The Wagon Has WiFi
The AI consulting boom is a 120-year-old con with a new coat of paint. Here’s how to read the bottle.
I recently watched an organizational leader I know speak at an event about AI. This person is smart. They are a compelling speaker. They know their sector cold. But an AI expert they are not—not even close. They aren’t even an experimenter, really. And yet there they were, holding forth on AI strategy as if just standing near the conversation somehow made them the expert.
I’m not trying to be mean—I’m saying this because I’ve seen it happen five times since. And I bet you have, too.
Something is happening across every sector right now that has a precise historical parallel, and the parallel should worry you. We are living through a replay of the patent medicine era. The technology is different—the human dynamics are identical.
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The Wagon Rolls In
For over a hundred years, traveling salesmen zigzagged across the country selling bottled “miracles,” dietary regimens, and pseudo-scientific cures for everything from tuberculosis to infertility. These weren’t just guys with wagons; they were sophisticated operations.
A typical show would roll into town, set up in the square, and open with entertainment. Music, comedy, magic tricks—a full variety act. The show drew the crowd. The crowd got comfortable. And then the “doctor” would take the stage.
The pitches were good. They had to be. These were people whose income depended entirely on their ability to make you believe, in the span of an hour, that they had the answer to your most urgent problem.
Some of what they sold was harmless—sugar water and herbal tinctures. Some of it was not. Many patent medicines contained alcohol, opium, cocaine, or mercury. The Kickapoo Indian Medicine Company ran dozens of simultaneous touring shows, selling “Kickapoo Indian Sagwa” as a cure-all. The name itself was a calculated move—it borrowed the perceived authenticity of Indigenous healing traditions and attached it to a product that had nothing to do with them.
This worked for over a century. Not because Americans were stupid—but because the conditions were perfect.
The Five Conditions
Here is what made the patent medicine era possible, and here is why the current AI consulting boom feels so familiar.
The knowledge asymmetry. Back then, how was a regular person supposed to vet a medical claim? They couldn’t. They didn’t have the data or the training to tell the difference between a real doctor and a good actor. Today, most organizational leaders are being asked to buy a jet engine based on the salesperson’s ability to describe the clouds. They can’t tell the difference between someone who has built production systems and someone who has built slide decks. The vocabulary is the same. The confidence is the same. The results are not.
The demand-side desperation. Rural Americans had real health problems and almost no access to real physicians. That gap created the market. Today, leaders across nonprofits, education, and local government have urgent operational questions about AI. The pressure is institutional. And the supply of people who can answer those questions with genuine, contextualized expertise is far smaller than the supply of people claiming to. When you are desperate and the wagon shows up, you don’t demand credentials—you buy a bottle.
The borrowed authority play. Kickapoo slapped an Indigenous name on sugar water. Today’s version is the consultant who name-drops partnerships with AI labs or leans on a job title at a recognizable company that they held for less than a year. Duration of experience is not depth of experience, but from the outside, they are nearly impossible to distinguish. The market rewards the signal, not the substance.
The cure-all pitch. Patent medicines claimed to fix everything—lungs, liver, joints, and disposition. The AI consulting equivalent is the vendor who tells you that AI will solve your revenue problem, your workflow problem, and your staffing problem all through one engagement. Anyone who has actually implemented this technology knows it is specific, iterative, and deeply context-dependent. If someone is selling you transformation in a box, you are looking at Sagwa.
The regulation vacuum. There was no FDA until 1906. There was no requirement to prove a health claim before making it. Today, there is no credentialing body for AI consultants—no license to revoke, no professional standard, no malpractice. The market is entirely self-policing, which means it is not policed at all.
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The Variety Show Never Ended
The medicine show didn’t lead with the sales pitch. It led with entertainment. You had to build the crowd before you could sell to it. The modern equivalent is LinkedIn—or more precisely, the “thought leadership” industrial complex that now runs on it.
Daily posts. Hot takes. Carousel decks with titles like “5 AI Prompts That Will 10x Your Nonprofit.” These are the variety act. The content builds the audience; the audience builds the authority; the authority converts to consulting revenue. It is the same funnel—just faster and with better distribution.
And just like the original medicine shows, most of it is optimized for performance rather than accuracy. The algorithm rewards the pitch, not the medicine.
Here is the part that should make you uncomfortable: much of this content is itself generated by AI. The tools being sold are producing the marketing that sells the tools. The medicine show is now powered by the medicine. A person with no implementation experience can use ChatGPT to produce a carousel deck that looks indistinguishable from one created by an expert. That is a new wrinkle the original patent medicine salesmen would have envied. They at least had to mix the Sagwa themselves.
Know a leader who’s about to sign an AI consulting contract? Send them this piece. It might save them from buying Sagwa.
How It Ended Last Time
What killed the patent medicine era was not better medicine shows—it was journalism and institutional action.
In 1905, Samuel Hopkins Adams published The Great American Fraud. He didn’t just play whack-a-mole with individual products—he tore down the whole system. He gave people a way to actually judge what they were buying. It helped lead to the 1906 Pure Food and Drug Act, which basically just forced people to stop lying on their labels.
Adams wasn’t telling people to stop being sick; he was giving them a fighting chance. He gave them diagnostic tools and pushed for structural accountability. The Act didn’t ban medicine—it just required that the label match the contents.
Reading the Label
We don’t have a Pure Food and Drug Act for AI consulting. We probably won’t get one. But the honest labeling principle still works for any leader willing to apply it. Before you sign an AI consulting engagement, ask these five questions:
Can they show you implementation work? Not a strategy deck—actual systems they built, in actual organizations, that are still running. If the portfolio is all keynotes and frameworks, you are buying Sagwa.
Can they name what AI will not solve? Anyone selling you certainty across the board is performing, not advising. Real expertise comes with boundaries.
Are they building your internal capacity or your dependency on them? The best consultants build you a bridge; the worst ones just build themselves a toll booth. If they can’t tell you exactly what your team will be able to do without them in six months, they aren’t there to help—they’re there to extract.
What is their actual, specific experience with your sector? AI implementation in a newsroom is not the same as implementation in a bank. Someone who has worked across no sectors but speaks confidently about all of them is a red flag.
Will they admit what they don’t know? This is the ultimate tell. In a field moving this fast, anyone claiming they’ve mastered the whole thing is either lying or delusional. That bit of uncertainty isn’t a weakness—it’s the only way you know you’re talking to a human being and not a script.
Have you encountered the AI medicine show in your sector? I’d love to hear it. Drop your story in the comments—the more specific, the more useful to other readers.
The Burden Is on You
The patent medicine era didn’t end because consumers got smarter. It ended because institutions built the infrastructure to protect people from having to be experts in everything. We haven’t built that infrastructure for AI yet—not for your local school board, your favorite nonprofit, or your city hall.
So, for now? The burden is on you.
But here’s the thing: you don’t actually have to become an AI genius to protect your organization. You just have to learn how to read the bottle. The medicine shows ended when people stopped buying what they couldn’t verify. That lesson is 120 years old—and it still works.
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