LOL.. my opinion is that quilting has advanced only as far as YOU want to advance it..
No rules say you have to use rotary cutters, machines or anything else. I still cut templates.. draw them onto fabric and cut them out with scissors.. then stitch together with a needle and thread. I also use rotary cutter, mat and electric machine on others. It is just more variety.. and more options.. and therefore open the avocation (it's more than a hobby for me) to more folks.. also with my RA the "machines" make it so that I can still "play" when I'm having a flare.