Keep in mind that the timeline from medical research being published to entering practice can sometimes be measured in decades, and causal inference is swimming

Keep in mind that the timeline from medical research being published to entering practice can sometimes be measured in decades, and causal inference is swimming against the RCT-heavy currents of medical research. Several journals I publish in, for example, expressly forbid causal language for non-RCTs (much to my consternation as a mathematical modeler). Many of the tools of causal inference were also relatively inaccessible until fairly recently. I'd argue that the potential outcomes frameworks are really useful from a philosophical standpoint in teaching students, and things like the target trial framework has been doing useful work in conceptualizing observational studies in the context of a hypothetical trial (and recognizing that trials are themselves essentially a special case of cohort studies). The major source of potential is the places where you can't ethically randomize interventions, yet still need to produce evidence.