This has pretty much been my experience. I went to one because I didn't know where else to start. They actually gave me a dose the day I walked in, without even waiting for labs--I'm not complaining but it doesn't sound like standard practice to me.
First I had to convince the doc that I didn't want cream or gel. Then I had to convince him that I wasn't willing to come in for weekly injections and could handle it at home. Then I had to convince him that 46pg/ml was too high for Estradiol and I needed an AI. I never managed to convince him on HCG, even after complaining about significant atrophy and testicular ache, but I obtained it myself...
I only get followup labs when I request them. Otherwise, they are perfectly happy to keep giving me T and take my cash. The cost has been reasonable (I'm paying out of pocket since I didn't have insurance when I started) but I now have insurance and I am looking for another doc.
They've been OK overall I guess, but as outlined above I have had to really advocate for the protocol I want. Maybe this is the case everywhere...but overall I couldn't recommend them to a friend.