Yeah, maybe for the most part it's a phrase I tack onto a Hello... how you doing? And in most those cases I'm not real interested just something I ask in passing. But I live in a senior apt complex and seniors will tell you EVERYthing that's wrong with them. So I really can't/don't escape that, and I end up listening to what they have to say.

But there are special people and close family that I truly do want to know how they are doing because they are important to me and I care for their well being and I do not ask it frivolously.

"how's it goin'?", to which i often respond with a question: "you really want to know?" - of course, no one will then admit that they don't.
it's a tricky one. if i feel under a lot of pressure - as is the case currently - i just "spill my guts", not even considering that the asker isn't interested. they shouldn't have asked in the first place
on the other hand, i never ask how someone is doing if i am not prepared to hear the answer.

I work in customer service and have grown to hate that question.

When people say "have a nice day" I sometimes say "Thanks, but life has other plans"

Somehow that non question turned into a greeting with ( most of the time) no real meaning to it.
As a kid, I was around other children less than most are, so I didn't get the intense, social indoctrination that they did,, hence I answer "how I am" without thinking, mostly.
Hey, they don't want to know, next time they won't ask!

So what would be better to say or ask when greeting someone? Did you take a good shit today?

Listening and watching and occasionally braving the wind storm in toronto

Sometimes people just talk for the fun of it.