The old ways of building a following are still available, but much, much less so than say in the 90's. Many of the local clubs have gone out of business, as you're more likely to make more money in a commercial space doing almost anything other than staging live music. There are of course exceptions, as in music hubs like LA and Austin, but around the Bay Area for example, I'd say 50% or more of the local clubs have shut down. Edit: typo.