I remember a long way back (long way back), there was a poll on the 'No Mutant's Allowed' website (and Fallout fansite), about which developer would YOU want to do the next Fallout? I remember that Bioware, Obsidian, the now defunct Troieka Games, and a few others made the list. However, Bethesda wasn't on the list. At the time, I was playing the shit out of Morrowind:GoTY, and I was a little ticked that they hadn't been considered. So low and behold, a few years latter and Oblivion hits shelves, and I was reminded of much cooler this would be if it was Fallout. Few more years later, Bethesda gains the rights to Fallout, I'm flipping out with excitement while the rest of the Fallout community is divided with fear and anticipation.
At the end of the day, they can't do any worse than Brotherhood of Steel or Tactics.
VATS seems almost totally optional from what I've read. They have play-testers at Bethesda that range from always using it, to never using it. So if you don't like it, it looks like you can just never use it an be fine (like ignoring Magick using in Morrowind). Using it won't break the game. In all honesty, I can't think of a better way to incorporate my love of the old Fallout combat system (Targeting an opponent's eyes with my .223 pistol and causing his head to explode) with real time FPS combat.
Now as long as they have a variety of new voice actors (so that not everyone is a clone of each other), keep the black humor, engaging player-driven storyline, and Dogmeat, they'll be fine. Besides, I've always wanted a Fallout games with Havok physics...