Manufacturers of products marketed to coat and encapsulate duct surfaces claim that these sealants prevent dust and dirt particles inside air ducts from being released into the air. As with biocides, a sealant is often applied by spraying it into the operating duct system. Laboratory tests indicate that materials introduced in this manner tend not to completely coat the duct surface. Application of sealants may also affect the acoustical (noise) and fire retarding characteristics of fiber glass lined or constructed ducts and may invalidate the manufacturer's warranty.
Although it intuitively makes sense to clean ductwork — after all, you dust and clean the rest of your house — the fact is dust that settles in your ventilation system generally stays where it is, unlikely to become airborne unless disturbed. Under most circumstances, the dust is inert and harmless, and stirring it up with cleaning equipment actually creates bigger issues.

If not properly installed, maintained and operated, these components may become contaminated with particles of dust, pollen or other debris. If moisture is present, the potential for microbiological growth (e.g., mold) is increased and spores from such growth may be released into the home's living space. Some of these contaminants may cause allergic reactions or other symptoms in people if they are exposed to them. If you decide to have your heating and cooling system cleaned, it is important to make sure the service provider agrees to clean all components of the system and is qualified to do so. Failure to clean a component of a contaminated system can result in re-contamination of the entire system, thus negating any potential benefits. Methods of duct cleaning vary, although standards have been established by industry associations concerned with air duct cleaning. Typically, a service provider will use specialized tools to dislodge dirt and other debris in ducts, then vacuum them out with a high-powered vacuum cleaner.

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.
If you suspect a mold problem — either because of visible growth or a musty smell consistently coming from supply vents — cleaning ducts won’t do much good if it doesn’t eliminate the mold. Mold begins with a moisture problem, and the ducts themselves are unlikely to be the source. The most likely culprits are the cooling system’s evaporator coils, which your heating and air-conditioning contractor — and most duct-cleaning companies — can inspect and maintain. Leaky return ducts can also introduce moisture. Again, if you suspect a mold problem, consider having a service company inspect the duct system for leaks.
Duct cleaning generally refers to the cleaning of various heating and cooling system components of forced air systems, including the supply and return air ducts and registers, grilles and diffusers, heat exchangers heating and cooling coils, condensate drain pans (drip pans), fan motor and fan housing, and the air handling unit housing (See diagram).