I voted for the first option. For me, I find the convenience of having my knife readily accessible outweighs the ergonomics issue. At work I usually am wearing gloves and I don't like having to dig around in my pocket to find my knife.
Aesthetically I often find them unappealing, but for me it's case of form following function.
Ergonomically, some clips bother me, but only a very little bit and not enough to make me forego the abovementioned convenience.
As far as tip up or tip down, I usually just go with whatever they are from the factory. Not a big deal for me.
Jesus said, "I am the way, the truth, and the life: no man cometh unto the Father, but by me." (John 14:6)