[Takes deep breath . . .] OK. Here we go, Luke.
Let's start with the fact that in-camera meters are reflectance meters. They read the light reflected from a subject or scene. [Incidence meters read the light falling on a subject or scene.] Add in that you must move the camera if you wish to read different parts of a subject or scene [This is quite apart from changing a metering pattern in the camera.]
Now think of studio portraiture. The camera is usually on a tripod. On top of that, you might wish to adjust your lighting of the subject in order to change the placement and relative intensity of the shadows on your subject's face. For this, a separate, hand-held incidence meter is close to ideal. Placing the meter close to the subject's face, you can read the intensity of each light in stops [or zones] with ease. If the meter 'freezes' the reading, so much the better.
Now imagine doing the same job with an in-camera reflectance meter. Which way is quicker and, more important, less disturbing to the subject?
Next scenario. Here, you've walked around with your camera and read the shadows and highlights of a scene. As noted above in this thread, the reflectance meter is better at this particular job than the incidence type. You've set up your camera on a tripod and oh so carefully composed your shot. And the light changes!
With a hand-held reflectance meter, you simply go and re-take the readings without disturbing the composition.
To sum up:
1. A hand-held meter means convenience. Period.
2. Reflectance and incidence meters both work but, in some situations, one type is better than the other.
[I love the button which says 'Post Quick Reply'. Actually, I take quite a bit of time thinking through a post such as this one. There's nothing quick about it at all.]