I tend to set it and forget it. There are a few exceptions though.
For heat, I have foot well vents open, since heat rises. I also like vents on my hands because my hands are icy cold in the winter.
For AC, I like having the top vents blow around my head and upwards, because cool air sinks.
These are the most efficient settings to condition the cabin.
However, there are times where I'm already super hot, and I want the AC to blow right on my face. And when I'm comfy again, I'll want to point them back to where I usually point them. In general, I might adjust a vent between once a week or once a month.
My view on the screen is that we choose when we allow ourselves to be distracted by it. Evaluate whether your current driving situation allows you a bit of distraction first. I have shut up in mid sentence when I needed to focus 100% on the driving situation. Same deal with the screen. Don't engage it if you're approaching a tricky intersection or need to switch lanes on a freeway.
In practice, now having driven the Model 3 for 2 months, I can say that for me, I barely need to use the screen. I'm never constantly fiddling with it or digging thru menus. It's just not necessary.
So take reviews of screen distraction with a grain of salt. Chances are, most of us are already way more distracted on our phones than this screen will ever be.