Makes the game feel like more than just Oblivion/Skyrim with guns.
Been playing a Pistol build recently and they perform 100x better with VATS spam, even if you have god like real-time aim. I stay in vats 99% of the time and I actually kinda feels like I'm playing the classic Fallouts in a really weird 3rd person way lol. I never felt this way with FO3 or even NV, as far as combat goes.