Physician, anesthesiologist speaking. Intravenous phenylephrine widely used, effective. No good in stomach.

Doctors struggle to harness all the historic use and evidence for treatments, sometimes based on great evidence. Often evidence is the best that can be had given available resources.

Drug companies hiding data (derived from volunteers and patients) is wrong, and a problem. Selective publishing of only positive findings in medical journals is common. Careers depend on publications. But despite these pressures, most doctors think hard about these issues, and do their truthful best for the patient in front of them, given the imperfect knowledge available.

OTC labeling is deceptive at best. Placebo only works for a few things.