who were honest enough to actually spell out the fact that the shortsightedness of our field has made sure a generation of physicians will be taken advantage of in the labor market. It is an excellent article, both more eloquent and in some ways more fatalistic than even my own take on things.
Downside on how they pass the buck... maybe they did float the idea of controlling residency slots (they being SCAROP) and hence the antitrust concern arose from them. I find it hard to believe there are anti trust concerns at this time; the projected over supply was published months back, and now people are finally admitting its true. How can be it anti-competitive for a professional society, which uses government money for trainee expenses (not uniformly but medicare pays for many of our slots) to say that we have too many and that this should be restricted? Is everyone so ignorant of the power to insurance companies now? To have a lack of supply dictate prices is completely unimaginable now with the built in work force.
In any event, here is my take;
If you are just thinking of joining this field now, or if you are 2nd-3rd year MS, and you cannot reasonably get into a top 10-15 institution in residency, do not apply.* The caveat being if you have absolutely no care in the world where you end up, or like rural areas (rural does not equal suburb or extended suburbs, rural equals collection hospitals or midwest locations far from St. Louis or Chicago) then you can accept a slot anywhere. If you can get into a top 10-15 residency slot, your job is going to be much worse than your mentors for years, and get used to people telling you to 'adjust your expectations'.
Now that the cat is officially out of the bag, the greedier PP groups are going to pump and dump us for a while, ala the mid to late 90s (ie: offer a 'partnership' track with low initial salary and 2-3 years of proving yourself, and at the end will either find a reason you did not meet the subjectively defined milestones in the contract or up the buy-in to 7 figures [and maybe even offer a higher interest loan from their own LLC to get you on the interest too!!]).
I love what I do- I have been pretty productive in my time, work hard, the people around me seem to be happy with what I have done and so have patients. And I hate every second that I chose this field- because I feel sold out, and because I know no matter how hard I work or even if I make a true advancement, I'm going to have less opportunity and be required to do more work simply because of when I was born and because everyone in the field had their head in the sand, either through passive ignorance that they should have any responsibility to those who come after them, or actively so they could profit off us.
Here's to all of us going into the labor force bloodbath of the next 10 years (and likely beyond... I'm sure there will be more expansion before it gets better).