> My expression was there was tension not completely discrete factions, there is clearly some empiricism used in medicine. One of the difficulties in getting published is defending a position and it’s easier to do this with a mechanism of action which I think slows things down too much.

There is always tension between objectives in real-world systems. There are essentially two frontiers in our healthcare system--a core of educated professionals that are conservative and move slowly with ample evidence behind decisions, and a wide range of laymen who are comfortable with personal risk (e.g. bodybuilding community). I have respect for both, and they work together. The core will always have too many false negatives and the horizon group will have too many false positives. Saying the balance right now slows things down too much needs more support as an argument, there will always be things on the roadmap for medicine and there will always be edge cases that can't get addressed perfectly

From what I've seen medical researchers are champing at the bit for new areas of treatment that they think are promising and they just need the smallest amount of convincing evidence to research. If they don't have it for something you think is valuable, collect the information in a systematic way and find someone to send it to.