In my experience, profilers are really low-level tools that often highlight the wrong problems, aren't very good at telling you where the optimization opportunities are, and tend to encourage microoptimization.
It's not that profilers are bad, it's that I get the feeling the people parroting this advice have no idea what they're talking about, and somehow believe that a profiler is "the solution", when profilers are neither necessary nor (most problematically) sufficient to fix most performance problems.
1. quickly seeing which high level functions or methods take the longest time, 2. which methods are called a lot.
Even 2. can be of marginal use. A lot of times, it's not surprising a method is called a lot, and not clear whether those calls are indicative of a performance problem. There are times, though, where a method is called a lot more than you expected, in which case it might be the clue to solving the performance problem.
For 1., it's usually click down through the call stack for the most expensive top level method, while there is still a single method taking up a good fraction of the overall time.
Hopefully the stopping point will still be a method you wrote, and not a library call. If it's your code, you likely have the ability to fix the performance problem by changing your code. If it's a library call, you might need to be a little more creative, in finding an alternative approach, or better understanding what that library call is doing under the hood.
So for me, the profiler just tells me I'm looking at the right general part of the code when trying to improve performance, and that's about it.
I could wait until the data in those tables grows to a crazy size and the reads are out of control (and spilling to disk) or I could just fix it now. Hmmm...
Me too. It's infuriating how presumptuous people can be.
Here is someone insisting to me over and over that virtual function call overhead is not measurable: http://stackoverflow.com/a/16603295/77070
Here is someone telling me that my attempts to avoid a virtual function call "definitely fall under the category of premature optimization": http://stackoverflow.com/a/5100072/77070
It's interesting to me that people will shout "premature optimization" before they have any idea what you are doing or how long you have worked on this problem before trying to optimize.