Bob,
I'm reminded of the plumbing story where a plumber was called in to fix a clogged drain. The plumber sized up the situation, hammered on the pipe, and suddenly the drain was running free. The client was given a bill for $100. The client asked the plumber for an itemized bill. The plumber quickly produced it, hammering the pipe, $1, knowing where to hammer, $99.
We all often forget what's required to know how to do something that looks easy to do. If we know what's wrong, 99% of the battle has been won, in most cases we could do the job ourselves. Trusting in Doctors to fix us is much like paying a plumber to fix a drain, you're trusting the Dr. to know what he's doing.
The same sort of trust needs to be established between drug developers and the regulators, but greed gets in the way. Trials are as intense as they are because drug developers have spent millions in trying to hide flaws that have been seen in their products. Personally I'd like to see trials simplified, but all approved products put on Phase 4 where all outcomes from product usage would be reported. I believe it would allow greater verification of the effectiveness of products while reducing the cost and time it takes to develop them.
Gary