In-tank medications that are reef safe don't work. Your next best option, is to just save the money, and keep your fishes well fed. The reason that people believe that every tank has ich and it's just dormant is because most tanks do and it usually is.
Healthy fishes are able to usually fend off too heavy of an infection, so they're not usually scratching or having bumps everywhere or dying. But if they get stressed, then those things can and do happen. Because the ich is still there.
Best in-tank treatment? Feed well and a varied diet.
^^ This coincides with my experience.
And after reading up on research on acquired immunity I also understand why.
I also think acquired immunity is the real mechanism that leads to all the claims of "successful" in tank treatments with "reef safe" medications or herbal remedies like garlic. The fish simply beat it on their own, often because the fish that caused the outbreak died or the stressor was only temporary like with a newly introduced fish that at first caused some unrest but ten settled in.
In those cases ich would also have disappeared if nothing was done.
But usually, if used, the "reef safe" medication is believed to have worked.
This also explains why the results with these things are so inconsistent and not repeatable under controlled conditions.
I had a light ich outbreak after I combined fish from 3 different systems. It was a flare-up that went away by itself over the course of roughly a month. I didn't intervene because I saw that the infection was decreasing - each new wave was weaker than the previous and some fish ever only showed symptoms during the first 2 waves. And none of the fish ever acted sick or severely bothered.
Now 4 months later there is no sign of it anymore.
Healthy and fit fish can and often enough will acquire immunity against ich (and other protozoan, viral or bacterial) infections.
I'm also quite confident that ich will eventually die out in a system where all fish have acquired immunity or natural resistance. The parasites will simply killed off when trying to attach to an immunized fish.
But the key to this is proper nutrition, decent water quality and a low stress environment.