Also it’s important to understand the context that medicine wasn’t originally “scientific “ for all the reasons you are touching on.
Historically treatments were based on some theory of how the body works, and a plausible intervention either based job that model, or based on tradition and anecdotal experience.
As people tried to implement more empiricism it hits all the difficulties you mention and others ... it’s an extremely difficult ugly challenge.
We should have lots of medical reversals. It means we are slowly getting better. Probably things could move faster if there was some giant anonymized database of every patient treatment, with documentation of symptoms, intervention, and outcome.
There are so many reasons why that is impractical, I’m astonished we are making the progress we are.
Historically treatments were based on some theory of how the body works, and a plausible intervention either based job that model, or based on tradition and anecdotal experience.
As people tried to implement more empiricism it hits all the difficulties you mention and others ... it’s an extremely difficult ugly challenge.
We should have lots of medical reversals. It means we are slowly getting better. Probably things could move faster if there was some giant anonymized database of every patient treatment, with documentation of symptoms, intervention, and outcome.
There are so many reasons why that is impractical, I’m astonished we are making the progress we are.