You should also keep in mind that the "diagnosis" of an ear infection is often half assed / made up, mostly because it's much easier to prescribe an antibiotic

You should also keep in mind that the "diagnosis" of an ear infection is often half assed / made up, mostly because it's much easier to prescribe an antibiotic (which satisfies most frustrated parents) than stop your busy clinic / urgent care / ED to explain why antibiotics aren't indicated (and then deal with the fallout of a complaint or negative review). In contrast, it's pretty difficult to prove that an ear infection was not present at the time of evaluation. The assessment is highly subjective, can be really difficult to thoroughly assess in young kids, and generally doesn't leave any hard evidence to review or critique. Nearly all of the bad incentives align to pressure providers to just diagnose an ear infection and prescribe the antibiotic and move on with their busy shift.