All of that is true, except they’re not enough of us. Most sub-subspecialists are the only ones at a given institution. The decades of training and dedication is not something that everyone can (or wants) to do. Laws aren’t really helpful here, as obviously you’re not going to let a patient suffer just because there is no one else to handoff too. Of course, that means in the end the physician and their family suffer, but unfortunately that comes with the territory. Mostly people need to understand and have respect and patience for their doctors.