i wouldn't say you must use it, however i see no reason why you shouldn't if you want to. yes some decent water changes will also sort it.
and i don't think that's really an appropriate comparison, when we take medications they go straight into our body, they're not injected into the atmosphere around us for us to take in gradually.
also when you treat a tank you may only have 1 sick fish in it, and exposure to medications unnescesarily for the healthy fish can lead to them building up a resistance and then it could be harder for you to treat diseases in the future. obviously using a hospital tank and just treating ill fish will help this but a lot of people don't have hospital tanks and will treat they're whole tanks.
So if you do add medications i think it's important to remove them as soon as they are no longer needed, carbon can help with this so I see no problem with encouraging people to use it.