For veterans of the game, it's pretty easy to speed-run the game, yeah. Even for veterans, the RNG of a 10% miss rate, and some other aspects, don't really improve the game but rather make it feel more tedious. It often leads to having to load back to earlier saves. The items part isn't really an issue, since there are so many item containers that it all balances out to a pretty similar item haul (this does mean less positive RNG for future runs, though).
The Coin Flips aren't really the issue. Most of those can be avoided through strategy. Also, there is a chance of getting books of enlightenment from book cases, it used to be the only way to get them in the early versions.
Scrolls are, admittedly, the truly game-changing item, if you're an expert of the game. If you get three scrolls, you can get three duplicates of Miasma, or better yet three Sergal Spears, and start cutting everything to pieces. They're kind of like cheat-code items, and while they certainly help, they might even help too much.