Economics and medicine

I am reading Complications by surgeon and writer Atul Gawande - very interesting! The subtitle is: "A surgeon's Notes On An Imperfect Science."

Some parts of the text (I have read only a few pages, but it is excellent):

In surgery, as in anything else, skill and confidence are learned through experience -- haltingly and humiliatingly. Like the tennis player and the oboist and the guy who fixes hard drives, we need practice to get good at what we do. There is one difference in medicine, though: it is people we practice upon. P. 18.

Surgeons, as a group, adhere to a curious egalitarianism. They believe in practice, not talent. P. 19.

Conscious learning becomes unconscious knowledge, and you cannot say precisely how. P. 21  

Studies generally find teaching hospitals have better outcomes than non-teaching hospitals. P. 24

Why economics is not more like medicine (or surgery)?

For an applied micro-economist patients could probably be small, medium, or large businesses that might need some help with costs, pricing, etc. Why aren't those services, call them consulting or businesses health-care, more common as something economists do on a regular basis? Some possible answers:

1) There isn't an effective demand for those services. Perhaps businesses don't see the need of economics because it could be too expensive and they simply can not afford that. 

2) There is no much value economics can add to a business from a micro-economics perspective, real world is so messy that abstract micro-models simply do not apply. 

3) Economists are already doing it (consulting firms) but only the very fortunate few serve the demand. 

4) Other professionals are already doing that instead of economists, such as DBAs, MBAs, etc.

5) In areas like macroeconomics the market is more limited than it is for micro. Only economics super-stars are called by governments. 

6) There is no need for that, economics is a totally different field. 

7) Economics can add a lot of value to businesses and that is why business hire them as part of the internal staff. No need for them to deal with professors and external researchers. 

8) Economists don't like to go out there . . . 

Of course, thinking of economics as medicine would lead us to think about what economics really is or should be. But imagine re-writing the quote above by Gawande as follows:

In economics, as in anything else, skill and confidence are learned through experience -- haltingly and humiliatingly. Like the tennis player and the oboist and the guy who fixes hard drives, we need practice to get good at what we do. There is one difference in economics, though: it is real businesses [or insert your favorite real-world entity here] we practice upon. P. 18.

Some development economists are becoming more like medical doctors with the use of randomized control trials, and they look at what interventions or prescriptions work better than others, or don't work at all to improve human well being. That is great! But I am thinking here in something else, the direct contact of the economist and the business (the patient).