If my goal is to feel more focused, that's an inherently subjective thing. If I feel like I'm more focused, I am more focused. So the placebo effect and a more objectively observed result are essentially the same here.

But the end goal is almost never to feel more focused, the end goal is to (say) accomplish a task faster or more accurately. And there are definitely placebo interventions that make people feel like they are doing things better without actually doing anything better.

Likewise, in this case, the end goal is for the surgeons to have a longer career. It's easy to imagine a placebo intervention that makes one feel better, but doesn't actually reduce wear-and-tear on joints, and hence doesn't prolong one's career.

Also, like the other commenter said: placebo effects are often less reliable or generalizable outside the specific context of the study. They may be motivated by, e.g., a subconscious desire to please the experimenter which goes away in real-life circumstances. Actual physiological interventions are much less likely to do this.

Eg, if you can give me a way to achieve some amazing pain relief as a result of placebo, every time, it feels to me like this crosses the line from placebo to medicine.

The mind can do some crazy things, but we need to make it do these things reliably. I don't want a placebo form of anesthesia only to have it not work mis surgery haha. If however you can replace anesthesia with a placebo (purely as an example).. i almost feel like it's real medicine then. A technique to replace chemicals sure, but testable and reliable.