What people don't understand is that modern medicine is not centered around the practitioners but around precise guidelines that are both medically and legally binding. When I say that you're out of luck, it's not to spite anyone. If a competent clinician specialist examined a case and sees no way out, going to the big fish professor will not benefit you otherwise than maybe entering a study, because from a reasonable clinical pov there are really many conditions for which we can only offer support.
So sometimes, no one "can". But clinicians are not expected to use creative thinking, and that's the very best medical evolution since the past century. It's the job of researchers to read science papers and formulate the guidelines to be transmitted to clinicians. You REALLY should not be doing that all by yourself as a practitioner.
I think you're right that most doctors don't do research, but doctors publish papers all the time. if I look at a surgery journal I'll see articles by surgeons. my doctor isn't like, in the lab running tissue assays, but he'll try experimental things when no clear-cut treatment exists, see if they succeed or fail, and adjust his practice accordingly.
also, dismissing people with "weird conditions" as "out of luck" is a pretty crappy thing to do. I can understand not having enough time or background to handle those cases, but I sure hope you're referring those people to someone who can rather than giving up on your patients because you can't be bothered.