Proper fit is important. Whether it is really the millimetric science that some of its practitioners would have us believe is debatable, but I certainly respect the technicians who have invested in equipment and training to be able to set up an athlete on a bicycle with enough precision and confidence to put that worry out of the athlete's mind. Make room for other concerns, like nutrition, training schedule and whether to start doping.
The thing about fitters is that they seem to care only about the position of the rider on the bike, not about the function of the bike itself. For instance, when one of them reconfigured a Surly Pacer I had set up for a customer who wanted a bad-weather version of her triathlon bike, he put a very steep-rise, short stem on it when converting it to the drop-bar road riding position from the aero-bar position I had set up to duplicate her tri bike exactly. I had even used the cast-off bar and stem from her tri bike. I'd made a finely-calculated effort to replicate her riding position and she had been pleased with the result. But then when she wanted to change the bike over to a different use she decided to use some shop credit at Fits R Us. I'm all about saving a buck, but damn. Fits R Us put on a stem that wrecks the handling of the bike. When I test rode it recently after some adjustments it was horribly squirrelly. It may put my friend in the perfect biomechanical position on a trainer, but it really stinks when actually riding.
I haven't told my friend because she doesn't mind it. But if I had been doing the fit I would have used a fork with a longer steerer so I could put the bars higher without using either a steep-rise stem or one of those ugly bolted-on stem risers.
At least the handling of this bike proves my theory about the effect of stem angle on bike handling. The connection points of rider to bike are not just points in space. The shape of the linkages matters.
The problem may not be fitters in general, it may be Fits R Us in particular. I have worked on bikes fitted by other practitioners, but in many cases the riders fall into a size range that requires no radical component choices.
A fitter will adapt a rider's bike to the human form without questioning the materials used in its construction, just as a tailor could fit you to an immaculately fitted tissue paper suit. It would be an ephemeral piece of rubbish, but you would look great in it while it lasted. When it comes to stupid design elements like 4 mm shift housing and head-tube cable stops, the fitters have nothing to say about it. Brifters that choke on a broken shift cable are fine with them, too. They'll make sure that the hard, narrow seat with carbon shell, titanium rails and a covering of endangered condor hide ($589.95 and free freight) is at the perfect height and angle. The carbon-fiber bar and stem, the 17-speed electronic shift controls and hydraulic brake levers will sit in the exact position for ultimate performance.
When faced with anyone who has developed Position Neurosis I send them to a professional fitter. I just don't have the showmanship to sound thoroughly convincing to a rider who needs the perfect combination of medical science and psychobabble to be able to put their fear of bad bike fit behind them. I'm glad someone is willing to