I can't speak for him, but in my mind, it doesn't help enough. At least not enough to use a built-in. I personally would rather just not take the shot. Yeah, I might use it for a snapshot or if I need to take a photo of something for e-Bay, but not if I want to create an image that I care about.
I think that's a fair statement, Mark. I often assume things that I shouldn't when I respond to people.
I'll try to explain myself a little better for those that were worried about my statement.
Diffusion itself doesn't soften light. Light becomes softer when it is larger in size relative to the subject. Think of the difference between a sunny day outdoors and an overcast one. On the sunny day you have a point light source - the sun - making hard light with hard shadows. On an overcast day you have the overcast sky lit by the sun which in turns lights the subject. Now the light source is huge, the light is soft and so are shadows, if they exist at all.
In a photo studio we create soft light by shooting our lights through a big soft box or we bounce it from an umbrella to make it bigger relative to the subject. How soft it is depends on the relative size of the two. So you also soften artificial light by moving it closer to the subject.
The softbox doesn't soften light because it diffuses the light - even though it does. It softens it by making it larger. The diffusion part of the equation is simply to spread the light evenly across the surface of the soft box to enlarge it.
Bouncing a portable flash gun from a ceiling accomplishes much the same thing. We don't do that in a studio because it is too hard to control but it is an effective technique for softening light when you are mobil with a portable flash unit.
You can put all the frosty things you want in front of a flash gun and it won't affect anything except the lumens of light striking the subject - unless they are large and enlarge the light source. But shoot the light at something that makes the light bigger and, in turn, lights the subject and you have soft light.
The little bounce cards that attach to flash guns do enlarge the light source a little and can be effective with smaller subjects up close. Remember it is the relative size between source and subject that determines softness. But the bounce card won't do much to soften light with large subjects. It can help a little but, as MarK says, not enough to matter the way most people use them.
My mobil flash work was usually corporate events. I suppose it is something like shooting a wedding. If I was in a room that allowed bouncing from the ceiling that's what I did - or off a wall if one was near. In the cases where bouncing wasn't an option, I just settled for hard light. But using a bounce card just didn't make enough difference in shooting people to deal with the hassle. My normal working mode was to have a shoe mount flash gun attached to the camera with a long, coiled cord and then I would keep the flash in a vest pocket. When I wanted to use it, I would pull it out of my pocket, extend my arm and shoot. No room for bounce cards with that technique.
A lot of pros use handle flash units and brackets to get more flash power. I used to do the same in the days before TTL flash metering. But I felt I got better modeling with a shoe mount flash gun held at arms length than I did from a bracket-mounted flash.
Hopefully this helps clarify my statements.