Ask Lemmy
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Even the nurses ask that in an office where a majority of patients have crippling, often painful disabilities. lmao. Can't escape it. I just mentally replace it with "hi" in my head and respond "decent, thanks" ("hello"). Or if I'm really struggling, I leave off the thanks.
I treat it as a real question in medical settings. In some cases it can be helpful information for a provider. Even in the worst case it says "I'm not here for pleasantries, I got problems and I'm here to address them".
It's so ingrained in conversational habits. I find myself really struggling for a greeting when I visit someone who I know is struggling or in pain. Like, I don't want to force them to think about how they're doing. But then I also don't know what else goes after that initial "Hey". v_v
Even as someone who's often bothered by the question, I'm fairly guilty of asking it myself, you're right that there's no escape.
My grandfather is quite ill, and his usual response is "as well as can be expected"