I believe a $3 [sic] pleated cotton filter is all that is ever needed to keep a system running top notch. A cleaning of the blower squirrel cage and of the evaporator [indoor] coil may be needed one time if fiberglass or no filters have been previously used. The return air grille [or grilles] need vacuumed off occasionally, as they are upstream from the filter. The $3 filter should be changed every 3 months [rule of thumb]....and most of them have a little white square on the cardboard frame to write install date.....and the arrow should point into the duct [if at filter grille]....or towards the furnace [if in ductwork slot]...or towards the blower [if in blower compartment]. My two cents.....
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.
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.
Duct cleaning has never been shown to actually prevent health problems. Neither do studies conclusively demonstrate that particle (e.g., dust) levels in homes increase because of dirty air ducts. This is because much of the dirt in air ducts adheres to duct surfaces and does not necessarily enter the living space. It is important to keep in mind that dirty air ducts are only one of many possible sources of particles that are present in homes. Pollutants that enter the home both from outdoors and indoor activities such as cooking, cleaning, smoking, or just moving around can cause greater exposure to contaminants than dirty air ducts. Moreover, there is no evidence that a light amount of household dust or other particulate matter in air ducts poses any risk to your health.