Call me old-fashioned, but above MSA with a VOR radial display and DME? Why on earth do I need a 'prescribed track'?
I think there are different issues here. It would be nice to think that pilots are capable of flying from point to point with reasonable accuracy without track guidance.
But that doesn't mean that it's acceptable to design procedures that require mental gymnastics. Your "but above MSA" rider suggests that you wouldn't bet your life on accurate dead reckoning with terrain and obstacles poking up through your level -- and quite right too!
There was a feeling around the time of the AA Cali accident that the crew were a little too comfortable with the idea of flying from point to point on direct tracks, because in the environment they were used to operating in, such directs were usually above the MSA. In the case of the track to their final waypoint, it wasn't!
So I agree strongly with Zeffy. Although pilots shouldn't need to be PANS-OPS experts to fly, a little awareness of the way the approach should be constructed is a good thing.