I don't know who tells these clinics to hold doses. Unless it's for a procedure, or you're at a ridiculous number (6 or 7 INR or above) - that just strikes me as a bad idea.
Best thing I've learned is to dose weekly. So if my dose changes, it might be on the order of 1 mg per week, or 2 mg per week and we back into what days we want to change. Right now, for example, I'm taking 5 mg daily, every day except Saturday, when I take 6 mg. If I'm low - I add another 6 mg day (maybe Wednesday for example). If I'm high - I just change Saturday to a 5 and make an extra salad or two.
Very small dosing changes. I'm going from 36mg per week to 37 or 35 per week, depending on the circumstances.
That being said - I do like to keep my daily dose as consistent as possible (I don't like splitting pills). So I get a prescription for 5 mg and a prescription for 1 mg pills and use the 1 mg cumulatively to make any dosing adjustments.