Anne,
Your words reminded me of my thoughts about Missy Stevens punch needle pictures featured in galleries as a fine art vs the punch needle designs produced by needlework designers. The obvious difference is in subject matter and style...designers generally have to produce work that is universally appealing to the mass market and fairly "easy" to do for the average stitcher.
A professional designer works at a job and not just for fun even though they're very happy to create & enjoy designing. Designing needlework for professionals is first and foremost a serious job, basically a commercial art job, not something done because of a love of needlework or a bit of pin money. True, there are people who have started designing because of a love for needlework and found success as they became more professional & businesslike about their work.
Craftspeople work in a similar mode...they're serious about their art and probably have more leeway to create what they want since they're not as totally commercial as a professional designer but they too have their eye on the bottomline as they have a good idea what sells in their market.
There is no rule that says professional designers or craftspeople can't "crossover" into other markets...many fine artists license their art to sell on products produced for a variety of markets including the mass market and commercial designers have produced fine art work shown in galleries developing a following of collectors.
I'm often tempted to just create what I like and not worry if what I do will sell or not...such as for example creating more artistic punch needle pieces that would be considered more fine art & not commercially oriented as a design.
I've admired embroideries by fine artists and often think what am I waiting for? I've got the ability to draw and lots of ideas I'd love to see "painted with threads"...but not the usual pretty thread painting subjects of cute animals or florals. My ideas might be to illustrate with threads something a little surrealistic in an urban scene, a group of figures, a fantasy, etc.
This next comment may sound blasphemous considering my business has been in painted canvas design but for myself, I like to needlepoint on plain canvas with the simplest light lines to denote design parameters. It's wonderful to see a design developing on blank canvas.
I've noticed many of my artist and designer friends have hobbies and other creative pursuits similar to most people...they get crazy about things to collect and carry on just like others except maybe they go a little more overboard!