The fact is if they are dirty why not clean them. As for the Dr’s comment about if it is not disrupted it is fine. As a pet owner sometimes un disrupted pet hair will sit in the corner of a room or under a counter un disrupted but I still clean it when I notice it. Just because you cant see it doesn’t mean you should leave it there to collect more and more. The people that don’t want there air ducts clean either simply cant afford it but would like it done. OR! the crowd that are to cheap.. You should Clean all portions of your house.
PickHVAC Tips: Installing the right size central air conditioner is extremely important. Have a load calculation done to ensure proper sizing. ACs that are too big aren’t as energy-efficient as they should be, and they cycle on and off too much. This creates over-cooling and temperature imbalance. Units that are too small run constantly in very hot weather and can’t keep your home cool. When an air conditioner is properly sized, it runs at optimal efficiency and indoor comfort.
The most recognized standards for HVAC design are based on ASHRAE data. The most general of four volumes of the ASHRAE Handbook is Fundamentals; it includes heating and cooling calculations. Each volume of the ASHRAE Handbook is updated every four years. The design professional must consult ASHRAE data for the standards of design and care as the typical building codes provide little to no information on HVAC design practices; codes such as the UMC and IMC do include much detail on installation requirements, however. Other useful reference materials include items from SMACNA, ACGIH, and technical trade journals.
Your HVAC unit and air ducts deliver heated or cooled air throughout your home year-in and year-out. The air your HVAC unit produces travels through your ductwork and heats or cools your home via the air vents in each room. The dust and other particles in your home’s air are known as particulate matter, which the EPA defines as "a complex mixture of extremely small particles and liquid droplets." The EPA also notes that "particle pollution is made up of a number of components, including acids (such as nitrates and sulfates), organic chemicals, metals, and soil or dust particles." Having clean air ducts means fewer of these particles moving through your home. If you remove your furnace filter and hold it up to the light, you can probably see several hundred of these minuscule particles floating in the air. 
Most organizations concerned with duct cleaning, including EPA, NADCA, NAIMA and the Sheet Metal and Air Conditioning Contractors' National Association (SMACNA) do not currently recommend the routine use of sealants to encapsulate contaminants in any type of duct. Instances when the use of sealants to encapsulate the duct surfaces may be appropriate include the repair of damaged fiber glass insulation or when combating fire damage within ducts. Sealants should never be used on wet duct liner, to cover actively growing mold, or to cover debris in the ducts, and should only be applied after cleaning according to NADCA or other appropriate guidelines or standards.

On average, we (Indians in Ontario) receive 3-5 calls per day for duct cleaning services from India. I did get ducts cleaned twice in 25 years. For a newly built house, it should be done as material goes into the ducts. Every year, before turning the heat on, I clean the ducts, using the vacuum pipe or with wet towel. Most of the dust, pet hair, small items get to the ducts from the top floors, not where system is installed. Even in winter months, I open 2-3 windows for air circulation for 15 minutes, specially right after cooking, almost daily. We breath in the same stale air, develop health issues. Also, I have an added air cleaning and fileration system installed. At a low rate, this system constantly cleans the inside air and also that it pulls from the outside. Duct cleaning is a scam, there are other efficient and cost effective methods we can use to purify the inside air.

He proceeded to clean each heat register by removing the grille and blasting it with an air pressure hose toward the duct opening thinking that the dust would magically be sucked inside. In one room this caused a ceiling smoke detector to go off because the excess dust fooled it into thinking there was smoke. I put my hand in front of a register he wasn’t working on and could hardly feel a suction. Although we discussed how I open and close damper doors, I realized later that he never checked, opened or adjusted them during the cleaning. He could have closed all but the one he was working on in order to increase suction results. His next step was to blast air into the duct and then attach a “squid-like” device that slapped around inside the duct as far as he could reach. This is important! In a newer house, ducts have long straight runs from the furnace. In older houses like mine they can turn and twist. In fact, the duct we have a problem with runs straight up from the basement inside a wall and turns 90 degrees into a soffit for three feet then into two 90 degree turns to get into the floor joist area for another two feet and finally a 90 degree turn up to the second floor register. When he cleaned this one he could only get three feet into the register with the hose or squid because of the turns. That was the case with most. Hardly what could be described as a decent cleaning.

Whether you’re starting your air conditioner for the first time this year, or a unit isn’t running properly and you need to service an air conditioner, following a few simple steps can save you time and money. While some service jobs should be left to a professional, there are several do-it-yourself fixes you can do to keep your air conditioner cooling all summer long.
Our Fort Smith, Arkansas area restoration services are available at your convenience. We provide emergency services after devastating property damage and work hard to restore and clean as much of the contents and structure as possible. We'll Work With You and Your Insurance Company to cover costs and expedite the process. If you need cleaning and restoration services or are looking for ways to create a healthier, more efficient environment, contact McMahon's Cleaning & Restoration, LLC to get started.
Heaters are appliances whose purpose is to generate heat (i.e. warmth) for the building. This can be done via central heating. Such a system contains a boiler, furnace, or heat pump to heat water, steam, or air in a central location such as a furnace room in a home, or a mechanical room in a large building. The heat can be transferred by convection, conduction, or radiation.
I hope that those customers you have with breathing problems don't follow your advice too closely. You are doing them a disservice. Dirt in your ducts does not always stay there, depending on what the contaminants are. I bet you tell your customers not to worry about mold either- just to kill it with bleach. Educate yourself before opening your mouth- You may kill someone someday with your opinion.

I'd have to disagree with all of your statements. Not only are they derived from no experience in the field, you are missing keys facts. Ducts even if air tight will get dirty. If they are not getting dirty, it means they are not working. Your returns side of the duct work is always under negative pressure when the system is operational.Therefore it is always drawing air in. Seeing how dust is made up mostly from dead skin humans shed daily. Around 1.6 Pounds of skin a year per human. Living in your home anything that is air born will be drawn back towards the cold air returns. That is what they are designed for, to draw stale air back to the system to be filtered and sent back through the house.Homes with carpet will actually have cleaner duct work than home with all tile or hardwood. This is because carpets hold onto dust particles and you vacuum them up. Whereas on hardwood or tile, dust can run freely back to the returns. Even if a duct system was sealed 100%, which is next to impossible to achieve 100% would still need to be cleaned. The cleaning may only have to be every 7-10 years for example. Most homes require every 5-7 years. And that's if it was done properly the first time. If you constantly hire people that have no or minimal knowledge of duct cleaning, You home would require cleaning more often. Every 2 years. That's a trade secret, The longer they recommend before the next cleaning, the odds are they did it right. That's not to say there aren't people that lie, because there are. Just have your duct cleaner take pictures before and after cleaning. Not just an outside view. Get in there, picture entire joist liners, Whole main runs and even long round pipes. Also it helps to have a company that guarantees their work. If it's not done right, they will come back and do it until it is. Most companies that do this make sure it is right the first time. Your not getting paid to do the job twice.
The HVAC installation costs below are based on residential installations only, and are priced for a single unit. Two units should be about twice the price. “Tim, shouldn’t there be a discount?” If people start giving you discounts, they are probably charging you too much to begin with.  That’s our philosophy anyway. Twice the parts and time should be twice the price from a fair contractor. The prices listed include component parts (with warranty), labor, and all materials for a complete HVAC installation.
Ventilating or ventilation (the V in HVAC) is the process of exchanging or replacing air in any space to provide high indoor air quality which involves temperature control, oxygen replenishment, and removal of moisture, odors, smoke, heat, dust, airborne bacteria, carbon dioxide, and other gases. Ventilation removes unpleasant smells and excessive moisture, introduces outside air, keeps interior building air circulating, and prevents stagnation of the interior air.
A little simple math can help determine the size system you need. A rule of thumb is 20 BTUs per square foot. So, a 500 square foot room would need 10,000 BTUs to cool or warm it efficiently. This assumes that you live in a temperate region and have adequate insulation with no energy loss. In the real world, all units have some degree of energy loss. This is reflected in an HVAC system's SEER rating for cooling and AFUE rating for heating.

In some older homes, there was a grey Mylar flexible duct. After years of use, it started to decompose. A duct cleaning company can come out and find why your air is so dirty and why your building doesn’t heat or cool like it used to. This is a savings on your part. You could also be sucking in Hot, dirty attic air. However, sometimes when a duct cleaning company comes out to clean it, the old duct can be destroyed and have to be replaced. Someone with little experience can replace this ductwork but if it isn’t done right it can ruin a lot of things and cost a lot in repairs.

Most people are now aware that indoor air pollution is an issue of growing concern and increased visibility. Many companies are marketing products and services intended to improve the quality of your indoor air. You have probably seen an advertisement, received a coupon in the mail, or been approached directly by a company offering to clean your air ducts as a means of improving your home's indoor air quality. These services typically — but not always — range in cost from $450 to $1,000 per heating and cooling system, depending on:

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