I don't really believe that. The real issue is that basic science in medicine is hard. You can't test a human in ways that might cause harm, which really limits

I don't really believe that. The real issue is that basic science in medicine is hard. You can't test a human in ways that might cause harm, which really limits how much investigation we can do. Ethics and morals also restrict what can be done to animals to investigate the basics on them too, though admittedly a lot of the time things just don't carry over anyway. That being said, I think the rise of "evidence-based" medicine is also causing issues. It gets used as a cop-out to avoid thinking about the mechanics of what is actually happening in an injury. While this is certainly a good things for treatments where A or B superiority is uncertain, there's a lot of cases where I think an RCT just doesn't really make sense. A pet example: I broke my ankle recently, and this dug into the literature and common practice. A significant number of people will get end-stage arthritis a few years after "simple" ankle fractures and often the doctors have no idea why. At the same time, an important part of ankle anatomy is often left unfixed (the deltoid ligament) because a few studies back in the 80s found it wasn't necessary to fix it. The bone that serves an equivalent purpose IS fixed (if broken) though. Mechanically, they restrict the ankle joint and prevent it moving in certain directions. When presented with biomechanical reasons for fixing it, and concurrent common poor outcomes for some patients, I've seen the response from surgeons thusly - "it's not supported by evidence" presumably because there isn't an RCT demonstrating definitive superiority. So much of medicine and treatment is literally just hearsay and whatever your surgeon happened to read last week. As a whole the standard is rising, but so much research is so disjoint, disorganised and inconsistent that doctors often have no definitive guidance. It's probably more of a problem in some fields (like ortho) than others, but its still surprising when you see it yourself.