A Consulting Axiom


I’ve been downgraded from an ear infection to a “full-blown” ear infection. Last week, the doctor at walk-in urgent care gave me an Amoxicillin prescription and told me to come back if the symptoms didn’t improve in four or five days.


They didn’t, but I went to a different walk-in clinic this afternoon to work a second opinion into the process. The doctor gave me a prescription for Levaquin to replace the Amoxicillin.

I know, nobody cares about this. I only mention it because it reminded me of something important.

I was a consultant for many years and I’m going to share with you now one of the axioms of consulting:

Whatever the client is doing, advise them to do something else.

If whatever they’ve been doing was working, they wouldn’t need a consultant, right?

Is Levaquin “better” than Amoxicillin for ear infections? No, but you see what I’m getting at.

  3 comments for “A Consulting Axiom

  1. MS
    30 Dec 2008 at 11:01 am

    Levaquin IS a little better than Amoxicillin, but it is also newer and much more expensive, like $10-$11 a day vs. about $1 a day for the older drug. The chances of Amoxicillin working are slightly less than Levaquin, so most doctors will prescribe the less expensive drug because it will work in most cases just as well as the newer, more expensive drug will. In the cases where Amoxicillin doesn’t work (like yours), the doctor is more likely to prescribe the Levaquin the second time around because the failure rate is lower than the Amoxicillin.

    Your consulting axiom is still valid though, even though your drug comparison analogy is a little off.

  2. PE
    30 Dec 2008 at 5:18 pm

    Hi MS –

    You want to hear something funny? The doctor gave me a $15 coupon for the Levaquin! I’ve never had a doctor give me a coupon for a prescription! So $25 brand name copay minus $15 equals $10. I’m getting a good deal here!

    That’s assuming it works …

  3. MS
    30 Dec 2008 at 8:22 pm

    You’re lucky. That $25 co-pay means the full price is probably $135 or so. I had a prescription for allergy meds that my insurance wouldn’t pay for at all, because they felt there was a generic equivalent in another drug, and I had to pay about $135 for 30.

    The pharmacist told me to use my AAA card to get a discount, and it knocked it down to about $98 instead. Now there really is a generic equivalent, so the insurance will pay for it, and it’s like $5 or $10 only now.

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