Someone here posted a stat that more video cards are sold than processors.
I went with integrated video from Dell as they didn't have anything that I wanted but the machine was cheap so I said fine and added an aftermarket card. I have integrated on my office machine and wanted to add two more monitors so I bought an additional video card to run them. I wanted digital out too.
I think that many go with integrated and if it really stinks, then they just add a card. I still have a Pentium 4 Celeron system that I bought for next to nothing and the video and audio performance was terrible. I'd get these pauses in the computer from time to time. Adding discrete video and audio cleared up the problem. Integrated audio is much better today. But I don't like the idea of using up system ram by the video processor.