Well, even though I do totally agree with you that it's BS, I wouldn't press your luck and try to argue for the 20's when you're first starting out on the medication. If she gives you 10's, my advice is to humor her, and try them out. And then when you go to your next appt, that's when you tell her it's not working very well (but only if that's the truth, of course), and see if she will then increase it. Worst case scenario, if she doesn't, you can always see another doctor and the fact that you will have already been prescribed Adderall once before will hugely benefit you and make it much more likely that the new doc will increase the dose for you. Whereas if you argue with her about it, and she looks at it as you're "drug-seeking", and decides to change her mind about giving it to you at all, that wouldn't be good.