It's a delicate balancing act. I've lost many fish in QT. I've had a host of bad suppliers in the past until I found a store out of town and started using reputable on-line resources. Many times, in the past, I'd purchase a fish, acclimate it to my QT tank, and wake up in the morning to find it covered with ich. Some survive, some don't. I have several QT tanks ranging from 10 gallons up to 75 gallons. Some of them with LR, some with sand, and some with only pvc. Some I keep up and running, some I stand up when I need them.
I like to do an observation period before I start treating fish to see what their symptoms are (if any), get them eating, and give them a time to rest before I start with the medications...
Don't get me wrong. At times, I will get a new fish in, and acclimate it to one of my QT tanks and everything goes well, and they will make it all of the way through my QT regimen, and get to join the others in my DT...
It does get frustrating at times dealing with QT, but it's even more frustrating for me to consider removing all 300 pounds of LR from my DT, tearing apart all of my coral that have grown over many rocks, removing my fish, treating all of them while my tank sits fallow, etc, etc, etc....
At the end of the day, I consider it worth it when I sit back and enjoy my disease free DT. It's worth the trouble to keep from introducing a diseased fish into my DT where I have more thousands of dollars than I like to think about invested in. Don't want to risk destroying my DT over a $50-$300 dollar fish...
I will admit my QT practices aren't absolutely perfect. I really need to step up my QT game for inverts...