I think the pattern also depends on the purpose of the quilt. Is it to just cover the top of the bed as a pretty extra cover, or is it going to be an entire bedspread? Recently, it seems that people are making quilts as bedspreads and not just as a topper cover.
I am guilty of this. I make queen-sized quilts with overhangs and 10" tucks for the pillows because that's how my family wants to use the ones I make for them. So that requires a lot of extra blocks.
I find that square patterns or medallion patterns are hard to add on to in order to make them rectangles for queen-size quilts.